Becker's Spine Review

11 SPINE SURGEONS models for lumbar spinal fusions. Despite OrthoCarolina's efforts to contain costs with clinical practice guidelines and a BPCI man- agement team, "expenditures were only slightly lower for BPCI lumbar patients." Dr. Odum ultimately found that lumbar fusion bundles were very challenging to manage due to the high variability of complex surgeries and discontinued the spine BPCI. Key thoughts from four spine surgeons on how bundled payments will develop in the field: 9. Jeffrey Wang, MD. Keck School of Medicine of University of Southern California (Los Angeles): "[Value-based care] is already developed and is making surgeons think more globally about treating patients and all the steps involved in the care of the patient. In the end, I am hopeful this will enhance the patient experience as it looks at the global situation, trying to make things more efficient and cost-effective for all. Hopefully, [bundled pay- ments] will eventually result in more efficient and effective care with less complications and better patient satisfaction. It forces the interaction of the clinicians with the hospital system and scru- tinizes all aspects of care. I know it will be fraught with frustra- tions, initial struggles and some pushback. However, as clinicians work with hospitals and make improvements in the entire system, there will hopefully be benefits in efficiencies." 10. Zeeshan Sardar, MD. NewYork-Presbyterian Och Spine Hospital (New York City): "Spine surgery is quite unique due to the variability in the number of levels to be addressed during surgery and the type of surgery performed which may or may not involve the use of instrumentation. ese new payment models would have to start with more homogenous procedures such as one level decompression, discectomy and ACDF. Implementation of such models may provide the op- portunity to review the entire episode of care and optimize the use of resources as well as identify potential areas that require improvement. On the other hand, bundled payments could make surgeons and hospitals more wary of performing surgery on certain high risk patients." 11. Jonathan Gottlieb, MD. Minimally Invasive Spine Cen- ter of South Florida (Miami): "I think at some level we are always striving towards efficiency whether it's in the operat- ing room or when it comes to the best value for your dollar. ere are a number of measures that are utilized to determine whether we are offering value-based care. But at the end of the day, it is going to be incumbent upon us to deliver a certain quality of care within an allocated number of dollars given to us. If somebody says, 'do what you need to do and let me know the cost,' in most cases it's going to cost more. But if you have an entity that says you have 'x' amount of dollars to complete the procedure, you will look for the most efficient ways to do it and I think invariably there will be cost savings in the system. It will put pressure on the people who are the least efficient and the ones that consume the most resources without providing anything meaningful in return." 12. Lali Sekhon, MD, PhD. Reno (Nev.) Orthopedic Clinic: "It sounds good in principle — tying reimbursement to efficien- cy and effectiveness. However, the execution is difficult. I have presented outcomes data to payers in contract negotiations and it is mostly ignored. e cynic in me says it will be used like meaningful use was; a stick rather than a carrot. Another way for payers to reduce reimbursement and increase denials." n 'It's devastating': Dr. Bill Droege watches fire destroy orthopedic clinic By Angie Stewart S t. Louis-based Esquire Orthopedic Rehabilitation and Sports Medicine was destroyed by a fire that erupted in the early morning of Jan. 20, local outlet Fox 2 News reported. Owner and CEO Bill Droege, DC, bought the building 40 years ago and turned it into the St. Louis area's first sports medicine clinic, according to Fox 2 News and NBC affiliate KSDK News. At least 70 patients were supposed to be seen at the clinic Jan. 20. Dr. Droege plans to meet with the clinic's four other physicians to figure out care plans for those patients. The practice likely lost several sports memorabilia items that were gifted by celebrity patients, Dr. Droege's daughter told KSDK News. "I can't tell you how horrible this is," Dr. Droege said in an in- terview with KSDK News. "To wake up and see 50 years of your business go down the drain, it's devastating." As he watched the building burn, Dr. Droege shared a message with reporters: "Tell my patients watching this, we'll be back." The fire started on the roof at about 4 a.m., according to Fox 2 News. Further details weren't immediately available. The out- let didn't report any injuries. n Dr. Bradford Waddell leaves HSS for OrthoAtlanta — 3 details By Angie Stewart Bradford Waddell, MD, joined OrthoAtlanta's team of more than three dozen physicians across 13 offices. Three details: 1. Joining OrthoAtlanta from Hospital for Special Surgery in New York City, Dr. Waddell will practice at OrthoAtlanta's Pied- mont and Piedmont West locations in Atlanta. 2. Dr. Waddell focuses on treating arthritic conditions of the hip and knee and specializes in anterior total hip replacement. He also performs computer-navigated and robotic surgery, partial knee replacement, hip resurfacing and hip fracture surgeries. 3. Dr. Waddell has been recognized as a resident leader and emerging leader by the American Orthopaedic Association. His contributions to the field include 28 peer-reviewed publi- cations, four book chapters, and over 130 national and inter- national presentations. n

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