Becker's Spine Review

Spine Surgeon Leadership 12 "The growing pains around EMR have been monumental," says Dr. Finkenberg. "Over the next five years, the administrative burden will be difficult but once the EMR are in place and the systems are able to talk to one another and share medical information, we'll spend less time on administrative issues and more time with patient care." 5. Lower Medicare, private payer rates leave solo practitioners behind. Solo practitioners in many specialties have joined larger practice organizations or become hospital employed because reimbursement has been cut too low to cover overhead expenses. "I think this trend will decrease access for this enlarging group of patients coming down the pipe," says Dr. Finkenberg. "Many physicians have decided that because of the issues with Medicare, they will opt out or consider limiting the number of Medicare patients they see per day. Some government studies say this doesn't occur, but in real life these changes are happening. Nobody wants to punish Medicare beneficiaries, but financial constraints on your practice mean you might not be able to treat a certain sector that isn't profitable because otherwise you'd go out of business." Several physician advocacy groups are working to repeal the Sustainable Growth Rate and devise a better physician payment system. Spine surgeons must stay educated about changes in Washington and advocate for policies that will allow their patients access to spine specialty care. "I think it's really important for physicians to stay on top of current legislation," says Dr. Finkenberg. "The advocacy committee at NASS sends out informative email alerts to let people know what is happening and how they can get involved to help their patients and practices. All we want is to give the best quality care to the most people possible." 6. Proliferation of accountable care organizations. Healthcare providers around the country are trialing new payment models, including accountable care organizations. Physician specialists can currently participate in multiple ACOs, but new legislation could limit that in the future. "The government is thinking of only allowing specialists to align with single ACOs and I know that will create huge access problems," says Dr. Finkenberg. "We are trying very hard to keep it open so specialists can service several ACOs without litigation and legal issues in this arena. Only signing up with one ACO would be a huge stressor on the access system." Spine surgeons interested in supporting these advocacy efforts can contact their representatives directly and speak with them about these issues. "I meet with Congressmen and ask what the number one thing I can do to influence how they look at these issues and vote on legislation, and 100 percent say meeting them face-to-face has the biggest impact," says Dr. Finkenberg. "It takes time away from your patients and practice, but it's crucial. Unless you keep on the front lines of the issues, it's a guessing game as to how policy will turn out." 7. More patients with comorbidities need spine care. Comorbidities such as being overweight or chronic illness are more prevalent in the past and prevent them from being surgical candidates for traditional procedures. However, more of these patients may now have access to advanced spine care with minimally invasive techniques. New devices and tools allow surgeons to broaden the potential patient base. "There continues to be advances in surgical techniques as well as new devices and tools created by surgeons in partnerships with industry," says Dr. Goldstein. "This expands treatment options for patients. Additionally, research is driving new minimally invasive techniques, motion preservation and better outcome studies for more traditional approaches." n YOU CANNOT AFFORD TO LOSE MORE REVENUE! Call the Expert in Revenue Optimization Billing | Coding Coding Reviews Managed Care Contracting Revenue Cycle Audits Fee Schedule Analysis Providing Custom Solutions Experts in Customized Revenue Optimization www.smpsd.com | 605.444.8207 | info@smpsd.com

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