Becker's ASC Review

30 ORTHOPEDICS How is access to operating room time, including whether key specialists are available to support spine surgery, and if the tools to support high-quality spine surgery such as microscopes and navigation technology are available or will be purchased? In an ASC setting if there is a vascular or neurological intraoperative injury, what type of support, transfer mechanism is in place to ensure patient safety What is the compensation framework, including what behavior is rewarded, and how is productivity measured? If productivity is measured in terms of cash collections, what is the performance of the revenue cycle and how are spine cases reimbursed in the commercial payer contracts relative to market norms? Is revenue shared equally among all providers or passed on work RVUs/collections. Will the surgeon have the ability to participate in ASC joint ventures, shared savings program benefits for value-based care, and other forms of passive income generation? How are non-financial terms navigated, including things like pathway to partnership/partnership criteria, restrictive covenants and noncompetes? How quickly did the last new spine surgeon build his/her practice? What resources are available to support a surgeon building his/her practice? Has any spine surgeon ever le the group and why? Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): Albeit most individuals are reluctant or even unwilling to readily disclose such misfortunes, the unreliable poison of any practice or health system would be local or federal inquiries into concerns over noncompliance or fraud with healthcare regulations. Any governmental agency investigating a practice for such allegations usually signals unsavory circumstances, bodes unwell prospectively, and may signal desperation by the hiring entity. Forbidding behavioral issues such as infighting and tedious negativity should also be analyzed and pursued with caution. Economically, the red flags could be many, like excessive voids, adjustments or modifications to accounts receivable most likely represent issues and should trigger hesitance prior to scrutiny by a reputable accountant. n Northwell adds 4-physician neurosurgery practice By Carly Behm N euroCare Long Island in West Islip, N.Y., joined New Hyde Park, N.Y.-based Northwell Health, Long Island Business News reported April 11. The practice, which has four neurosurgeons, will perform cases at South Shore University Hospital in Bay Shore, N.Y., the report said. Kevin Mullins, MD, was named co-chair of neurosurgery at the hospital. Salvatore Zavarella, DO, is now vice-chair of neurosurgery at the hospital. n 'These are crazy times': Orthopedics' biggest disruptors By Riz Hatton e orthopedic industry is constantly changing. Two orthopedic surgeons connected with Becker's to answer, "What is disrupting orthopedics?" Note: ese responses have been lightly edited for length and clarity. Traci Granston, MD. Vice President of MSK Clinical Strategy at Cohere Health: Intelligent prior authorization is disrupting orthopedics. Forward-thinking health plans are investing in intelligent prior authorization solutions that drive cost savings and better musculoskeletal outcomes while reducing provider abrasion and administrative burden. As an orthopedic surgeon of 20+ years and the vice president of MSK clinical strategy at Cohere Health, I'm fortunate to be able to bring my passion for patient care into the critical work we're doing to improve the prior authorization process for patients and their physicians. We've seen significant results, like a 43% reduction in medically unnecessary arthroscopies and 92% provider satisfaction. What's more, Cohere's partnership with the American Academy of Orthopaedic Surgeons further enhances access to high-quality, data- driven care by tapping into complementary cutting-edge tech and clinical expertise, respectively. Philip Louie, MD. Spine Surgeon at Virginia Mason Franciscan Health (Tacoma, Wash.): 1. Nontraditional healthcare ventures entering the healthcare space (ex. Amazon, Best Buy, Costco, Uber, etc.). ese are crazy times! Various economic forces are driving consumers (and in this case, patients) to change some of their fundamental behaviors. With inflation rates at all-time highs, Americans have started shiing more of their budgets away from goods and toward services — especially healthcare. Health spending, which is projected to reach $5.2 trillion nationally by 2025 (according to CMS) — has become an alluring growth avenue for many large retailers. From the healthcare provider perspective, the ideal situation may be flexible. Although U.S. healthcare largely continues to operate in a fee- for-service model, many of the investments by the big retailers are emphasizing value-based care — which theoretically could lead to a concentrated focus on prioritizing preventive care. Furthermore, the additional capacity and focus on in-home, specialty and primary care could not only improve access for underserved patients and those with limiting social determinants but could also help further advance pay-for-performance (outcomes) over fee-for-service (volume), adding fuel to the quality versus quantity conundrum.

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