Medicare currently doesn't reimburse for spine surgery in ambulatory surgery centers, despite evidence appropriately-selected patients can have good outcomes. Three spine surgeons discuss if Medicare will begin reimbursing spine surgeries at ASCs and why it should.
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 are some of the biggest pitfalls to spine surgery patient satisfaction?
Please send responses to Anuja Vaidya at avaidya@beckershealthcare.com by Wednesday, July 23, at 5 p.m. CST.
Question: Do you think Medicare will reimburse for spine surgery in ambulatory surgery centers in the near future?
Neel Anand, MD, Clinical Professor of Surgery, Director, Spine Trauma, Cedars-Sinai Spine Center, Los Angeles: I think they will. It will work out better for them as it will cost them less. Their savings could be huge. So they will realize that and approve.
Brian R. Gantwerker, MD, The Craniospinal Center of Los Angeles: It is my sincere hope to control cost. ASCs help drive down costs to the Medicare system. The cost savings are very significant and it drives competition in the market. I am still not sure exactly why this has not happened, but it would stand to reason there are some unseen actors or factors preventing this from moving forward.
Richard A. Kube II, MD, CEO, Founder, Prairie Spine & Pain Institute, Peoria, Ill.: The short answer is yes. There are always political pressures to appease the AHA, but I do not believe they can ignore the cost savings for much longer. There is an increasing pool of data that demonstrates the safety of performing these procedures in surgery centers and the improved patient satisfaction.
The numbers and the patient demand will push things that way. There are a lot of baby boomers who have had a procedure in a surgery center and will want to repeat that experience when they have other procedures done after reaching Medicare age. With patient demand and at least as good satisfaction and outcomes, I believe the potential savings — in the billions of dollars — will be hard to ignore.
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