Becker's Spine Review

14 PRACTICE MANAGEMENT Here's what 3 spine surgeons are doing to keep practice costs lean By Carly Behm B etween inflation and rising costs and reimbursement woes facing physicians, many spine surgeons are strategizing to manage finances at their practices. Editor's note: Responses were lightly edited for clarity and length. Question: What cost-cutting measures are you taking at your practice? Mladen Djurasooic, MD. Norton Leatherman Spine (Louisville, Ky.): We are implementing several cost measures. In the OR, we are constantly reevaluating implant costs, in particular biologics (e.g., bone gra extenders), which can be surprisingly expensive. In the office, we are constantly trying to convert paper processes into electronics. For example, currently we are looking at processes to allow direct input of patient-reported outcome measures into an EMR rather than having paper forms, which require manual input. Alok Sharan, MD. Spine and Performance Institute (Edison, N.J.): Over the past few years I have been transitioning my practice towards primarily outpatient procedures and performing them at ambulatory surgery centers. At this point the majority of patients in my practice who need a lumbar fusion, laminectomy, or a cervical fusion are able to go home the same day. Using our awake spine surgery protocols, we are able to discharge patients home the same day and have them take opioids for only a few days. Many payers are pushing cost-cutting measures by changing the site of service of cases towards ambulatory settings. Doing a case in an ASC instead of a hospital requires more than a change in the site of service. It requires educating the patient properly, optimizing their health, and making sure they will be safe at home. In anticipation of payers using the ASC as a cost-cutting measure, I have been constantly refining our protocols to make the surgical process a great experience for the patient so that they recover safer, better and faster. Vijay Yanamadala, MD. Hartford (Conn.) HealthCare: We have recognized that there are many sources of waste when it comes to spine surgery. In the operating room, we have started an initiative at Hartford HealthCare to ensure every surgeon knows their cost for a particular case as well as the system average. is helps all of us understand where our costs come from and how we can reduce them while maintaining the same quality of care. Ultimately, this is all about improving the value of the care delivered, ever reducing costs while improving the quality and outcomes for our patients. Personally, this has enabled me to see what implants are costing compared to my peers and also what disposables are being opened in my case (sometimes just because they were on an old preference card) that I can ultimately eliminate. is sort of lean work is embedded within our ethos at Hartford HealthCare and remains essential to improving our efficiency. n Rothman Orthopaedics partners with insurance brokerage firm By Carly Behm P hiladelphia-based Rothman Orthopaedic Institute and Conner Strong & Bucklew, an insurance brokerage and employee benefits consulting firm are partnering to form Rothman Direct. Some members of Conner Strong & Bucklew will have access to Rothman Direct, a service for scheduling appointments, according to an April 10 company news release. Features of Rotman Direct include extended call center hours, nurse navigation services and online scheduling tool to connect with Rothman physicians. "The partnership with Conner Strong & Buckelew strengthens our direct-to-employer channel and we are excited to provide affordable healthcare benefits to their clients and their dependents," Alex Vaccaro, MD, PhD, president of Rothman, said in the release. "The integration of Rothman Direct will provide care coordination that will enable Conner Strong & Buckelew clients the world-class treatment they need faster." n Virtua Health to acquire Reconstructive Orthopedics By Carly Behm M arlton, N.J.-based Virtua Health inked a deal to acquire Moorestown, N.J.-based Reconstructive Orthopedics, NJ Biz reported April 19. The acquisition is expected to close in July, the report said. It will add 60 clinicians and 300 total employees to Virtua Medical Group. Reconstructive Orthopedics has eight locations and will operate as Virtua Reconstructive Orthopedics. The practice was founded in 1977. n

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