Becker's Spine Review

26 PRACTICE MANAGEMENT Consolidation to become more mainstream in orthopedics — 2 surgeon predictions By Alan Condon O rthopedic practice consolidation is expected to increase in the coming years as hospital systems, insurers and private equity firms continue to recruit physicians and smaller physician-owned practices explore strategic options in re- sponse to the COVID-19 pandemic. Two spine surgeons predict how consolidation will affect the future of the orthopedic field: Andrew Cordover, MD. Andrews Sports Medicine & Orthopaedic Center (Birming- ham, Ala.): I believe that in the next few years, the consolidation trend will continue. It will be likely that there will be fewer small to mid-sized practices that are not owned by a hospital, private equity or some other enti- ty. Consolidation of these groups will prob- ably become more mainstream. However, there are some merits to the model. e new, value-based payment models for both fed- eral and private payers require sophisticat- ed management and data analysis that most practices do not have available. Additionally, collective negotiating and maintenance of quality metrics may be easier to demonstrate. Consolidation can provide opportunities for vertical integration through surgery centers or other ancillary services, as capital and addi- tional practice resources will be more readily available through these groups. Another ben- efit would be the economies of scale that may be realized operationally or through group purchasing of supplies, employee benefit packages and various insurance policies. Also, volume will be driven by larger contracts. Adam Bruggeman, MD. Texas Spine Care Center (San Antonio) and CMO of MpowerHealth (Addison, Texas): Spine care delivery will clearly shift toward the outpatient setting as payers see cost savings and providers have greater opportunity for ownership in surgery centers. Trends are shifting toward employment models and consolidation of practices, as we see hos- pital systems, private equity and insurance companies continue to employ a greater percentage of the workforce. Also pushing this trend is the growing attitude of phy- sicians who prefer to avoid the ever-grow- ing practice management requirements and increasing burden of preauthorization associated with payers. n 4 surgeons stepping into leadership roles at Hoag Orthopedic Institute By Alan Condon I rvine, Calif.-based Hoag Orthopedic Institute is shaking up its leadership team with four key ap- pointments since January: 1. Jeremy Smith, MD, was named chief of spine surgery. He aims to develop the spine surgery program, and im- prove public education and outreach for spine surgery and Hoag's joint replacement program. 2. Steven Barnett, MD, became chief medical officer, replacing Robert Gorab, MD, who held the position for more than a decade. Dr. Barnett oversees Hoag's clini- cal quality and annual outcomes reporting process, and leads the medical staff. 3. Jay Patel, MD, succeeded James Caillouette, MD, a founder of Hoag, as chief strategy officer. Dr. Patel over- sees planning and strategy for Hoag's expansion plans and continues to serve as co-director of the joint re- placement fellowship. 4. David Gazzaniga, MD, head team physician for the Los Angeles Chargers, was appointed chief of sports medi- cine, where he is working to develop a sports medicine institute and expand access to care. n Are orthopedic surgeons dropping Medicare, Medicaid patients? By Alan Condon M ost orthopedic surgeons are continuing to take on Medicare and/or Medicaid patients, accord- ing to Medscape's "Orthopedics Compensation Report 2021," published May 14. But about one-fifth of surgeons will stop treating at least some of their Medicare/Medicaid patients and not take on new ones, or are still undecided, the survey found. Here's how orthopedic surgeons responded to the survey: 1. I will continue taking new and current Medicare/Medic- aid patients: 78 percent 2. I won't take new Medicare patients: 3 percent 3. I won't take new Medicaid patients: 3 percent 4. I will stop treating some or all of my current Medicare patients and won't take new Medicare patients: 2 percent 5. I will stop treating some or all of my current Medicaid patients and won't take new Medicaid patients: 1 percent 6. I have not yet decided: 17 percent Note: The survey collected data from 17,903 respondents between Oct. 6, 2020, and Feb. 11, 2021. n

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