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12 SPINE SURGEONS Private Practice in Spine Surgery: Key Challenges & Opportunities from Dr. Scott Blumenthal By Laura Dyrda S cott Blumenthal, MD, co-founder of the Center for Disc Replacement Tex- as Back Institute in Plano, discusses big challenges and opportunities for private practice spine surgeons today. Question: What are the biggest chal- lenges for spine surgeons running their own practices today? Dr. Scott Blumenthal: It's becoming more difficult for spine practices to achieve approv- als from third-party payers to appropriately treat their patients. is creates difficult challenges for practices, because it increases the work load on team members securing authorizations, patients get frustrated as they work through the insurance approval process and providers find themselves trying to do the right thing for patients while also meeting the insurance company criteria. Overall it is more costly, cre- ates barriers to the surgeons receiving payment and is not efficient for the treatment of the patient. Additionally, the cost of running a high-quality clinic continues to increase, while the revenue generated from performing professional services decreases. Q: What are the best practices doing today to ensure suc- cess going forward? SB: e practices that will thrive are ones which will garner multiple sources of income in ancillaries. Surgeons who have deliverable ser- vices will receive professional fees and can receive additional income from their ownerships in ASCs or other surgery hospital opportuni- ties. is has become a strong strategy for many practices to provide multiple sources of revenue. Also, practices have the capability of tracing outcomes data to help them create surgical registries. is data gives practices the ability to negotiate bundled payment contracts based on their outcomes. n How Spine ASCs Fit Into the Future of Healthcare: Key Thoughts from Dr. Anthony Yeung By Laura Dyrda A nthony Yeung, MD, founder of Desert Institute for Spine Care in Phoenix, discusses his thoughts on how spine surgery will evolve over the next five years. Question: How do you see spine evolving in ASCs over the next five years? How will it change and how will it stay the same? Dr. Anthony Yeung: Current escalation of costs by health- care stakeholders and patient demand cannot be sus- tained. ASCs are currently the most cost efficient way to stem the rising cost of surgery and nothing is free, so re- sults have to match the cost and efficacy of the treatment for a given timeframe. The future hopefully will be less regulation by President Trump and HHS Secretary Tom Price to allow ASCs to com- pete in a free market by being more efficient and effective in the delivery of healthcare. Multidisciplinary ASCs with surgeons in charge of procedure privileges at the ASC may ensure appropriateness and quality since the provider en- tity is at risk financially. Let regulations help ASCs with incentives to develop sur- gery recovery centers affiliated with the ASC, thus making it safer for outpatient procedures that offer routine postop monitoring and pain control, ie., known postop risks such as postop breathing difficulty from obstructive airway com- plications. Patients must be able and willing to pay for their care when not covered by their insurance plans. Q: What opportunities are there for spine surgeons to expand their outpatient ASC and practice? AY: They will have to provide service and care more effi- ciently than competing entities, like hospitals, but also be able to deliver better results, not just do it cheaper. Q: What do spine surgeons need to know about payers and reimbursement for their procedures in ASCs? AY: It is a moving target. Payers will continue to reduce reimbursement, and will likely be able to do so until the surgeons and providers learn to play the game, thus in- creasing the costs even more. This is not a good time to be in healthcare when a doctor can no longer be able to do what they are trained to do. n Dr. Anthony Yeung Dr. Scott Blumenthal