Becker's ASC Review

18 ORTHOPEDICS Why orthopedic care hasn't become easier By Carly Behm P ressures related to payers and overhead have made maintaining an orthopedic practice increasingly difficult, says Matthew Harb, MD of e Centers for Advanced Orthopaedics in Washington, D.C. Dr. Harb spoke with Becker's about how he's approaching these challenges. Note: is conversation was lightly edited for clarity. Question: What's become easier about running your practice in recent months? What remains a challenge? Dr. Matthew Harb: It has become very hard to talk about things that have gotten easier, and the biggest reason I say that is because physician reimbursement for office visits as well as for procedural reimbursement continuously declines. Running a practice depends entirely on resources, which directly impact efficiency. Efficiency is based on resources. How many patients you can see in a certain amount of time depends on how much ancillary staff you can hire to assist you along the way. So when you're in a constant state of decreasing reimbursement increasing overhead, everything becomes more challenging. Q: How are you approaching those challenges? MH: We're trying to maintain the current rates that we have. Our practice is unique in that we've combined with other private practices to allow us to have a little bit more leverage when it comes to negotiating. But as these pay cuts come in, it becomes more challenging. As Medicare reimbursement decreases, the private insurers follow. So typically, private insurers will reimburse more than Medicare, but that declines as well. en if you look at staff salaries, office equipment costs, billing expenses, office rent and injection medications, all of these costs are rising. So in order to try to maintain the same amount of revenue, you have to see more patients in a shorter amount of time, and ultimately that takes away a little bit from patient care or trying to create a very nice patient experience. Q: How are you thinking about recent concerns with tariffs and medical supply costs? MH: I think everyone's trying to figure that out. One major concern for us, across multiple locations, is the potential rise in costs for durable medical equipment, braces and office supplies. We haven't directly seen that yet. en, on the hospital and surgical center side, costs for equipment like drapes, surgical instruments and medications could potentially increase. But I can't say we've seen any of that quite yet. I think it's still too early to tell or make predictions along that line, as far as what will happen. If supplies become too expensive from one source or from an international source, then it may make more sense to look locally. But items and equipment come from various sources, and at the end of the day, patient safety comes first. We obviously want to try to maintain a low overhead in any areas we can safely do that. Time will tell what effect tariffs will have on us. n Healthcare consolidation should be a 'net benefit': Dr. Matthew Lavery By Carly Behm T he healthcare landscape is trending toward consolidation amid small practices, and leaders should stay mindful about how the benefits of those moves will support patients, Matthew Lavery, MD, said. Dr. Lavery, president of Indianapolis-based OrthoIndy, discussed the healthcare trends he's watching in 2025. Note: This conversation was lightly edited for clarity. Question: What orthopedic trends that you're following closest? Dr. Matthew Lavery: One of the things I'm continuing to monitor really closely is the sense that we're moving more towards site neutral payments and orthopedics. I think it's a continued challenge for everybody. I think it may be a larger challenge for hospitals that have separate certifications and legal requirements to maintain their status as hospitals.There may be some benefits to those people who are in the ASC world, and there may be some challenges that people who are in the hospital world face, and currently with us structured as a hospital, that's that's something we have to keep our eye on really closely. So we'll continue to follow and monitor that. The things that don't ever change are focused on providing excellent patient care. What is the experience a person wants from start to finish? The other big trend that we all follow is consolidation in healthcare. I think [OrthoIndianapolis is] an example of trying to find a way to make consolidation and increased size a net benefit to the people we serve. I think there are always questions in the mind of the general public as to whether consolidation is beneficial, but it's the reality of the world we live in. In healthcare, if you look around, you really don't see a lot of private practices in existence anymore. They have to compete with large health systems who have a little bit of a different playing field. They have a little bit of a running head start in some ways, whether it's their tax advantage status or whether it's their size. When they go to negotiate contracts with payers, that's very different from small-to-midsize practices. I'll certainly be watching for the benefits of that consolidation to the end user, and how we can make sure that we're trying to capitalize on as many of those benefits as possible. If we're growing in size we want to make OrthoIndiana a more robust institution that long term, can continue to provide a different perspective and opportunity for patients versus just going to a large system. Being physician-owned, we all have a lot of skin in the game, because we want the place we work to be the type of place that our family members and friends would want to come to. n

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