Becker's Spine Review

35 PRACTICE MANAGEMENT SPINE DEVICE & INNOVATION HEALTHCARE REFORM MedPAC Proposes Eliminating ASC Payment Updates in 2017: 5 Key Notes By Laura Dyrda T he Medicare Payment Advisory Commission may eliminate payment updates for ambulatory surgery centers next year, according to an ASCA report. Here are five key notes: 1. MedPAC approved a recommendation to eliminate ASC payment updates in 2017 as well as recommendations that ASCs report cost data. 2. While eliminating ASC payment updates, MedPAC recommended updating inpatient and outpatient hospital payments in 2017, projected at 1.75 percent. 3. For 2016, CMS updated the annual payment by the percentage increase in the Consumer Price Index for all urban consumers. The update was 0.8 percent with a multifactor productivity adjustment at 0.5 percent. The MFP-adjusted CPI-U update factor was 0.3 percent. The rate increase was less than HOPDs, but more than the MedPAC proposed rate increase of 0 percent. 4. Beginning in 2016, CMS excluded codes for services provided on the covered ancil- lary services list that aren't provided ancillary and integral to a covered ASC surgical procedure. The codes removed included SRS treatment services CPT codes. 5. At this point, MedPAC's recommendations aren't binding on Congress. HHS and Congress's final decisions on payment are typically released in the fall and could differ from MedPAC's recommendations. n Sagittal Alignment Data at Your Fingertips Vertebral Motion Analysis (VMA) lets you assess spinal motion and sagittal alignment with one straightforward test. No long-film x-rays. No mark-ups. No additional work. Learn more at orthokinematics.com *Vertebral Motion Analysis () uses device-assisted bending during fluoroscopic imaging combined with cloud-based image-processing to assess intervertebral motion, instability, and alignment. Sagittal alignment measurements are obtained via the OrthoView software (K -€€‚ƒ). C O M I N G T O S E L E C T I N S T I T U T I O N S I N M A R C H 2 0 1 6 still being defined. Biologics for fusion is another area of growth and we may expect to see new products available for fusion technology. Samuel Cho, MD, Associate Professor of Orthopedics, Assistant Professor of Neurosurgery, Ichan School of Medicine at Mount Sinai, New York: I think there are several exciting devel- opments that are coming our way in the spine world in 2016. Minimally invasive surgery continues to evolve with better imaging and instrumentation. We still need to work out the details of whether MIS can achieve the same goals as con- ventional open procedures, but I remain optimistic that we can get there in the next few years. Biologic bone gra sub- stitutes continue to receive attention. We need more osteoinductive options than rhBMP-2 and several companies are working on this. Outcomes and cost-ef- fective studies are important to prove and justify the value of spine surgery to the payers, the government and, most importantly, to our patients. n

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