4 predictions about outpatient spine in 2019

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Growth in the outpatient spine space isn't slowing any time soon, industry leaders say.

Four predictions from surgeons and executives in the space:

1. Christopher Summa, MD, spine surgeon at Santa Cruz, Calif.-based Sutter Health: "More and more spine surgeries will move to the outpatient setting. Numerous studies already show improved outcomes as well as reduced complications in those patients treated in the outpatient setting. This environment requires us surgeons to not only focus on appropriate patient selection, but also efficient surgical procedures. Additionally, increasing numbers of patients themselves are requesting minimally invasive outpatient spinal surgeries [from which] they can return home the same day."

2. Alexander Taghva, MD, of Orange County Neurosurgical Associates in Mission Viejo, Calif.: "The current area for biggest innovation [in spine], I believe, is still in providing devices and techniques more suitable for outpatient surgery. With the advent of more advanced surgical robotics, we may be able to do surgeries with high accuracy and minimal morbidity in safer, more cost-effective settings. The tools are currently present to provide high-level outpatient care. What we currently need is for insurers and CMS to modify the payment structures [for] physicians and facilities to reward them for high-quality care versus bigger surgeries."

3. Robert Bray, MD, neurological spine surgeon at Newport Beach, Calif.-based DISC Sports & Spine Center: "The insurance companies are a huge driving force for the outpatient spine surgery structure today; they want it. That wasn't the case when I built DISC 18 years ago because at that time insurers would not give us a participating contract. But now they are willing to play ball and actively help us make the move. From their point of view, they want a risk mitigation, a known outcome for the risk across their patient population. We are able to show insurers the data we've collected for the past 16 years, that by moving the case outpatient we can save them money."

4. Bill Stewart, area vice president of value-based purchasing of DePuy Synthes, a Johnson & Johnson company: "What we've seen with spine is that surgical procedures that are migrating outpatient, typically one- to three-level anterior cervical discectomy and fusion and discectomy, are moving outpatient. But lumbar spine is much slower to move outpatient. What we've seen with lumbar spine is a small number of sites are doing it. A lot of that is because it's capital intensive to do lumbar spine."

Want to share your thoughts on this topic? Contact Angie Stewart at astewart@beckershealthcare.com.

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