Since the COVID-19 pandemic began nearly two years ago, spine and orthopedic specialties have made major shifts in how care is delivered. As 2021 ends, spine and orthopedic leaders are thinking about what to expect next year.
Five observations:
1. Practices need to look out for the well-being of their staffs. André Blom, CEO of Des Plaines-based Illinois Bone and Joint Institute:
"Staffing models will be significantly touched by the COVID effect for probably the next three years. We need to pay attention to the health and well-being of all of our team members. Collectively we are navigating both difficult and unknown waters with regard to the prolonged strain caused by COVID. And just like we didn't really know where things would end up when it started last February, we can't fully predict an end point at this stage. We will be well served by following the health and energy of our team members in the next couple of years."
2. Remaining independent will be a challenge for practices. While large practices are consolidating with smaller ones, many leaders are mindful that maintaining independence is top of mind.
J. Bryan Williamson, MD, medical director of Houston-based OrthoLoneStar:
"The most pressing issue for independent orthopedic practices is navigating the rapidly changing healthcare environment," Dr. Williamson told Becker's. "Hospital employment, private equity consolidation, diminishing reimbursement and increased regulatory oversight are just a few of the issues challenging the ability of orthopedic practices to remain strong and independent. Fortunately, we believe independent orthopedists are in the best position to thrive in this dynamic healthcare market."
3. CMS is implementing new outpatient standards. CMS outlined several changes for 2022 and finalized its plan to halt the elimination of the inpatient-only list, which it had previously planned to phase out by 2024.
Under the final 2022 rule, 14 spine codes will return to the inpatient-only list, and seven musculoskeletal codes will stay off it. The initial 2022 proposal to remove the inpatient-only list concerned many orthopedic surgeons and leaders.
4. Outpatient migration trends will continue. Pauses in nonurgent spine and orthopedic surgeries at hospitals have ebbed and flowed since the beginning of the pandemic. Outpatient surgery centers have played an important role in maintaining nonurgent surgeries, and some hospitals have noticed.
In Colorado, Aspen Valley Hospital executives are anticipating a 70 percent decline in orthopedic revenue, in part, because of more orthopedic centers shifting surgeries to ASCs.
5. Data analytics will be key to practice success.
Alex Bateman, CEO of Atlanta-based Resurgens Orthopaedics, said there's a lot of untapped potential in mining data to help patients and practices:
"We have a tremendous amount of data and information that comes through our practices, and even a group of our size hasn't really invested in a way to turn that information into intelligence that will in turn allow us to treat patients better, manage their health better and create better economics for the provider and cheaper care," he told Becker's.
Mark Vorherr, CEO of Cincinnati-based Mayfield Brain & Spine, said his practice is well-positioned to put the data it has to to good use:
"I believe that both qualitative and quantitative data are equally valuable in sustaining an elite independent medical group. By expanding our reporting and mining of proactive outcomes data, we are positioned to expand our leadership in high-quality patient care."