Spine surgery is a dynamic industry, where a single day can feel like a year's worth of growth. The rise of value-based care has pushed private practice surgeons towards teaming up with other hospitals and health systems to negotiate the best contracts.
Additionally, the Trump administration has potential to dramatically change healthcare policies and models. While it may not happen in the next year of two, changes are coming.
At Becker's 16th Annual Future of Spine + The Spine, Orthopedic and Pain Management-Driven ASC Conference, June 14 to 16 in Chicago, a keynote panel made predictions for the future of spine surgery in the next five years. The panel included:
● David Rothbart, MD, neurosurgeon and medical director of Spine Team Texas in Southlake
● Marsha Lindsay, chair and chief strategist of growth, brand and innovation at Lindsay, Stone & Briggs
● Brian Mathis, chief development officer at Eden Prairie, Minn.-based OptumCare
Rise of value-based care contracts
Value-based care is not a new term among spine surgeons. The shift towards this model has been rapidly accelerating over the past five years and even device companies are jumping on board to establish value-based contracts with patients for implants and different devices.
As these contracts become more common with surgeons and in practices, new bundle-cared options will begin to develop. "When I think about the trajectory of getting into value-based care, and think ahead for the next five years, I've got to imagine the accountability of the contracts also increases," said Mr. Mathis. "Contracts at our surgery center range from full bundle payments that go for 30 days pre and 90 days post and we are responsible for everything that happens to a bundle of what happens just the day of surgery in the surgery center."
However, not all private practices or physician groups have the power to negotiate contracts comparable to hospitals and health systems. This leaves them in a tight position, and with them in the demand to form new relationships and make new partnerships.
Large and small hospitals unite
As CMS shifts more procedures outpatient, ambulatory surgery centers development has increased to meet growing demand. It isn't just physicians owning and operating surgery centers either; hospitals are also developing centers. Partnerships are being formed from the need to negotiate better contracts and the desire of health systems to open outpatient centers. However, smaller physician groups don't need to give up their autonomy when partnering with a larger hospital or health system.
"We have a hybrid model," Dr. Rothbart said. "By that, I mean we get to manage ourselves, [but] have a very strong working relationship and contract with Texas Health Resources, which is one of the two large healthcare systems in Dallas. [This] is really market driven because in Dallas no one healthcare system dominates the entire market."
Many surgeons attest to resiliency of independent practices, and independent physicians are now moving towards uniting and forming groups to retain autonomy. "[The future of independent spine practices] is a transformation to new compensation models and also new operational and marketing models," Ms. Lindsay said. "The ecosystem we are moving toward is one that is heavily dependent on first person data, known as the patient. The consumer expects a frictionless, personalized and customized experience."
Spine and orthopedic practices continue to dodge and overcome various obstacles in their way as the industry evolves. And as transparency continues to become clearer, patients get more involved with their care and new relationships are made, the future of the industry is limitless.