What 53 spine leaders are focusing on right now

As quarter four is underway, spine leaders are doubling down on key priorities to finish the year strong and pave the way for success in 2025.

The 53 leaders featured in this article are speaking at Becker's 22nd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, set for June 18 to 22, 2025 at the Swissotel Chicago. 

If you would like to join the event as a speaker, please contact Rosie Talaga at rtalaga@beckershealthcare.com.

As part of an ongoing series, Becker's is connecting with healthcare leaders who will speak at the event to get their insight on thought-provoking questions within the industry. The following are answers from event speakers, lightly edited for clarity.

Question: What needs your focus right now to finish 2024 strong?

Eric Anderson, MD. Co-Founder of Advanced Pain Institute of Texas (Lewisville): To finish 2024 strong, here are a few key focus areas for us:

1. Enhance patient experience, retention and satisfaction by conducting surveys and gathering feedback.
2. Expand innovative treatment options

3. Improve marketing and outreach by focusing on our referral network and digital presence.

4. Enhance operational efficiency by streamlining the workflow and reviewing our finances.

5. Fostering staff development by prioritizing team motivation, training and incentives

Karen Bewer, BSN, RN. Director of Quality and Regulatory Compliance at Wisconsin Spine and Pain (Milwaukee): To finish 2024 strong, we need to focus on efficiency and employee appreciation to keep our staff happy. The end of the year brings more procedures, as many patients have met their annual deductibles for the year and want to get their procedures scheduled and completed before another benefit year begins. We also need to focus on our employee engagement and satisfaction, as a busier, sometimes longer workday and fuller schedules can conflict with their desire to take time off for holiday travel and celebrations.

Brian Bizub. CEO of Raleigh (N.C.) Orthopaedic Clinic: A main focus is ensuring that supply chain disruptions are managed well to continue to maximize utilization in the ASCs. Additionally, we are focusing on prioritizing patients' quality of care and safety and the retention of ASC staff.

Andre Blom. CEO of Illinois Bone and Joint Institute (Des Plaines, Ill.): Our supply chain manager needs our focus. With shortages in IV fluids due to the hurricanes, and the Baxter Facility being down, the management of elective cases in the busiest quarter of the year is under imminent threat.

Nick Bohra. CFO of U.S. Orthopaedic Partners (Jackson, Miss.): As we close out 2024, my focus is on optimizing RCM and boosting cash collections to ensure our practices maintain a strong financial foundation. We are continuing to expand our team to enhance support for our physicians and practice administrators. This quarter, we will roll out a new business intelligence platform that equips our corporate and local leaders with the data tools needed to effectively manage our business. These initiatives aim to elevate the value we deliver across our entire network as we prepare for 2025.

John Brown. Administrative Director at the Musculoskeletal Institute of AdventHealth (Fort Worth): Two areas that need our focus are operating room accessibility and keeping surgeons happy with their experience, as our consumer.

Paul Bruning, DHA. Neuromusculoskeletal Service Line Director of Sutter Health's Silicon Valley Division (Sacramento, Calif.): We need to invest in our people to finish 2024 strong and stay strong moving into 2025. This past year has been full of growth, and next year will have even more growth. As with all growth, there are pains and stresses. Continuing to be productive and serve our patients has been very successful, despite the challenges and stressors of expansion and growth. This could not happen without the most important part of the organization: its people. As we finish out the year, investing and supporting our people will pay off in dividends for 2025. 

Andrew Carlson. Director of Growth and Strategy at Growth Orthopedics (Lexington, Ky.): From the perspective of an orthopedic administrator focused on growth and strategy for independent practices, ensuring our strategy and mission continue to be aligned across our practices and physicians is as vital now as it is throughout the year. This is a busy time of the year for many orthopedic practices, and while our patients and their experience always need our undivided attention, the people within our practices also require our intentional focus. The patient experience, day-to-day operations and financial management can not stumble, and we must always invest in our teams and our physicians. We are in the people-business, and that means focusing on our patients along with our teams providing the care for those patients.  Make sure you thank a team member today, and remember you can not provide excellent care for patients without them.

