Richard Kube, MD, and Brian Gill, MD, discuss how their spine practices are affected by reimbursement issues. Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. We invite all spine surgeon and specialist responses. Next week's question: What inspires you to continue practicing in the field of spine?
Please send responses to Heather Linder at hlinder@beckershealthcare.com by Wednesday, June 12, at 5 p.m. CST.
Richard Kube, MD, Spine Surgeon, CEO and founder of Prairie Spine & Pain Institute, Peoria, Ill.: Reimbursements affect our practice in two major ways. The first and most frustrating issue is the effect on day-to-day practice. It is no secret that insurers are targeting spine procedures for denials, often citing guidelines that are either outdated or followed rigidly and not open to debate. This takes numerous hours of time away from patient care and increases staffing needs. Patients are often denied the treatment that I deem the best suited for their conditions. There are increasing numbers of treatment delays.
All of this leads to the second issue of growing or at least maintaining business. With shrinking collections for more work and higher overhead, it becomes increasingly difficult to run a medical practice. It is little wonder that so many graduating physicians are turning to hospital employment. The trend is so powerful it is as though it was by design. In addition, with changing rules one cannot forecast receipts accurately, leading to decreased investment in the practice and hence lower job creation. The types of benefits we provide employees come into play as well.
J. Brian Gill, MD, Orthopedic Spine Surgeon, Nebraska Spine Center, Omaha: Spine reimbursement issues greatly impact our group’s ability to add new staff members or to be able to plan accordingly for capital improvements. These tend to be put on hold until reimbursement issues can be finalized. Most insurers tend to follow Medicare's rate reductions in which the threat of rate reductions is always present due to the sustainable growth rate formula. This has been bypassed at the last minute by Congressional acts but makes it difficult for medical practices to plan accordingly. We have tried to expand the services that we provide as a group as well as try to reach new patient populations and markets.
More Articles on Spine:
5 Areas for Spine Surgeon Leaders to Pave the Way Today From Dr. Richard Wohns
4 Statistics on Dysphagia After Posterior Cervical Surgery
6 Statistics on Medicaid vs. Commercial Insurance: Lumbar Stenosis Surgery Outcomes
Please send responses to Heather Linder at hlinder@beckershealthcare.com by Wednesday, June 12, at 5 p.m. CST.
Richard Kube, MD, Spine Surgeon, CEO and founder of Prairie Spine & Pain Institute, Peoria, Ill.: Reimbursements affect our practice in two major ways. The first and most frustrating issue is the effect on day-to-day practice. It is no secret that insurers are targeting spine procedures for denials, often citing guidelines that are either outdated or followed rigidly and not open to debate. This takes numerous hours of time away from patient care and increases staffing needs. Patients are often denied the treatment that I deem the best suited for their conditions. There are increasing numbers of treatment delays.All of this leads to the second issue of growing or at least maintaining business. With shrinking collections for more work and higher overhead, it becomes increasingly difficult to run a medical practice. It is little wonder that so many graduating physicians are turning to hospital employment. The trend is so powerful it is as though it was by design. In addition, with changing rules one cannot forecast receipts accurately, leading to decreased investment in the practice and hence lower job creation. The types of benefits we provide employees come into play as well.
J. Brian Gill, MD, Orthopedic Spine Surgeon, Nebraska Spine Center, Omaha: Spine reimbursement issues greatly impact our group’s ability to add new staff members or to be able to plan accordingly for capital improvements. These tend to be put on hold until reimbursement issues can be finalized. Most insurers tend to follow Medicare's rate reductions in which the threat of rate reductions is always present due to the sustainable growth rate formula. This has been bypassed at the last minute by Congressional acts but makes it difficult for medical practices to plan accordingly. We have tried to expand the services that we provide as a group as well as try to reach new patient populations and markets.More Articles on Spine:
5 Areas for Spine Surgeon Leaders to Pave the Way Today From Dr. Richard Wohns
4 Statistics on Dysphagia After Posterior Cervical Surgery
6 Statistics on Medicaid vs. Commercial Insurance: Lumbar Stenosis Surgery Outcomes