Neurosurgeon Brian R. Gantwerker, MD, and spine surgeon Isaada Thongtrangan, MD, share their thoughts on bundled payments and value-based care in spine.
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: Does your practice have a population health program? If so, what impact has it had? How do you see the program developing?
Please send responses to Alan Condon at acondon@beckershealthcare.com by 5 p.m. CST Wednesday, Oct. 16.
Note: The following responses were edited for length and clarity.
Question: How do you see new payment models such as bundled payments and value-based care developing in spine?
Brian R. Gantwerker, MD. Founder of the Craniospinal Center of Los Angeles: I see spine bundling being attempted but failing. Bottom line: You cannot cram every spine operation into a neat little box. Read: an anterior cervical discectomy and fusion is not a hip arthroplasty — not ever.
Issada Thongtrangan, MD. Microspine (Phoenix): Value-based payment appears to be a good idea in theory, but it is a controversial subject as there are several factors that play a role in this model. For example, the complex patient who might have several comorbidities that will highly likely develop complications — are we going to avoid doing surgeries in this group of patients? What if they need special types of biologics, bone grafts and instruments, etc.?
We need to take those factors in consideration. It is a complex subject to be further investigated and explored but I hope that we find the common ground that will be best for all parties — especially the patients.