Janet L. Carlson, MSN, BSN, RN. Executive Director of Ambulatory Surgery Centers at Commonwealth Pain & Spine (Louisville Ky.): 2024 has been a significant year of strategic growth for Commonwealth Pain and Spine. We have broken ground on 3 de novo build-to-suit ASCs since April. Having said that, my entire focus is on upfitting our first ASC in Evansville, Indiana with clinical talent, supplies and equipment to achieve the next surgical and operational steps. Regulatory compliance and excellence in ASC certification will be our priority to achieve superior, reproducible and safe patient outcomes to each community we serve.

Boyle Cheng, PhD. Orthopedic Spine Surgeon at UPMC Presbyterian (Pittsburgh): More science, more research and most importantly improved patient outcomes need our focus to finish 2024 strong.

Anne Christopher, MD. Medical Director and CEO of MidAmerica Spine Center (St. Louis): Our organization is focused on completing our strategic growth goals for this year. Specifically, we are wrapping up construction on our new surgery center, and we are working with our physician partners on the syndication of a second surgery center. This has been an exciting year, and we are looking forward to finishing strong.

Deborah Lee Crook, RN. CEO of Rush Oak Brook (Ill.) Surgery Center: Navigation and managing of the hurricane's effects on our IV and irrigation supplies need our focus. Additionally, optimizing room utilization to assure we can capitalize on all available fourth quarter add-on cases. Lastly, energizing staff during our busy season.

Daniel Denis, MD. Neurosurgeon at Ochsner Health (Kenner, La.): To finish 2024 strong, I need to focus on achieving excellent outcomes for my spine surgery patients. Quality and safety can improve by closely following my current outcomes, focusing on patient selection, discussing complex cases in multidisciplinary meetings and seeking help from another surgeon when needed.

Kevin Fleming. Vice President at the Orthopedic Institute of AdventHealth Central Florida Division (Orlando): As we look to finish strong in the last quarter of 2024, the AdventHealth Orthopedic Institute, along with our partners at Rothman Orthopaedics of Florida, are laser-focused on access. We know that many patients choose the last quarter of the year for musculoskeletal procedures and surgeries for a number of reasons. As such, being able to get patients into our clinics and find a procedural location that is convenient and close to their daily life is of the utmost importance. Of course, clinical quality and an exceptional outcome are table-stakes in providing whole-person care.  So, we work to make sure that we can see patients quickly and efficiently, with a goal of next-day appointments. Having just opened a large joint venture ASC in collaboration with Rothman Orthopaedics this year, we’re finding that we have even more options to offer our community. Access to the best care matters to our patients, so it is top of mind for us.

Brian Gantwerker, MD. Spine Surgeon and Neurosurgeon at The Craniospinal Center of Los Angeles: Finishing strong in 2024 requires good prep for the year to come. That means meeting with your tax professional, getting your contributions into your retirement plan, consulting with your financial guru and familiarizing yourself with legislation becoming effective Jan. 1. Additionally, it is important to ensure the end of the year rush doesn’t negatively impact your family-time.  At the end of the year, with the holidays and time off, we should all remember that our families need us too. It’s good to focus on the homefront.

Nameer Haider, MD. Director of Minimally Invasive Surgery at OMNI Surgery Center (Utica, N.Y.) and Director of Regenerative Spinal Orthopedics at ROSM (Washington D.C.): We are focusing on:

1. Conducting an end-of-year inventory review and stocking up on necessary materials to avoid shortages.
2. Reaching out to patients who may need to schedule end-of-year procedures before insurance deductibles reset.
3. Performing a coding audit to ensure we are both compliant and coding correctly to receive maximum reimbursement.
4. Benefitting from Section 179 before the end of the year, purchasing and implementing qualified equipment and considering bonus depreciation for equipment purchases.

Ashley Hilliard, MSN, RN. Administrator at Deerpath Ambulatory Surgery Center (Morris, Ill.): To finish 2024 strong, my focus is ensuring we have the materials necessary to keep up with the end of the year rush. The current IV solution issue is forcing us to be creative. In addition, as we go into the last quarter of the year, we continue to focus on submitting clean claims and decreasing denials that delay reimbursement.

