Two spine surgeons discuss why they are not participating in formal value-based programs and where they are focusing their resources when it comes to patient care.
Brian Gantwerker, MD. Craniospinal Center of Los Angeles: At this time, I have chosen not to participate. I am doing MACRA (Medicare Access and CHIP Reauthorization Act of 2015)/MIPS (merit-based incentive payment system) and working with my EHR vendor and a specialist — we have dialed into getting everything done. I have learned that if it costs something to lose less, then it's worth it. Those who refuse to participate, if they are Medicare physicians, will lose more and more. If one opts out of Medicare, which I predict more and more physicians will do, then it's a nonissue.
Vladimir Sinkov, MD. Sinkov Spine Center (Las Vegas): We do not participate in any formal value-based programs. From my perspective as a spine surgeon, I have not found any of them to provide any actual value to my patients. Instead, I approach each patient individually, determine the exact diagnosis and create a treatment plan that is most medically appropriate and takes into account their living situation and financial resources. I spend a significant amount of time with each patient to explain the nature of their problem and how and why the proposed treatment plan can help them. This ensures proper compliance, best clinical outcomes and highest patient satisfaction. I cannot imagine anything more valuable than that in patient care.