Issue link: https://beckershealthcare.uberflip.com/i/170079
46 Sign up for Becker's Orthopedic, Spine Business & Pain Management E-Weeklies at www.BeckersOrthopedicandSpine.com or call (800) 417-2035 8 Thoughts on How President Barack Obama's Re-Election Impacts Spine Surgery By Laura Miller E ight leading spine surgeons discuss how President Barack Obama's reelection will impact spine surgery and what spine surgeons can expect from the Patient Protection and Affordable Care Act in the future. Andrew Cordover, MD, Andrews Sports Medicine and Orthopaedic Center, Birmingham, Ala.: The re-election of President Obama will have many effects on the healthcare industry, surgeons and spine care. One of the main concerns I have as a healthcare provider, particularly in the area of spine care, is providing care for an older population under the evolving yet troubled Medicare system. President Obama has defended the program and I hope, as a surgeon, that he can help build up the Medicare program to better serve the aging population in this country. Another change that will come from President Obama's re-election includes reforming unresolved issues that affects both patients and surgeons. For patients, this includes better access to quality care, healthcare coverage and affordable prescription medication. For surgeons, one of the main issues is finding a way to provide better care to an aging population at a reduced cost. This includes finding a solution to strenuous approval processes for patient care and reimbursement. A patient should never wait for vital care because it must go through an approval process. Moving forward, Republicans and Democrats need to work together to create a patient-based system that makes access to care easier for those who need it the most. Thomas Errico, MD, President, International Advocates for Spine Patients: What's clear is that the re-election of President Obama ensures the ongoing implementation of the Affordable Care Act (ACA). Some of that is good (elimination of pre-existing condition exclusions, elimination of lifetime benefit caps, inclusion of tens of millions of people into the healthcare system), and some of that is bad (the unchecked power of the Independent Payment Advisory Board, the uncertainty around guaranteed benefits in state health exchanges, and declining physician reimbursements). What's unclear is how the ACA can simultaneously expand access to care for millions of people while purportedly controlling costs. It seems that to significantly control costs, something has to give. Will they reduce physician reimbursement? No one seems to be in any hurry to sign up Today Stay updated on the latest news, trends and business concepts for spine surgeons and practices Spine Business E-Weekly Sign up today for our Spine Business Review E-Weekly at www.beckersorthopedicandspine.com scrap the flawed Medicare Sustainable Growth Rate, which means Medicare reimbursement will decline 27 percent next year. Will they cut costs for drugs, devices and hospital care? Those things are clearly on the chopping block. In the short term, the device tax and the implementation of the Independent Payment Advisory Board will adversely impact investment into innovative technologies, and likely curtail physician reimbursement. Those two elements do not bode well for spine surgeons and their patients. Our organization — International Advocates for Spine Patients — remains vigilant to ensure that implementation of the ACA does not unnecessarily restrict patient access to medically indicated spine surgeries, nor unduly dis-incentivize investment in innovative and life-improving medical technologies. Brian R. Gantwerker, MD, Spine Surgeon, The Craniospinal Center of Los Angeles: With this election, we as physicians cannot close our eyes and hope the Affordable Care Act will go away. We need to catch up with what we should have been doing since its passage — which is figure out how we can stay viable and continue delivering quality care. Regardless of whether or not you voted for the President, we have to operate within this new framework. I think three things now need to be done: 1) Create a coalition of spine surgeons and pain specialists; 2) Come up with a plan regarding how we want to remain independent practitioners and NOT hospital employees; 3) Secure our reimbursement security through lobbying and our spine and pain management coalition. We are antiquated in our dogmatism. It's time to wake up, create a plan and ACT. Steven Garfin, MD, International Society for the Advancement of Spine Surgery President: The re-election of President Obama has potentially both positive and negative implications for spine surgeons. His re-election virtually insures that the Affordable Care Act (ACA) will not be repealed anytime soon, and that means millions more Americans will have insurance and be able to pay for necessary healthcare, including preventive services, and surgical and non-surgical treatment of acute and chronic conditions. Additionally, the ACA promises an environment where administrative costs and hassles of dealing with insurers will be reduced. Finally, surgeons have an opportunity to play a leading role in new delivery systems to improve care and reduce costs, including accountable care organizations and state-based health exchanges. It is also theoretically more likely that President Obama will protect public investments in medical research and public health, which will ultimately lead to an improved environment for innovation and emerging technologies that can improve patient lives. On the negative side, the ACA contains provisions that may be beneficial to the overall population while punitively punishing the needs of individual patients. For example: an increased focus on, and massive funding of, comparative effectiveness research that draws large, population-based conclusions may reduce or eliminate a surgeon's ability to treat an individual patient based on that patient's specific needs, desires and values.