Becker's Spine Review

29 Becker's ASC 22nd Annual Meeting - The Business and Operations of ASCs – Call (800) 417-2035 spine tumor surgeries. With their tremendous exposure and hands-on ex- perience during their training, our residents and fellows will be prepared to manage complex spinal pathology from day one in their practice. In terms of research, my goal is to develop translational research to improve treatments of spine tumors, spinal deformity and spinal cord injury. I hope to advance our research endeavors in chordoma treatment, spinal cord injury repair and spinal application of stem cell at USC. In addition, because of my passion for spinal oncology, I strive to develop a top-notch multidisciplinary spine tu- mor program in Southern California. Ultimately, I aim to improve the treat- ment outcome and quality of life for our spine tumor patients. As an academic neurosurgeon and spine surgeon, I believe that I can impact the future of spine care for patients through education and research. ere- fore, my long-term personal career goal is focused on cultivating education and research for spine treatment at USC. rough our residency and spine fellowship programs, I want to help to train neurosurgeons and orthopedic surgeons to become future leaders in spine surgery. Dr. Kube: In a single word — more. Specifically, we do strategically plan for the near and distant future. In the short term, we are focused on the ramp up of an additional satellite office location. We are also giving attention to our recently hired — six months ago — spine surgeon, Dr. Ahmed Mohamed, who primar- ily serves patients at our Southern Illinois location. He has been steadily add- ing to the geographical footprint we started when the location was a part-time satellite clinic. He is already becoming busy. We hope to further refine as well as expand the services we provide there. We are also in the process of recruit- ing another physician to assist with our current volume at our main office in Peoria. ose are our main goals for the next six to12 months. With respect to longer term goals, some of the shorter term goals do spill over into the longer term. We intend to continue our model of expanding regionally through satellite creation, physician hire and the evolution of sat- ellites into a full-time presence. We are also refining contracts with payers. Although it is also a short-term goal, we see it taking some time, working with the payers to help them understand bundled payments and how we cre- ate value for their insured lives by taking surgical cases from the hospital environment to the ambulatory setting. ere are certainly a lot of additional specific ideas, but these are the most pressing ones that regularly appear dur- ing conversation with management. n 5 Key Notes on Adult Spinal Deformity Patient-Reported Outcomes By Laura Dyrda A new study published in Spinal Deformity examines patient-reported outcomes for adult spinal deformity. e study authors examined 84 patient reported outcomes studies on adult spinal deformity from 2004 to 2013. e researchers found: 1. Patient-reported outcomes studies published increased from one in 2014 to 16 in 2013. ere were 24 unique PRO studies. 2. e most frequently used instruments were: • Oswestry Disability Index: 47.8 percent • Scoliosis Research Society-22: 35.6 percent • SRS-24: 21.1 percent • Short Form-36: 13.3 percent • Visual analog scale: 13.3 percent 3. e level of evidence was most oen four — 42.9 percent of the time — and there weren't any level one studies on patient- reported outcomes for adult spinal deformity. 4. In around 16 percent of the articles using ODI, there were in- complete preoperative and postoperative PRO scores; the same was true for 58 percent of articles with SRS-24 and 22 percent of articles with SRS-22. 5. e article authors concluded that while the research increased over the past 10 years, the quality and standardization are still lacking. e only instrument routinely used for cost-effective- ness studies was the SF-36. n Supreme Court Keeps ACA Exchange Subsidies Intact — 5 Things to Know By Laura Dyrda e Supreme Court ruled nationwide tax subsidies for health insurance ex- changes are here to stay, according to a report from e New York Times. e Supreme Court has been deliberating on King vs. Burwell for the past several weeks, deciding whether tax subsidies given to poor and middle class enrollees were allowed for federally-funded exchanges in addition to state-run exchanges. Here are five things to know: 1. e Supreme Court justices voted in a six-to-three decision to allow the subsidies for all exchanges, not just the state exchanges. In the Patient Pro- tection and Affordable Care Act, the language says subsidies are available to people purchasing on "an exchange established by the state." 2. Chief Justice John G. Roberts Jr. wrote the majority opinion. e three dissenting judges were Justices Antonin Scalia, Clarence omas and Sam- uel A. Alito Jr. In his opinion, Chief Justice Roberts wrote, "In this instance, the context and structure of the act compel us to depart from what would otherwise be the most natural reading of the pertinent statutory phrase." 3. In voting to maintain the subsidies, Chief Justice Roberts wrote the ACA was passed to improve health insurance markets and interpreted the legisla- tion as such. President Obama's lawyers argued Congress didn't intend to limit subsidies when passing the ACA. 4. More than 6 million people currently have insurance on the marketplace, and removing the subsidies would have impacted many of those people. Around 85 percent of the customers using exchanges qualify for subsidies. 5. Several stakeholders rallied around keeping the subsidies, and aer the decision hospital companies saw share prices soar; Tenet Healthcare shares were up 8.8 percent and Community Health Systems shares went up 8.5 percent, according to a Reuters report. n

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