Whether it be the transition of procedures to the ASC or the addition of new technology, the musculoskeletal industry seems to be in a state of constant change.
Three spine and orthopedic leaders connected with Becker's to share some of the biggest trends they believe will shake up the industry in years to come.
Adam Barry. CEO of Summit Orthopedic (Woodbury, Minn.): I think one of the disruptors is the insurance companies want to make sure that the patient is bearing enough of the responsibility that they're going to start to be different consumers of that healthcare. And so we're always looking into that and looking how we can solve that. Another kind of disruptor that we're starting to just get on the front end of right now is how are we going to do revisions in our ASC? So what are the things we can do to get ahead of that and be on that forefront? I think we're in the early stages of revisions in terms of where that can go. In 2010 we did our analysis and we saw that 60% of our surgical cases were done in a hospital and 40% were done in the ASC. So it was 2010. At the end of 2020, we did a decade in review, and that basically got flipped. We were 30% in the hospital and 70% in our ASC. Then covid happened and we looked at it last year. And so now we're at 87% of all of our surgical cases are done in our ASCs, 13% are in the hospital. And that was still before Medicare allowed total shoulders, which now since the first of the year we've done that. So we anticipate that that 13% is even going to diminish more. So when I think about the evolution of where this is going and the disruptors, if you haven't done it already, you should be doing predominantly ASC-based cases.
Janet Carlson, MSN, RN. Executive Director for Ambulatory Surgery Centers of Commonwealth Pain & Spine (Louisville, Ky.): Well, for me it is the certificate of need laws. We are partnering with health systems to take on their patient base, but then when I go in a CON state to apply for an ASC to be developed, the first people to contest me are the same health systems. And so I now am going to be buried in diligence and legal fees. So then that makes me look for other markets without certificate of need because then I'm going to bring the economic development of a brand new build to suit de novo. I'm going to create jobs. And so I would say the certificate of need specifically where I'm working in Kentucky, it's a single specialty. I can only do a two room ASC. That's hampering everything that I can do because frankly, the state is doing a very great job of bringing in recruited economic development partners like Ford. They're building a Ford plant not far from one of our busiest clinics. And in that market they're building five AAA high schools. They're building roads, EMS, but nobody is talking about healthcare infrastructure. And so now we're going to have, in my humble opinion, these two room ASCs all over Kentucky. And when you think about it, I'm going to be competing for the same staff, the same talent, when I could come under a larger roof with eight or 10 rooms, two to four procedure rooms and bring everybody together under one roof and offer more services to the community that's growing.
Robert Tatsumi, MD. President of Oregon Spine Care (Tualatin): Personally for my practice, I've kind of transitioned over the past few years into just primarily doing outpatient surgeries. And I think it's a combination of the patients demanding or really wanting to have the procedures done in an outpatient setting, whether it's the lumbar fusion, cervical disc replacement, cervical fusion. And the transition for me was one, when I was doing the hospital, the patients would go home the same day and I'm like, well, if you can go home the same day and you have this down in the surgery center. And then it was a matter of having payers to carve outs for lumbar fusions cases that are not Medicare approved. And we are lucky to have the staff to get that accomplished and get very good rates. And so that was very helpful.