Becker's Spine Review

21 SPINE SURGEONS UC San Francisco cuts patients' spine surgery recovery times in half — How? By keeping them awake By Eric Oliver U C San Francisco is cutting patient recovery times by of- fering to perform proce- dures while they're still awake. What you should know: 1. The university began offering awake spinal fusion surgery in spring 2018. 2. About 10 patients have opted to stay awake through the procedure since then. 3. By staying awake, patients can be mobile and pain-free by the end of the day. 4. UC San Francisco keeps patients awake while using the long-acting, local anesthetic liposomal bupiva- caine. When injected in the lower back, the anesthetic relieves pain for 72 hours. By not having to put a pa- tient under, surgeons can perform the procedure in one to three hours, compared to four to six hours. "It's changing my practice in that I can get my patients through their surgery much more quickly," said Praveen Mummaneni, MD. n Spine reimbursement from CMS dropped 27% since 2000: 5 key notes By Laura Dyrda A team of researchers at Mayo Clinic's Phoenix campus, calculated the average reimbursement rates for neurosurgeons since 2000 and outlined the key trends at the American Association of Neurological Surgeons Annual Meeting. Medscape reported the study authors examined the 10 most common spine and cranial neurosurgical procedures, compiling data for Medicare reim- bursement. After calculating the average reimbursement rate for the proce- dures, Mayo's researchers compared the percent change to the change in the consumer price index from 2000 to 2018. Five key findings: 1. After adjusted for inflation, the average reimbursement rate for all the spine and cranial procedures examined fell 25.8 percent from 2000 to 2018. 2. The reimbursement for spine procedures dropped 27 percent over the 18 years examined, after adjusted for inflation. 3. Cranial procedure reimbursement rate declined by 24.6 percent over the study period, after inflation was taken into consideration. 4. The unadjusted reimbursement rate was up 7.63 percent for all proce- dures studied. 5. Neurosurgeons' total adjusted reimbursement rate, including both spine and cranial procedures, dropped 25.8 percent over the study period after adjusting for inflation. n Forest Park Medical Center kickback trial ends in convictions for 4 physicians By Laura Dyrda T he kickback trial involving Dallas-based Forest Park Medical Center owners and physicians ended April 9 with convic- tions for seven defendants and one acquittal, according to the Dallas Business Journal. Four things to know: 1. e jury found co-administrator Mac Burt guilty of 10 of the 11 counts against him. Four physicians were also convicted in the case: • Douglas Won, MD, was found guilty of one of two counts against him. • Michael Rimlawi, MD, was convicted in three of four counts against him. • Shawn Henry, DO, was convicted in three of four counts against him. • Mike Shaw, MD, was convicted in all four counts against him. Two other individuals — Jackson Jacob, the owner of companies that Forest Park channeled payments through, and workers compensation insurance consultant Iris Forrest — were also convicted of charges in the case. 2. e trial revolved around a large conspira- cy in which the physician-owned hospital re- ceived $200 million in "questionable insurance benefits" aer compensating physicians for referrals. According to the report, the hospi- tal provided around $40 million in bribes and kickbacks that were described as consulting fees or payment for the physicians to market their practices. 3. e principle founders of Forest Park made plea deals and cooperated with the govern- ment. 4. Sentencing has not occurred for the individ- uals convicted in this case. n

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