Alexandra Hogue. Director of Operations at Orbis Surgery Center (Houston): My focus is currently anesthesia services, due to the unexpected death of one of my contracted service providers. Also, a focus is beginning the construction of our new ASC. This has been in the making for a while now, but we want to get it started by Dec. 1 to open in summer 2025.

Andrey Ibragimov, RN, MSN. Director at Ingalls Ambulatory Surgery Center of UChicago Medicine: To finish 2024 strong, we remain committed to our core value: putting patients first and elevating the human experience. Our ongoing patient-centered approach drives us to continually adapt and improve, ensuring we deliver top-tier care. Right now, based on valuable feedback from our surgeons, it’s clear that investing in new technology is critical to advancing patient outcomes. My focus is on exploring innovative, financially sound strategies to bring cutting-edge solutions to our center. By doing so, we ensure both patient satisfaction and clinical success through thoughtful, strategic investments.

Matt Kraemer. Administrator at the Orthopedic & Spine Institute of Northern Arizona Healthcare (Flagstaff): In order to finish 2024 strong, our focus needs to remain on controlling our operating cost, especially supplies and implant costs, in addition to maintaining and continuing to grow our volumes. With dwindling capitated reimbursement, the only way to maximize our operating margins is through controlling our costs. Collaboration with implant vendors to adjust costs based on case location and third party payers reimbursement are both tactics to reduce the pressure on lean operations.

Jeff Lehmen, MD. Spine Surgeon at SSM Health Spine Surgery Center (Jefferson City, Mo.): I think to finish 2024 strong, there needs to be aggressive private insurance and preauthorization reform. Others have suggested ways to access the literature efficiently during appeal processes to prove indications, but insurance companies, oftentimes, will not pay for the surgery, despite this literature or other recommendations. I think the insurance companies need to be held liable for their patient or employer contracts, which are intended to provide necessary healthcare.

Michael C. Lewis, MD. Joseph L. Ponka Chair of Anesthesiology, Pain Management and Perioperative Medicine Department at Henry Ford Health System (Detroit), Professor and Chair at Michigan State University College of Human Medicine (East Lansing) and Anesthesiology Professor at Wayne State University (Detroit): To close 2024 on a high note, I am driving collaboration and executing key initiatives across teams. Strengthening member engagement, particularly by re-engaging mid-career professionals, remains a top priority. I am aligning our objectives with the evolving challenges in healthcare, while ensuring clarity and measurable outcomes. By staying adaptable and addressing emerging needs, we will build strong momentum and position ourselves for success in 2025.

Isador Lieberman, MD. Spine Surgeon at Texas Back Institute (Plano): I have a difficult time conceptualizing a year end for clinical care or practice administration, the focus is always persistent continuous improvement in both.

Thomas Loftus, MD. Founder and Neurosurgeon at Austin (Texas) Neurosurgical Institute: Generally speaking, the final quarter of the year will require efficient clinic scheduling to manage the typical end-of-year acceleration in patient visits. With continually sky-rocketing insurance costs and subsequent higher deductibles, patients have become more sensitive to their renewing deductibles. This is particularly prevalent at the end of the year, so the demand for surgeries seems to rise at this time. Our focus needs to be on accommodating these patients in the most efficient and effective way possible. It’s an opportunity to finish the year strong if we handle the increased demand effectively.

Andrew H. Lovewell. CEO of Columbia (Mo.) Orthopaedic Group: For the remainder of 2024, our focus will not change from a patient-first mentality. Outside of the fluid crisis in the country right now, our focus is on growth, strategic alignment and patient experience. We will continue implementing new services to our organization that improve the patient experience and care continuum. Additionally, we are focusing on digital innovation to improve patient access and engagement. We are heavily exploring AI functionality to create economies of scale and leverage staff members' time toward more productive or patient-facing tasks.

Brett Maxfield. Director of Anesthesia and Surgical Services at Teton Valley Health Care (Driggs, Idaho): To finish 2024 strong, my focus is on ensuring that the needed resources are available to perform surgery in the busy time ahead. The disruption caused by natural disasters has required the majority of my focus to be redirected to resource acquisition and management through the end of the year.

