Becker's ASC Review

37 ORTHOPEDICS 4 biggest business challenges facing orthopedic practices By Alan Condon W ith U.S. inflation hitting 9.1 percent, the highest it has been in 21 years, overheads and staff wages on the rise, and reimbursement and physician fees continuing to be cut by insurers, the next year is set to be particularly challenging for orthopedic practices. Here are the four biggest business challenges facing orthopedic surgeons, with insights from physicians from across the country: 1. Medicare and commercial payer cuts. Physicians are staring down the barrel of further CMS cuts to their professional fees in 2023, and commercial payers — which base their rates on Medicare's — are likely to follow suit. Insurers are further decreasing reimbursement for procedures as well as bundling payments, which heightens the financial strain on many practices; overhead, staff salaries and inflation are increasing, while reimbursement is dropping. In July, CMS released its Medicare physician fee schedule proposed rule for 2023, which would decrease the conversion factor by 4.42 percent to $33.08 while inflation and the cost of running an independent practice continue to rise. e potential effect around the country is that physicians may limit the number of Medicare and Medicaid patients they treat or opt out of Medicare altogether. ere may also be a ripple effect on commercial payer contracts tied to federal rates, "is is in the midst of the worst inflation in the past 20 years, so the effect will be more than 5 percent on paper," according to Issada ongtrangan, MD, of Microspine in Scottsdale, Ariz. "Physicians already lose financially when they take care of Medicare patients, especially if they are not healthy, and more and more physicians opt out of taking care of these patients. What do you think will happen to healthcare for Medicare patients in the future if this trend continues? Providing quality care will be more challenging in this environment, and sadly [there is] nothing we can do about it." 2. Recruiting and retaining clinical and administrative staff. Recruitment is always a challenge, but the effects of the COVID-19 pandemic, burnout and an impending physician shortage are making recruiting and retaining top-tier talent an even bigger challenge. Nurses and medical assistants are among the most difficult positions to recruit in today's labor market, which has pushed many practices to increase wages and strengthen compensation packages and benefits to address staff shortages. "We are practicing in an unprecedented time where there are staffing shortages across the board. Not having enough nurses, radiology technicians, scrub technicians, CRNAs, etc., have really hindered our ability to provide the level of care we are accustomed to providing for our patients," Robert Hirschl, MD, president of the Neuroscience Institute at Orlando (Fla.) Heath, told Becker's. "We need to think outside the box when it comes to our staff utilization and how we recruit and retain top quality individuals." 3. Developing ancillary services. Orthopedic groups are increasingly looking to provide a range of integrated services, including ASCs, physician-owned hospitals, MRI and physical therapy, under the 15 best medical schools for orthopedic surgeons in 2022: Report By Claire Wallace A new report from Kiiky has rated the top 15 universities for orthopedic surgeons in 2022. The study uses data including student-faculty ratio, tuition, clinical experiences and class activities to complete its global rankings. FIfteen best medical schools for orthopedic surgeons: 1. The University of California (San Francisco) 2. Johns Hopkins University (Baltimore) 3. University of Pennsylvania Perelman (Philadelphia) 4. University of Washington (Seattle) 5. University of California Los Angeles 6. University of Michigan Ann Arbor 7. Stanford University (Redwood, Calif.) 8. University of Pittsburgh 9. University of Chicago 10. Mayo Clinic College of Medicine and Science (Rochester, Minn.) 11. All India Institute of Medical Sciences (Delhi, India) 12. Jefferson Medical College of Thomas Jefferson University (Philadelphia, Pa.) 13. Royal College of Surgeons in Ireland (Dublin) 14. University College London Medical School (England) 15. Northwestern University Feinberg School of Medicine (Chicago) n Orthopedic robotics company seeks $40M investment By Carly Behm McGinley Orthopedics is crowdfunding $40 million in investments. The money is being raised through a Regulation A+ equity crowdfunding investment offering, the devicemaker said in a Sept. 20 news release. The funds are expected to help the company accelerate the growth of its IntelliSense Drill Technology. The money will also help the company's development of its intellectual property portfolio. "We are leveling the playing field through our Regulation A+ investment opportunity," CEO Joseph McGinley, MD, PhD, said in the release. "It gives everyday investors access to growing private companies like McGinley Orthopedics and removes Wall Street influence." n

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