Anthony T. Yeung, MD, of Phoenix-based Desert Institute for Spine Care, emphasizes an unfavorable reimbursement trend for both independent and employed spine surgeons and the impact on the spine field.
Dr. Yeung will be speaking at the Becker's 16th Annual Future of Spine + The Spine, Orthopedic and Pain Management-Driven ASC Conference. To learn more and register, click here. Contact Maura Jodoin at mjodoin@beckershealthcare.com or Kristelle Khazzaka at Kkhazzaka@beckershealthcare.com for further information about sponsorship and exhibitor opportunities.
Question: Where do you think pay and reimbursement is headed for independent spine surgeons?
Dr. Anthony Yeung: There will continue to be downward pressure by payers on independent spine surgeons regardless of their reputation and skills. Unfortunately, the trend and pay for all surgeons, independent spine surgeons or salaried spine surgeons, will continue to trend downward in the long term. Reimbursement may increase temporarily in situations in which even "above average" or "superstar" surgeons who are dependent on insurance or government payers will be impacted. All who are expected to pay or receive payment will continue to leverage their dominance in the reimbursement industry to aggressively and routinely try to maximize reimbursement, while payers will continue to relentlessly reduce payment with their own reimbursement criteria. Either way, the reimbursement trend will force, not just spine surgeons but all business entities, to distinguish themselves by narrowing their surgical area of expertise.
Quality does not ultimately prevail in the current short term unless the superstar surgeons can attract private pay. By distinguishing themselves to attract cash patients or clearly distinguish themselves from average spine surgeons doing general spine, individual spine surgeons may still prosper as long as they have the incentive to work not just harder, but smarter.
The reduction in pay and reimbursement will ultimately adversely affect patients by forcing dedicated surgeons to be more attentive to the reimbursement game, retire or be less dedicated to their work, ultimately reducing the quality of care. Current reimbursement may increase temporarily by consolidation and vertically integrate, but it will still be a moving target. The few who truly distinguish themselves and create patient demand by their results will still prosper, but by moving toward high-demand procedures without also demonstrating clear results will limit independent practice. The surgeon will have to distinguish much like professional athletes and depend on his or her surgical decision-making as well as their skills.
Q: How can spine surgeons be successful in an increasingly competitive environment?
AY: Many are already using professional help in marketing, social media, mobile apps or possibly falling prey to business entities who constantly try to get their attention for marketing or reimbursement support. Where this goes is not clear; it may not add to the quality of care, but it may affect surgeon motivation and work ethic.
For me, I am distinguishing myself by being the clear leader in my field through lecturing, publishing, teaching and most importantly, taking on patients who I know will get good anticipated results and "warranty" my results for private pay patients