Issue link: https://beckershealthcare.uberflip.com/i/293049
15 Sign up for Becker's Orthopedic, Spine Business & Pain Management E-Weeklies at www.BeckersOrthopedicandSpine.com or call (800) 417-2035 Dr. Watters discusses plans for his term as presi- dent and the key issues for spine surgeons today, including evidence-based medicine, healthcare reform and reimbursement. Q: What key initiatives will NASS focus on over the next year? Dr. William Watters: NASS will be piloting its spine registry this year. This registry will be diagnosis-based and will allow collection of data across a spectrum of spinal care. Increasingly, in- surers are looking for practitioner participation in registries as one metric for value-based pay- ment systems and this will be a potential benefit for our membership. It will also be a rich source of research and education for NASS in the areas of outcomes and comparative effectiveness. Secondly, NASS is issuing evidence-based, expert derived coverage statements on nearly 30 dif- ferent spinal treatments over the course of this year to better inform payers of the current state of spinal care and the appropriate use of these treatments. These coverage statements argue for reimbursement for spinal care, based on both evidence and the opinions of world experts in these treatments and can be used by both NASS and the NASS membership to fight against de- nial of appropriate care for our members and their patients. Q: Where are the biggest opportunities for growth in evidence-based medicine in spine? Where do you think spine surgeon researchers should focus their efforts? WW: First of all, it is important to understand that evidence-based medicine is a means of evalu- ating the strength and reliability of data in clinical research; that is in research on the diagnostics and treatment outcomes in human beings. EBM does not apply to laboratory research such as animal studies or to the materials R&D that goes into de- veloping spinal implants. With that in mind, I feel the biggest opportunity for growth in EBM is in utilizing the technology of this discipline to prove the value of treatments we employ. In addition, by systematically combining the results of this research with the input of expert opinion where gaps in the research database exist we can use EBM to extend even further good spi- nal care. This is the process modified and utilized by NASS (developed by the RAND Corporation) in its Appropriate Use documents now being pub- lished that provide much more usable clinical in- formation for our members in making treatment decisions than the traditional EBM guidelines. Q: Healthcare reform will continue imple- mentation this year. What are the biggest challenges for spine surgeons related to healthcare reform changes? WW: To be frank, the way it has been rolling out, it is hard to be specific. Surprises keep popping up and implementation dates prolonged making the entire situation fluid as we discuss this. But some very significant trends are clear and they almost Evidence-Based Medicine, Healthcare Reform & Reimbursement in Spine: Q&A With NASS President Dr. William Watters (continued from cover) Dr. William Watters