CMS and insurer policies are areas Mark Schwartz, CEO of Warrenton, Va.-based Blue Ridge Orthopaedic & Spine Center, is watching closely in 2022.
Mr. Schwartz spoke on the "Becker's Healthcare Spine and Orthopedic Podcast" about these and other uncertainties that are key priorities at the practice.
Note: This is an excerpt. Listen to the full episode here.
Question: What are your top priorities right now, and what are you thinking about when you're looking at the strategic placement of Blue Ridge today?
Mark Schwartz: I think COVID-19 still is an area of concern. I mentioned that we look to keep staff and patients safe, and we're very proud that we've had zero infections in our facility for over three years. So it's really a testament to our team. I think navigating through this uncertain environment in healthcare has really impacted the entire healthcare system. I see ASCs and operative centers in general as an important safety valve to allow for elective surgical care, and that's one of the things that we are focused on with our staff.
The other thing is the uncertainty as it relates to CMS. The changes on going from outpatient inpatient was surprising. Folks were thinking about moving and investing in terms of things that were approved for outpatient [but are] now seeming to go inpatient. We've kind of thought that everything was moving more to an outpatient basis, which also CMS has said at the same time. That's an area that we just continue to monitor in terms of uncertainty. But it does impact us as we look forward to understanding where to invest in terms of opportunities.
The other thing that we look to do is to seek to ensure our reimbursement for payers, either for cost or for reimbursement for the implants directly, allows for growth in our surgical volumes. We feel like that should align both the payer and the patient and provide an incentive. It's not always been the case though where the cost for implants sometimes exceed the cost or reimbursement for those.
We're also looking at the opportunity to continue to serve our communities and in particular Fauquier County and ensure access for Medicare enrollees in the county. What does that look like, given that there's no ASC opportunity for those folks who are often transportation challenged to get care in our local area?