Becker's ASC Review

January/February 2024 Issue of Becker's ASC Review

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22 ORTHOPEDICS Private insurance 'critical' for bundled models to thrive in spine By Carly Behm B undled payments from private insurers were a viable option for lumbar spinal fusion patients, according to a study published in the January 2024 issue of Spine. e study looked at lumbar spinal fusion patients from October 2018 to December 2018 who used CMS' Bundled Payments for Care Improvement Advance model, and compared that data with private bundle data from 2018 to 2020 to analyze the transition away from BPCI-A. "Our healthcare system is undergoing a significant shi towards value-based models, and bundled payment programs are an integral tool in this transformation," Alexander Vaccaro, MD, PhD, and Jose Canseco, MD, PhD, who were authors in the study, said in a statement to Becker's. "e use of bundle payment strategies have sputtered recently under government oversight as its intended goal of reducing costs ultimately led to a race to the bottom in terms of reimbursement, making care for the sick and elderly more difficult due to associated costly comorbidities." e study found readmissions fell under private bundled payment models compared with CMS' Bundled Payments for Care Improvement initiative. e net surplus was lowest in 2018 but didn't differ between the years in private bundles. Researchers concluded that bundled payments can be successful in lumbar spinal fusions and that "constant price adjustment is necessary so bundled payments remain financially beneficial to both parties and systems overcome early losses." "[Bundled] payments have recently started to gain traction in the private insurance realm," Dr. Vaccaro and Dr. Canseco said. "As suggested in our study, partnering with private insurers is crucial for the success of these models. By working together, healthcare providers and payers can achieve the ultimate goal of improving patient care while also achieving financial success in a healthcare environment with ever-rising costs. Risk stratification adjustment tools will have to be a key feature of these new bundles in order to allow surgical practices to remain financially viable while attempting to meet the higher demands and associated costs of caring for patients with significant comorbidities." n Former Hospital for Special Surgery CEO joins Zimmer Biomet board By Carly Behm L ouis Shapiro, who was president and CEO of New York City-based Hospital for Special Surgery, joined Zimmer Biomet's board of directors, the devicemaker said Jan. 3. Mr. Shapiro stepped down from his leadership role to retire in 2023 and was succeeded by Bryan Kelly, MD. Mr. Shapiro joined HSS in 2006 and previously worked at Geisinger Health System in Danville, Pa., according to a news release. "With a long history of leadership in the industry, and as the former President and CEO of a leading healthcare system, Lou brings a significant depth of industry leadership experience, a unique customer perspective and a shared lifetime commitment to our mission to alleviate pain and improve the quality of life for people around the world," Zimmer Biomet's Board Chair, Chris Begley, said in the release. n Former NuVasive, LimaCorporate exec to lead Orthofix By Carly Behm Orthofix named Massimo Calafiore as its new president and CEO. Mr. Calafiore, who is CEO of LimaCorporate, is expected to step into his new role in early 2024, Orthofix said in a Nov. 28 news release. He will replace Orthofix's interim CEO Catherine Burzik, who took the role in September after Keith Valentine was fired following an investigation. Ms. Burzik has elected not to stand for board reelection, Orthofix said. Orthofix is also looking to replace its interim CFO and interim chief legal officer. "Throughout his career, Massimo has demonstrated his ability to unlock value opportunities for multi-segmented, global businesses," Ms. Burzik said in the release. "He has successfully driven sales and commercial operations to achieve both industry leading profitability and growth. Importantly, he has proven experience integrating companies and building high performing teams." Before joining LimaCorporate in 2022, Mr. Calafiore was executive vice president and chief commercial officer at NuVasive. He also has experience working with Waldemar Link. n

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