John McAllister, MD. Medical Director and Orthopedic Surgeon at St. Peter's (Mo.) Surgery Center: As the holidays approach and deductibles are met, I think it is important to take needed time off, while being as efficient as possible in scheduling cases. Checking OR availability opened by other providers during their time off may allow additional cases to be scheduled. ASCs need to notify other providers of availability when surgeons or other providers are not working as well. 

L. Pearce McCarty III, MD. Co-Chair of Non-Labor Governance at Allina Health (Minneapolis): Two areas demand focus to finish 2024 strong and prepare for a successful 2025. The first is managing surgical capacity through the end of the year, particularly given operation disruptions that occurred secondary to Helene-driven IV fluid supply issues. Quarter four typically represents an outsized volume of surgical cases relative to the remainder of the year, and ensuring undisrupted service for the rest of the quarter is essential. Second, developing a strategy for effective implementation of AI-driven clinical and non-clinical platforms to facilitate care delivery and operational efficiency is an ongoing, top priority.

Yeshvant A. Navalgund, MD. CMO of National Spine & Pain Centers (North Huntington, Pa.): To finish 2024 strong, my focus is on driving the adoption of minimally invasive surgical techniques across our ASCs, ensuring we stay at the forefront of patient-centered care. This includes integrating the latest advancements in technology, such as AI, to improve patient outcomes and streamline operations. Additionally, I’m concentrating on aligning physician incentives with non-opioid, definitive treatment options to further elevate care quality and financial performance. Navigating the ongoing changes in healthcare regulations and reimbursement models will also be key to maintaining sustainable growth.

Efstathios Papavassiliou, MD. Director of The Spine Center and Neurosurgeon at Beth Israel Deaconess Medical Center (Boston): Over the last few years, Medicine had to deal with unprecedented challenges and changes. Despite the financial challenges and pressure for productivity, we need to take a step back and remind ourselves to focus on the reasons we became physicians. A strong finish to the current year will be reengaging with the patients in a meaningful way. Reestablishing the physician-patient relationship, honest engagement, transparency and humanity will allow us to do what we can do best. As the Hippocratic Oath states, we must "practice our art with purity, holiness and beneficence." 

Peter Passias, MD. Professor at Duke School of Medicine and Associate Chief of Spinal Surgery of Departments of Orthopaedic and Neurological Surgery at Duke University Hospital (Durham, N.C.): One of the largest areas of focus is for hospitals and payers to adapt to the newly released DRG fiscal changes that have been implemented by the CMS. These represent inherent changes to the reimbursement of both hospital systems and physicians, and they will set the trend for structural changes in the practice of medicine 

Mick Perez-Cruet, MD. Professor and Vice Chairman of the Department of Neurosurgery at Oakland (Calif.) University William Beaumont School of Medicine and President and Founder of Michigan Minimally Invasive Neurosurgical Institute (Waterford): My focus is on quality patient care. Along these lines, we have introduced new and innovative technology into our ASC.. We have recently introduced the Pentero Zeiss microscope, which enhances surgical visualization when we perform minimally invasive spine surgery. In addition, we introduced two new technologies to our surgery center: the GE flouroscopy C-arm, capable of producing computer tomography quality visualization intra-operatively, and Augmedics augmented reality image guidance navigation. These systems allow us to place percutaneous pedicle screws quickly and efficiently, without exposing the patient and operative staff to radiation exposure. In essence, these technologies have improved the safety and efficiency of performing outpatient minimally invasive spine surgery at our physician-owned surgery center.

Arti Prasad, MD. Chief Strategic Development Officer of ECHO Minnesota, Hennepin Healthcare and Professor of Medicine at University of Minnesota (Minneapolis): A focus to end 2024 strong is launching the proposed work for my grants.

Adriana Puram, BSN, RN. Nurse Administrator at Surgcenter of Greenbelt (Md.): To finish 2024 strong, my primary focus is optimizing efficiency and patient throughput, without compromising quality of care. We're concentrating on reducing turnaround times in the OR and improving pre-operative coordination to ensure smooth scheduling and minimize delays. Enhancing staff engagement, especially in critical roles like nursing, is also key to driving performance, as we aim to close the year with elevated patient satisfaction and operational success. Additionally, we are carefully monitoring our cost structures to maintain financial health, while continuing to deliver exceptional outcomes.

