At the 20th Annual Spine, Orthopedic + Pain Management-Driven ASC Conference, attendees gathered to explore the implications of value-driven care for surgeons and their practices.
The panelists for the session, “What Surgeons Need to Thrive With Value-Driven Care” included Terrence T. Crowder, MD, Orthopedic Spine Surgeon from Sonoran Spine Center; Brenton Pennicooke, MD, Assistant Professor of Neurological Surgery and Orthopedic Surgery from Washington University St. Louis; and Matthew Gee, Chief Executive Officer of Gulf Coast Surgical Partners.
Alan Condon, Editor in Chief of Becker's Healthcare, moderated the panel.
Key Takeaways:
1: Current bundled payment models do not consider important factors like a patient's health and age.
The panelists pointed out that bundled payment models have limitations, as they do not take important factors into account. This means that care providers may not get reimbursed appropriately for their work.
2: Models should be adapted to consider patient complexity and quality of care.
The panelists suggested that models should be adapted to include factors such as patient complexity and quality of care in the reimbursement process. This would allow centers that handle complicated cases with high quality care to receive a premium for their services.
3: Successful bundled payment models require direct negotiations with employers and payers.
The panelists discussed the challenges of negotiating with insurers and the success they have had by going directly to employers for bundled payment models. By working directly with employers and payers, care providers can ensure that they are adequately reimbursed for their services.
4: Some hospitals rely on costly marketing strategies to stay relevant in their markets.
The panelists noted that hospitals in Arizona compete against each other and must spend substantial funds on marketing to stay visible online. This may have negative implications for patients who end up paying for these marketing costs indirectly.