Three spine surgeons discuss how they deal with rising deductibles and increased patient financial responsibility.
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 the key trends in spinal fusion surgery?
Please send responses to Anuja Vaidya at avaidya@beckershealthcare.com by Wednesday, Jan. 23, at 5 p.m. CST.
Question: How are you addressing higher deductibles at your practice?
Brian R. Gantwerker, MD. Founder of the Craniospinal Center of Los Angeles: In Los Angeles, the cost of living is already so high, many patients are already under financial pressure. At our practice we have a straightforward pricing process for procedures. Our staff also spend a lot of time on the telephone educating patients on what their insurance covers and does not cover. Patients are always grateful for the knowledge and are less frightened of their out-of-pocket expense once they know what a deductible is and what the rest of their financial year will look like with regard to medical bills.
Christian Zimmerman, MD. Spinal Neurosurgeon at Saint Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): More Americans are choosing higher-deductible healthcare plans, with resultant evidence of less healthcare usage being the chosen endpoint. Generally, these programs incentivize less primary care activity, but procedural-based treatments surely reach most deductible limits when hospitalization is required.
In our practice, especially for those with HDHPs, patients are less reticent to attempt prolonged conservative measures and distance surgery [for] when and only when treatments and time have failed. The expectations of insurers for surgical approvals is much more narrow (especially concerning multi-level fusion procedures), which appear to carry over into the most referable cases of surgical need.
Vladimir Sinkov, MD. Spine Surgeon at New Hampshire Orthopaedic Center (Nashua): While we cannot change the rules and contracts of our patients' insurance companies, we try to accommodate when we can. We offer payment plans when possible for office visits and surgery co-payments.
As a result of the way the deductibles work, a lot of patients reach them by the second half of the year. Every fourth quarter there is a rush of requests for surgeries to be done before the year ends and the deductibles renew. I try to avoid taking vacations or going away to conferences and open more surgery days so that I can accommodate the increased demand.