Here four spine surgeons weigh in on what concerns them most going into 2016.
Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. We invite all spine surgeon and specialist responses.
Next week's question: CMS recently finalized a bundled payments initiative for hip and knee replacements. Do you see a similar initiative for spine coming down the pipeline in the future?
Please send responses to Anuja Vaidya at avaidya@beckershealthcare.com by Wednesday, Jan. 13, at 5 p.m. CST.
Question: What are your biggest concerns going into 2016?
Richard Kim, MD, Neurosurgeon, DISC Sports & Spine Center, Marina del Rey, Calif.: First, I hope the trend toward greater acceptance of using ambulatory spine centers continues. Insurance carriers have been frustratingly slow to get on board, but they appear to be coming around to the benefits — clinical, as well as financial. I'd like to see this accelerate.
Second, I'd like to see continued innovation in minimally invasive spine surgery. There are still significant limitations in achieving some results that are comparable to open techniques, such as graft volume, deformity correction and others. All this innovation needs to be data driven. We need to continue to show clinical outcomes equivalent or superior to open techniques, in order to justify pushing the limits.
Brian R. Gantwerker, MD, The Craniospinal Center of Los Angeles: Increasing overhead and decreasing reimbursement. What I do think is unique is the rolling out of new insurance plans and that patients are paying more for less — less coverage, more cost. Is this how to save healthcare dollars? By making our patients spend more and actively discourage them from seeking treatment?
Richard Kube, MD, Founder, CEO, Prairie Spine & Pain Institute, Peoria, Ill.: Our biggest concern is the ability to recruit a quality spine surgeon to our practice. Increasing numbers of new graduates are looking for hospital employment. Those who are, typically do not consider central Illinois their top choice of places to live. We are unfortunately increasingly in a position of having to turn people away because we are not able to cover the volume and see patients in an appropriate time frame.
Plas T. James, MD, Atlanta Spine Institute: My biggest concern for 2016 is how Obamacare will affect doctors and patient access. The media is filled with stories of increased rates and lowered benefits. Patients see the huge deductibles as a reason to postpone surgery because they simply don't have the money to pay for it. Major carriers are dropping out of the program, and doctors and hospitals are turning down the plans. Yet we see big corporations pushing their employees on to their Obamacare-type plans in order to comply with the employer mandate. How are patients supposed to get the treatment they need if the government-ordered insurance does not support their health needs in a cost-effective way? The upcoming election cycle is filled with promises of "improving" or "repealing" Obamacare. But the specifics of either are lacking and the patient population is still in need.