Becker's Spine Review

14 SPINE SURGEONS Rothman ditched bundled payments, has no regrets By Carly Behm A lthough Philadelphia-based Roth- man Orthopaedics has eliminated bundled payments, its president, Alexander Vaccaro, MD, PhD, said using them is still worth it for some practices. He reflected on that decision a year later and told Becker's Spine Review how he thinks other practices should look at the payments. Question: At a Becker's event last year, you announced that Rothman was dropping out of bundled pay- ments. Has your view of bundled pay- ments changed over the past year? Dr. Alexander Vaccaro: My view of bundle payments has not changed. It is an effective way of developing patient-facing value-based healthcare decisions. e innate problem, however, is the intrinsic "race to the bottom" effect of bundled payments that reduces long- term reimbursements to important stake- holders in the process. is, unfortunately, misaligns incentives to participate. I have not seen any material changes in the approach from CMS that would make continued partic- ipation in the BPCI program compelling. At Rothman, we are proud to deliver the highest quality care, and affordability is part of our mission statement. We believe a commitment to increased value in healthcare should be re- warded for the long-term, not just in the short term for initial savings. Q: What would you advise other prac- tices to consider when it comes to bundled payments? AV: Every practice circumstance is unique. I think it is extremely important to engage in the process of bundled payments to under- stand where a particular group is in their value proposition to patient-facing care. e ability to manage risk in reimbursement requires so- phisticated data analytics, alignment among all stakeholders and the operational resources to navigate patients through evidence-based care pathways. Q: What other value-based models do you see developing in orthopedics? AV: As practices become more sophisticated in their ability to manage risk, there will be a nat- ural shi toward capturing premium dollars in the form of sub-capitation agreements. ese arrangements may be with health systems, Ac- countable Care Organizations, large primary care groups or any entity that is involved with Medicare Direct contracting. Considerations for carve-outs, such as for spine procedures where there is greater variability, would need to be factored in to ensure financial viability and maintain high quality patient outcomes. Q: How will the payer market in Flor- ida influence Rothman's operations? AV: We will focus on delivering evidence-based cost-effective care to local communities in the Florida market which is easily accessible so that we can exceed the expectations of our pa- tients. n Dr. Scott Tromanhauser succeeded as Boston hospital's spine chief By Alan Condon Scott Tromanhauser, MD, stepped down as chief of spine surgery at New England Baptist Hospital in Boston, WickedLocal. com reported May 10. Neurosurgeon Chima Ohaegbulam, MD, succeeds Dr. Tromanhauser, who held the role since 2014. Since 2005, Dr. Ohaegbulam has been on the hospital's faculty. He specializes in minimally invasive surgery, motion-pre- serving techniques and robotic spine surgery, among other areas of spine. "I'm honored to take on this new role guiding our exceptional spine surgery team as we build upon [New England Bap- tist's] already outstanding reputation for orthopedic surgery," Dr. Ohaegbulam said. The surgeon graduated medical school in Nigeria before moving to the U.S., where he completed a residency and spine fellowship at Boston Children's Hospital and Brigham and Women's Hospital. n

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