Bethwel Raore, MD. Neurosurgeon at Apex Spine & Neurosurgery (Atlanta): We are focusing on being efficient with preauthorizations in order to maximize our participation in the end of year rush of patients needing surgeries before deductibles are reset in January.

Mahoua Ray, MD. Medical Director at Kansas Pain Management (Overland Park): Two focuses are staffing, particularly among nurses and technicians, and optimizing prior authorization. 

Michael Redler, MD. Orthopedic Surgeon at Connecticut Orthopaedics (Fairfield County): The end of the calendar year in Orthopaedics always brings some very specific challenges. In sports medicine, a lot of athletes are now trying to get their surgeries completed, as the season ends and before the second semester begins. For many patients, the last quarter of the year is a time when deductibles are met, and there is a great desire to have surgeries completed before the new calendar year begins. Over the years, I have observed that when the economy presents more challenges, there is more pressure to get surgeries completed: deductibles have been met, and some patients may be losing their jobs or benefits at the end of the year. With the improving economy this year, there does not seem to be as many cases secondary to economic factors that we have witnessed in other years.

Marjorie Reiter. Administrator at Surgery Center of Central NJ (North Brunswick): There are a few things on which we need to focus to finish 2024 strong. These include survey readiness, specifically the State Department of Health due April 2025; RFP and ROI for proposed EMR acquisition and implementation; physical plant issues and ensuring the billing and budget process is on track to complete as much as possible by the end of the year.

Ken Rich, MD. President of Raleigh (N.C.) Neurosurgical Clinic: Between the recent strikes of longshoremen and the damage from hurricanes to producers, we are most concerned about access to necessary supplies. Without them, we cannot run our ASC. I think we will be forced to reconsider things like “NPO past midnight“ and be very diligent about waste in our ASC.

Johnny Russell, DHA. Director of Area Operations at Sutter Health (Sacramento, Calif.): Access is the big focus. As the year comes to an end, we need to ensure that we can care for patients who need our services. Block utilization, early release and communication are paramount.

Jennifer Schoenig. Executive Director at Long Island Spine Specialists (Commack, N.Y.): My practice has a bifurcated focus on Revenue Cycle and Marketing. RCM is focused on reducing outstanding AR by aggressively pursuing claims aged in excess of 60 days. On the operations side, marketing and patient compliance has become the top priority to maintain growth and compliance heading into the holiday season.

Thomas Schuler, MD. Spine Surgeon and Founder of Virginia Spine Institute (Reston) and Chairman of the National Spine Health Foundation: There is a continued focus on customer service. Everyone is busy at the end of the year, and maintaining a constant effort to improve the patient's experience, while addressing their needs, will produce a successful 2024. 

Lali Sekhon, MD, PhD. Neurosurgeon and Spine Surgeon at Reno (Nev.) Orthopedic Center: Quarter four is always the busiest part of the year. Most meetings are done, patients want surgery because many have maxed out their copays, and the last 3 months of the year is our time to work. Then, the holiday break is time to spend with family, pause and reflect on the year passed and plan for the year ahead.

Brett Shore, MD. Orthopedic Surgeon at DISC Sports & Spine Center (Newport Beach, Calif.): My focus right now is on providing high-quality and efficient care to my patients so they are in the best position to thrive going into the new year. Additionally, I am revisiting my marketing and social media presence to allow my practice to grow and succeed as we approach the end of 2024. Finally, I am maximizing my availability to my patients, for both office and surgery visits, so patients who have met their insurance deductibles can have their procedures performed before the end of 2024.

Tammy Smittle, BSN, RN. CEO of Stonegate Surgery Center and CNE at Northwest Hills Surgical Hospital (Austin, Texas): My main focus is to keep my surgeon partners and utilizers engaged with my facilities. The best way to accomplish this is through open and frequent communication. 

Tony Spasaro. Director of Ambulatory and Surgical Services at Monument Health (Rapid City, S.D.): Right now, a main focus is patient access to care. With staffing shortages and patient demand rising, our focus is lowering our first and third appointment wait times by exploring walk-in clinics and weekend availability.

