Becker’s Spine Review is a publication for orthopedic and spine surgeons and surgery center administrators. Each week, Becker’s releases additions to their Ask Spine Surgeons series, and earlier this month, spine surgeons were asked to answer a few questions. Check out Dr. Richard Kube’s responses, below!
Question: What are the most important trends in spine reimbursement?
Richard Kube, MD, Founder, CEO, Prairie Spine & Pain Institute, Peoria, Ill.: There are several different trends that are negative. There are increasing numbers of patients requiring surgeries that are being deemed experimental and hence, care is denied. This form of rationing is affecting overall case volumes, which do impact overall reimbursement. This important trend is likely to continue until it awakens a largely unaware public of the situation.
These folks will either have to go without treatment or they will have to find a facility able to provide high value for the services. That leads to the next issue which is bundling of the surgical episode into one payment. CMS has already done that for joint replacements and spine is on the horizon. Look for rates to potentially drop again as this will create an end sum game for those heavily operating in the hospital setting. It provides for an opportunity however, for those in an ambulatory setting as they can provide value and may be able to capture larger market share.