Becker's Spine Review

Becker's Spine Review November 2015

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46 Whistle-Blower Physician: 'We Have Got to Get Hospitals Out of the Business of Hiring Doctors' By Ayla Ellison F ort Lauderdale, Fla.-based Broward Health, formerly North Broward Hospital District, agreed to pay $69.5 million last month to settle allegations brought by Michael Reilly, MD, and the Department of Justice in a federal lawsuit. Dr. Reilly claimed the system violated the False Claims Act by engaging in improper financial relationships with physi- cians. Although Dr. Reilly's action was against Broward Health, he claims health systems across the country have the same problems. Dr. Reilly told Kaiser Health News the issue begins with the growing trend of hospitals employing physicians. "We have to get hospitals out of the busi- ness of hiring doctors," Dr. Reilly told Kaiser Health News. "It's potentially detrimental to the patient, and it's terrible for healthcare." Dr. Reilly was offered an employment deal with Broward Health, but he rejected the offer aer his lawyer told him it was illegal. In his lawsuit, which was originally filed in 2010 and unsealed last month, Dr. Reilly claims the system carefully tracked the value of physician referrals and pressured physicians to increase referral volume when they lagged. In addition to fostering an environment to motivate physi- cian referrals, the employment trend "blunts physician innova- tion, discovery and ingenuity," Dr. Reilly said. e Broward Health settlement is just one of more than a dozen Stark Law cases the DOJ has settled in the last two years. Just a week aer Broward Health settled with the DOJ, Altamon- te Springs, Fla.-based Adventist Health System agreed to pay $118.7 million to the federal government and to the states of Florida, North Carolina, Tennessee and Texas to settle allega- tions it violated the False Claims Act and Stark Law by main- taining improper compensation arrangements with referring physicians. n High vs. Low Volume Surgeons for Scoliosis Procedures: 5 Key Notes By Laura Dyrda A new study published in Spinal Deformity examines the outcomes variation between high volume and low volume surgeons performing scoliosis correc- tion. The researchers conducted a retrospective analysis of adolescent idiopathic scoliosis patients from the New York State Inpatient Database for cases between 2008 and 2011. The researchers also took hospital and surgeon volumes into account. There were 3,928 primary fusion operations included in the study. The researchers found: 1. There was a 7.1 percent reoperation rate after the initial spinal fusion for adolescent idiopathic scoliosis. 2. The surgeons who performed less than six AIS fusions per year were considered low volume and had a 14.1 percent reoperation rate. 3. The high volume surgeons — those who performed 43 to 228 cases per year — had a 5.1 percent reoperation rate. 4. The study authors concluded, "Early reoperation after spine fusion for idiopathic scoliosis is seen more frequently in lower volume institutions and surgeons." 5. Limiting scoliosis correction to high-volume surgeons could prevent future reoperations and associated risks for the patients as well as high costs for procedures and hospi- tal stays in the future. n "We have to get hospitals out of the business of hiring doctors. It's potentially detrimental to the patient and it's terrible for healthcare." — Michael Reilly, MD, Fort Lauderdale

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