Negotiating with payers is one of the most important, if most challenging, aspects of a physician's practice. For surgeons seeking to boost reimbursement rates or ensure bills and claims are paid out as expected, there are a few factors to keep top of mind.

Musculoskeletal digital health platform MPowerHealth has teamed up with Blue Cross and Blue Shield of Texas to launch a retrospective bundled payment program for knee and hip replacement surgeries. 

Florida Blue, the state's Blue Cross Blue Shield arm, is collaborating with Healthcare Outcomes Performance Co. to address healthcare affordability.

Artificial disc replacement technology has advanced dramatically since the FDA approved it in 2004, and many surgeons laud the devices. However, it has its detractors.

A third-party payer established positive coverage for one- and two- level lumbar disc replacement with Centinel Spine's Prodisc L, the devicemaker said April 5.

Americans dissatisfied with U.S. healthcare are looking abroad to understand how other systems could be replicated at home, but they need only look north of the border to see the challenges Canada is facing addressing its increasing backlog.

In recent years, more and more complex surgical spine procedures have migrated to the ambulatory surgery center (ASC). Advances in technology and surgical technique, strategic patient selection, and payer policy updates have aided in this migration.

In the last two weeks, two lawsuits concerning spine and orthopedic insurers have made headlines.

Orthopedic surgeon advocacy efforts have focused on topics from payer relations to patient care. Two surgeons told Becker's the areas that are currently top of mind in orthopedics.

CMS and commercial payers are trending toward bundled payments as the healthcare industry shifts from fee for service toward value-based care, while the notion of a single-payer system continues to be tossed around but is unlikely to become a reality in the near future.

A Florida ASC and a Minnesota practice made headlines in January as the physician groups pushed back against commercial payers in issues relating to spine care.

Value-based care, outpatient care migration and consolidation are healthcare topics executives are keeping a close eye on going into 2022.

Two orthopedic surgeons weigh in on payer obstacles they expect to see in 2022, from reimbursement issues to payer investment in health programs.

Plans to expand digital prior authorization access and three more updates involving payers and CMS for spine and orthopedic surgeons to know in the last month:

Humana and Boston-based Cohere Health are expanding their partnership enabling a digitized prior authorization process nationwide, according to an Oct. 13 news release.

The payer landscape in orthopedics is constantly shifting due to the growth of value-based care and the increase in hospital-employed physicians. Four surgeons told Becker's how they see the payer landscape changing in the near future.

Four orthopedic surgeons told Becker's how value-based care can become more effective, from improving data analysis to using a stakeholder-focused approach.

Documentation will be more important than ever if CMS doesn't adjust its 2022 proposal to restore the inpatient-only list, according to Joseph Bosco III, MD, of NYU Langone in New York City.

Value-based care can improve the quality of treatment for orthopedic surgery patients and reduce overall costs, according to findings from New York City-based Hospital for Special Surgery.

Seattle-based Regence BlueShield is adding more providers and covering more procedures in its Episodes of Care value-based care program, which launched in January 2020.