Spine surgery as a specialty is moving more towards outpatient surgical facilities. Surgical facilities typically are more cost-effective to the insurance company and to the patient. Procedures in ambulatory surgery centers are less expensive than when they're done in an inpatient facility such as the hospital. Therefore, with improved technology and the changing economic landscape in spine surgery, more spine surgeons are opening or developing partnerships in ambulatory surgical facilities.
I would say that in the next five years, 50 to 60 percent of spine surgeons will be involved in performing procedures in ambulatory surgical facilities. In the past, almost all spine procedures were done inpatient.
Interestingly enough, spine surgeons are ahead of the times and are malleable in changing their treatment and practice approach versus other physicians. For a long time spine surgeons have been somewhat insulated from the drastic changes in healthcare. Now they are certainly wrapped up in the changes in healthcare, especially with the Affordable Care Act with changes to reimbursement patterns, cost containment, by payers when it comes to approving or disapproving specific surgical procedures.
However, those who are making the changes are doing things like we do in our practice, direct marketing to the public, going out-of-network on need plans rather than participating in network plans which continue to drop reimbursement rates. As well as employing the latest surgical technology and techniques so that procedures can be moved to ambulatory surgical centers where the spine surgeon can show the efforts in cost containment and include efficiencies in terms of getting the patient through the healthcare spectrum more effectively and efficiently and with less cost.