Becker's ASC Review

43 ORTHOPEDICS TOTAL CEO compensation for 8 spine, orthopedic device companies By Laura Dyrda C EOs of medical device company giants routinely make seven-figure salaries, with total compensation reaching even higher when bonuses and stock awards are included. Here are the 2016 salary and total compensa- tion statistics for the CEOs of major device companies in the orthopedic and spine space. Alex Gorsky. Chairman and CEO of Johnson & Johnson Salary: $1.6 million Total compensation: $21.2 million Omar Ishrak. Chairman and CEO of Medtronic* Salary: $1.6 million Total compensation: $15.4 million Kevin Lobo. Chairman, President and CEO of Stryker Salary: $1.1 million Total compensation: $12.8 million David Dvorak. Former President and CEO of Zimmer Biomet Salary: $1.1 million Total compensation: $10.6 million Mr. Dvorak was replaced by Daniel Florin in July 2017. Gregory Lucier. Chairman and CEO of NuVasive Salary: $800,000 Total compensation: $6.1 million Bradley Mason. President and CEO of Orthofix Salary: $705,576 Total compensation: $4.8 million Eric Major. President and CEO of K2M Salary: $525,000 Total compensation: $2.9 million David Paul. Chairman and CEO of Globus Medical Salary: $430,000 Total compensation: $1.7 million *based on proxy statements filed for 2017 fiscal year n 'An unprecedented amount of confusion' — Orthopedic society criticizes CMS for TKA final rule By Eric Oliver T he American Association of Hip and Knee Surgeons recently issued a position statement on the 2018 Medicare Outpatient Prospective Payment System rule that removed total knee arthroplasty from Medicare's inpatient-only list. The society noted while CMS removed TKA from the inpatient-only list, the agency did not allow the procedure to be performed in freestanding ASCs, which denotes a desire to move slowly concerning TKA. The society be- lieves CMS expected a large majority of TKA procedures would continue to be performed in an inpatient setting. "Unfortunately, the unintended consequence of this change has been an unprecedented amount of confusion on the part of a variety of stakeholders regarding how to interpret this new rule. Hospitals, surgeons, and payers are interpreting the rule from different perspectives and as such are each coming to very different conclusions," the society said in a statement. Confusion is apparent when billing for the procedure. A reinterpretation of the two-midnight rule is creating confusion because CMS treats some cases spanning less than two midnights as inpatient procedures, if a patient's record contains documentation of need. Traditionally, a case is inpatient if a patient stays for more than two nights. The society believes the current rule is being misinter- preted by parties requiring documentation of medical need. Documentation of medical need is not required in all cases, but it is in select cases. The society also chastised pressure placed on physicians to make outpatient the default designation for a patient prior to surgery, especially in cases where one midnight for recovery is sufficient, but the patient is "clearly not [an] acceptable outpatient candidate." AAHKS issued three pillars of guidance for its members: 1. Expect the vast majority of patients to be treated, by default, as inpatient. The group argues, "The physiology of patients did not change, nor did the standard of care, from December 2017 to January 2018." 2. Hospitals, physicians and payers should agree the burden of proof is on the physician to state what criteria are present that suggest inpatient resources should not be utilized. 3. AAHKS encourages its members to use outpatient des- ignation when doing so will not increase adverse event risk. "Consequently, AAHKS would encourage its members to only utilize an outpatient designation for a patient when doing so does not pose the risk of making the occurrence of, or failure to detect, such an adverse event more likely." n

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