Issue link: https://beckershealthcare.uberflip.com/i/1164972
23 SPINE SURGEONS Dr. Robert Gewirtz: AI in spine, changing patient populations and the future of outpatient procedures By Alan Condon R obert Gewirtz, MD, is a fellowship-trained neurosurgeon with Mount Carmel Central Ohio Neurological Surgeons in Westerville. Dr. Gewirtz completed a residency in neurosurgery at Cleveland Clin- ic. He completed a fellowship in neurosurgical trauma at Allegheny General Hospital in Pittsburgh and a fellowship in cerebrovascular surgery at Stanford University Medical Center in Palo Alto, Calif. Here, Dr. Gewirtz discusses the big ways spine is evolving. Question: How do you see artificial intelligence impact- ing spine surgery? Dr Robert Gewirtz: I think AI will be part of the reading process for imaging studies in the future. However, spine surgeons will still need to be able to review and interpret their own studies indefinitely. AI will also be a powerful research tool. I can see a day when an AI program will assign a probability score for each patient, utilizing their imaging studies and clinical factors, to help determine optimal therapy for our patients. e dark side will be insurance companies using AI to deny coverage for treatment or surgery based on a sim- ilar score. Q: How has your patient population changed over the past 5 years? How do you expect it to evolve in the fu- ture? RG: My patients continue to get older and less healthy. BMIs continue to go up, but smoking is trending down. It seems everyone is on an anti-platelet or anticoagulant therapy. Q: How can surgery centers improve profits without in- creasing patient costs or sacrificing quality? RG: Surgery centers that do a high volume will have a lower fixed cost per case. New models of reimbursement for CMS patients have to be explored so that we can deliver care in the outpatient setting, but not at a loss. Q: How do you see outpatient spine procedures develop- ing in the future? RG: Outpatient spine will continue to grow and become more sophis- ticated. I think hospitals will be incentivized to invest in or own these centers and move as many patients as possible into our arena. is will be necessary as more spine physicians become employed and less entrepreneurial. n 5 plead guilty in $80M healthcare fraud scheme: 8 things to know By Angie Stewart F ive individuals who practiced at and operated a New York pain facility pleaded guilty in a six-year, $80 million health- care fraud scheme, according to the Times Herald-Record. Eight things to know: 1. Prosecutors said the fraud scheme took place at Middle- town, N.Y.-based Dolson Avenue Medical, which was re- named the Pain Relief & Wellness Center after an FBI raid in August 2017. The facility offers chiropractic care, acupunc- ture, physical therapy and other services. 2. The clinic's business manager and bookkeeper, Andrea Grossman, pleaded guilty Aug. 1 to one felony count of conspiracy to commit healthcare fraud. She is set to be sen- tenced on Nov. 6. 3. Chiropractor Jeff Spina, DC, pleaded guilty July 26 to three felony counts: conspiracy to commit healthcare fraud, healthcare fraud, and obstruction of a federal audit. Each carries a maximum 10-year sentence. His sentencing is scheduled for Oct. 24. 4. Medical practice administrator Kim Spina pleaded guilty on June 18 to healthcare fraud and conspiracy to commit healthcare fraud. Her sentencing is scheduled for Oct. 10. 5. James "Jay" Spina, DC, pleaded guilty on May 2 to con- spiring to defraud health insurers. His sentencing is sched- uled for Sept. 17. James, Kim and Jeff Spina are siblings. 6. Jeff and Jay Spina could lose their chiropractic licenses because of the felony convictions. The indictment alleges the brothers operated at least eight other businesses that fraudulently billed Medicare and other insurers. 7. Pain Relief & Wellness Center remains open under chiro- practors David Spina, DC, Tracy Parrino, DC, and Stephen Brune, DC. 8. Along with the one involving the Spina siblings and Ms. Grossman, a federal indictment against neurologist Charles Bagley, MD, was unsealed in August 2018. Dr. Bagley was a pain management physician at Dolson Avenue Medical. He pleaded guilty to conspiracy to commit healthcare fraud and will be sentenced on Dec. 13. n