Becker's ASC Review

31 ORTHOPEDICS What changes Dr. Oren Gottfried expects to see in spine in 2020 By Alan Condon O ren Gottfried, MD, is president of the North Carolina Spine Society as well as professor of neurosurgery and clinical vice chair of quality in the department of neurosurgery at Duke University School of Medicine in Durham, N.C. Here, Dr. Gottfried discusses what changes he expects to see in the spine field in 2020 and what strategies spine surgeons can implement to tackle declining reimbursements. Question: What area of spine do you expect to see the most change in 2020? Dr. Oren Gottfried: I expect to see predictive analytic tools helping guide spine surgeons with regard to who will benefit most from surgery; appro- priate preoperative health optimization; achieving ideal spinal alignment with reduced need for return to the OR; details of the surgery or approach best suited to the individual patients; informed decision making for patients with knowledge of potential outcomes based on their individual risk factors and helping surgeons promote value, efficiency of healing and reduced costs with our complex patient population. I appreciate that there is significant innovation and exciting new spine technology, and I would like to see all surgeons guided by concrete data that shows maximal value with great outcomes at the lowest expense. I think in a population health observant model we need to put technology forward to reduce the overall episode of care costs. I think surgeons will be even more aware in the future of their outcomes and costs of their care. I think surgeon dashboards will help push this effort. At Duke Uni- versity, I send this data out to each surgeon on a regular basis to compare data to national and institutional benchmarks. Q: What are your plans for your practice this year? What strategies or initiatives are you implementing? OG: I keep all of the spine surgeons at my institution updated with their quality and safety outcomes, patient satisfaction in the clinic and hospi- tal as well as many value-based metrics. I think surgeon report cards are key to improving quality of our care and reducing costs. Q: How do you see the emerging trend of price transparency affecting spine? OG: I think every surgeon should see the costs of what they do in and out of surgery on a regular basis. I suggest surgeons think about every item they use in the OR — including what it costs — and if there are cheaper, as effective alternatives. As a group, we need to take a spinal pathology and look at surgery outcomes and costs, and assess the reasons and drivers for such variability in overall costs and outcomes. If someone is using more expensive materials and not providing a proportional improvement in care and longevity of outcomes, we need to reconsider their approach. Q: What are some strategies that spine surgeons can implement to deal with declining reimbursements? OG: I would argue in a population health value-based care model, reduc- ing the costs of our surgeries while providing great outcomes can only lead to spine surgeon's maintaining a greater amount of the reimbursements of the overall care. If we spend extensively on the surgery itself, we will continue to see declines. n 3-group merger to create $144M spine, orthopedic and pain hospital By Alan Condon T hedaCare is merging with Appleton-based Hand to Shoulder Center of Wisconsin and Neenah, Wis.-based Neuroscience Group to form a spine, orthopedic and pain hospital in Apple- ton, reports Fox 11 News. Four things to know: 1. With the merger, Appleton-based ThedaCare plans to open a $144 million facility that will feature medical offices, a specialty surgery center and an orthopedic and spine hospital. 2. Demand for spine and orthopedic services is rising due to an aging population becoming more active in the state, ThedaCare executives told Fox 11 News. 3. The 230,000-square-foot facility will break ground in the spring and open in late 2021. 4. The hospital will create around 75 healthcare posi- tions and 200 construction jobs. n Stryker bets on extremities, to buy Wright Medical for $5.4B: 5 key notes By Laura Dyrda S tryker signed a defini- tive agreement to ac- quire Wright Medical Group for $5.4 billion. Five things to know: 1. Stryker agreed to purchase issued and out- standing ordinary shares of Wright Medical for $30.75 per share, a total equity value of around $4 billion. Including convert- ible notes, the enterprise value of the transaction is $5.4 billion. 2. Wright Medical is fo- cused on extremities and biologics, and will comple- ment Stryker's trauma and extremities business. 3. Some analysts an- ticipate there could be antitrust issues with the planned transaction, especially as Wright Medical's STAR ankle business has 70 percent of the total ankle replace- ment market. 4. The board of directors from both companies have approved the transaction and plan to close during the second half of 2020. 5. Stryker doesn't an- ticipate the acquisition will affect net earnings per diluted share and adjusted net earnings per diluted share last year. The company has not updated its expected adjusted earnings per share for the full year. n

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