Becker's Spine Review

Improving Spine Practice Profits 34 5 Ideas for Spine Practice Growth in Today's Healthcare Market By Laura Miller T exas Back Institute in Plano has spent the past three decades building a large spine practice, and with the ever-changing healthcare environment, an adaptable growth plan is more important now than ever. "We are spending a lot of resources on growth and it's a very exciting time," says Michael Hisey, MD, President of Texas Back Institute. "We are in a time where everyone expects change. You have to be in a position to take advantage of that; those who do will succeed. Everything is going to be redistributed and you want to be in a position to help decide how that gets redistributed to the benefit of stabilizing your practice and treatment for your patients." Here are five ideas for spine practice growth in today's healthcare environment. 1. Merge with other providers. Merge or engage in formal partnerships with other providers in your community. Work with them to build relationships which can more effectively facilitate patient care. This could help leverage your collective negotiating power.   2. Build a presence in an underserved market. Another growth strategy includes filling the need for spine specialists in an underserved community. The practice could bring on another surgeon for a new location in the community; often the local hospital will partner with the spine practice for the recruitment of a new physician in the market.   "Bring in the new surgeon and place him in the community with a potential for growth," says Dr. Hisey. "The hospital and the practice will support him with marketing infrastructure and staff." However, don't expect the additional cases from a new surgeon to grow the practice's profitability. "Growth is beneficial to us for negotiating power and to leverage overhead, but we don't expect the newer surgeons to add to the overall profitability," he says. 3. Affiliate with other groups in saturated markets. In a wellserved market, it's beneficial for surgeons and groups to affiliate with other groups in the community to grow their economies of scale instead of developing a new business or crowding others out of the market. "Most referral networks are composed of family practice physicians, neurologists and other pain specialists who take care of the patients until they need surgery," says Dr. Hisey. "If you have those specialists in your practice, you could cut yourself off from potential referral sources. However, it is also important to balance this against the need to meet the demands of those patients and referral sources requesting a multidisciplinary approach." Dr. Michael Hisey Texas Back Institute offers a multidisciplinary approach either through their own physicians or in cooperation with other physicians in their market.  n Neurosurgeon Salary vs. Hospital Revenue Generated By Laura Miller N eurosurgery generates $1.68 million in revenue for hospitals on average, according to the "2013 Physician Inpatient/Outpatient Revenue Survey" from Merritt Hawkins. "It takes a while, perhaps two or three years to really develop a practice and hit a stride," says Dr. Hisey. "It's a faster growth strategy to team up with people who are already there. However, you have to understand and account for personalities in the groups when you are partnering. It's important for everyone to work well together." Here are statistics on neurosurgeon-generated hospital revenue, hospital salaries for neurosurgeons and their corresponding revenue-to-compensation ratios based on data from the survey: 4. Cover more of the episode of care. Seek opportunities to bring more care under your group's control. Median 2012 hospital compensation: $669,000 Median 2013 revenue: $1,684,523 "If you can negotiate better prices for the hospital systems and have influence over these costs, you will be in a better position for contracting for bundled payments," says Dr. Hisey. "The more pieces of the episode of care you have control over, the better place you'll be for the final deal." Revenue-to-compensation ratio: 2.52:1 5. Strategically align instead of bringing other specialists into the group. Depending on your referral network, it may make more sense to strategically align with non-operative and pain management specialists instead of bringing them into your group. Median 2012 hospital compensation: $519,000 Orthopedic surgeons Median 2013 revenue: $2,683,510 Revenue-to-compensation ratio: 5.17:1 n

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