Zeeshan Tayeb, MD. Owner and Medical Director at Pain Specialists of Cincinnati: As the year wraps up, it is a great time to focus on the accomplishments, but also to set forth plans for the upcoming year. As we review this year's accomplishments and plan ahead, we need to be mindful of the present. Many patients have met deductibles and are seeking to maximize the benefits of their insurance. This is where we can utilize our time in the clinic and the procedure suite to accomplish many visits and cases, without having to facilitate collections from the patient. The last quarter of the year is a great time to work with patients, as many of them have time off from work and can easily fit in routine testing and preventative health treatments while deductibles are met.

Maria K. Todd, PhD. Administrator and Health Law Paralegal, Robotic Orthopaedic Institute and Director of Business Development at St. George (Utah) Surgical Center: I am in a snowbird market. It has been difficult connecting with the people I do marketing for, such as individuals in Canada while I am in Southern Utah. Learning what works and implementing it is what I need to finish strong. However, it's also crunch time in ASCs and surgical offices because locals want their surgery now. It is before the next deductible rolls, and they may have satisfied their out-of-pocket maximums.

William Vanderveer. CEO of Redefine Healthcare and Redefine Management (Union, N.J.): Our self-created GPO is one of our most important 2024 initiatives. We have been able to create 25 to 30 percent savings across the board for our portfolio of ASC’s by creating our own GPO.  We have been able to see significant savings to our bottom line by just investing in our own GPO’s. This has also allowed us to pursue payer bundles and better fee for service rates with the payers.

Connie Wilson, RN. Director of Patient Care Services and Nurse Executive Administration at Shriners Children's Hospital Lexington (Ky.): As we look toward finishing 2024 strong, we need to focus on several key areas:

1.  Embracing Innovation: specifically the rapid advancement of technology in spine and orthopedic care, minimally invasive techniques and robotic-assisted surgeries.
2. Patient-Centered Care: refining our approaches to pain management and rehabilitation to meet individual needs and preferences, including integrating telehealth services to provide accessible follow-up care.
3. Interdisciplinary Collaboration: strengthening our partnerships among surgeons, pain management specialists, and rehabilitation professionals will lead to more comprehensive care models. 
4. Data Utilization: leveraging data analytics and investing in systems to better understand patient trends and treatment effectiveness. 
5. Financial Sustainability and Efficiency: focusing on optimizing operational efficiencies, understanding reimbursement models, and adapting to changes in insurance policies.
6. Continuing Education: prioritizing ongoing education for our teams and staying current with the latest research, technologies and treatment modalities.

Tricia Wollam. Clinical Administrator at Alliance Surgery Center (Traverse City, Mich.): As we move through the fourth quarter of 2024, I am focusing on the staff, high quality patient care and patient satisfaction. Case volumes are increasing significantly, and I need to ensure that staff morale is at the forefront every day. I want the staff to be supported so they can continue to provide the highest quality of care to our patients. Our patients should leave our facility feeling well cared for by receiving excellent care. It is imperative for us to allow staff to keep their work-life balance intact during these busy times. In turn, this will give longevity and loyalty from the staff.

Sylvester Youlo, MD. Orthopedic Surgeon at Phelps Health (Rolla, Mo.): 2024 has been a productive year for me and Phelps Health. Our orthopedic department added a foot and ankle surgeon to our group. My practice has grown tremendously, especially with the number of U.S. service members and their families that come from Ford Leonard Wood, the local United States military base, for orthopedic care. I am looking forward to having almost all service members and their families receive their orthopedic care from my practice, instead of driving two hours to Columbia, Mo. Finally, I am looking forward to completing an MHA next summer, adding to an already diverse portfolio.

Graham Young. Senior Vice President of Business Development at U.S. Orthopaedic Partners (Jackson, Miss.): In quarter four, my focus is on wrapping up value-driven initiatives that will set USOP up for a strong start in 2025. The initiatives are specifically centered on data analytics and benchmarking to enhance the support we provide to our partner practices and physicians. This month, we're rolling out our in-house business intelligence platform, equipping physicians with tools that offer multiple lenses on our operations and fine-tune the KPIs that matter most to their success. We’re eager to see how these efforts will shape our shared path forward.