Here are three trends for successful surgery centers.
1. Money may lie in co-management arrangements. John Cherf, MD, president of OrthoIndex, predicts more physician groups — and particularly orthopedic physician groups — will work with hospitals to manage service lines. "The way things are going right now, hospitals are going to enter their own period of negative reimbursement pressure. Hospitals want orthopedic surgery, and they may compete for physician loyalty in the form of co-management arrangements," he says. Physicians could be paid to co-manage a service line through a typical medical directorship. However, this requires management skills that not all physicians have. While Dr. Cherf predicts an overall migration toward co-management of service lines, he says physician practices should be wary of appointing leaders who are more suited to clinical duties.
2. Rise of accountable care organizations. ACOs are already starting with private payors and are due to begin for Medicare patients in 2012. In theory, ACOs should seek out surgery centers as the low-cost, high-quality alternative. But Saul Epstein, co-administrator of ParkCreek Surgery Center in Coconut Creek, Fla., predicts ASCs could turn out to be a cost center for ACOs. "When an ACO is paid a lump sum for a patient's care, surgery will be seen as a cost center," he says. Mr. Flower thinks ACOs require different mindset than ASCs are used to. While an ACO will be concerned about the entire continuum of care, the ASC is used to focusing on one single niche, he says.
3. Technology is trending toward minimally invasive techniques. An improvement in orthopedic technology has allowed for nearly all subspecialties to include minimally invasive procedures. In some areas, such as knee arthroscopy, the procedures are fairly common, while in others, such as spine surgery, the minimally invasive procedures are still relatively new. The trend toward minimally invasive surgery is a positive change for orthopedic surgeons because they are able to provide better outcomes for their patients, if the surgeries are done properly. "By doing spine surgeries through smaller incisions, there is less damage to the muscle and tissues," says Stefan Prada, MD, a spine surgeon with Laser Spine Institute in Tampa, Fla. He performs minimally invasive endoscopic spine surgery on his patients. "When you do smaller incisions, there has been shown to be less bleeding, less risk for infection postoperatively and quicker recovery time."
There have also been a several advances in joint replacement surgery which have been able to increase the longevity of the implant, reduce the risks of surgery and improve patient outcomes, says James J. Purtill, MD, an orthopedic surgeon at Rothman Institute in Philadelphia. Advancements in orthopedic and spine technology allow surgeons to provide better care for their patients than in the past. Surgeons can also take the lead in developing new technologies in several surgical areas, especially biologics, to improve the future of orthopedics.
1. Money may lie in co-management arrangements. John Cherf, MD, president of OrthoIndex, predicts more physician groups — and particularly orthopedic physician groups — will work with hospitals to manage service lines. "The way things are going right now, hospitals are going to enter their own period of negative reimbursement pressure. Hospitals want orthopedic surgery, and they may compete for physician loyalty in the form of co-management arrangements," he says. Physicians could be paid to co-manage a service line through a typical medical directorship. However, this requires management skills that not all physicians have. While Dr. Cherf predicts an overall migration toward co-management of service lines, he says physician practices should be wary of appointing leaders who are more suited to clinical duties.
2. Rise of accountable care organizations. ACOs are already starting with private payors and are due to begin for Medicare patients in 2012. In theory, ACOs should seek out surgery centers as the low-cost, high-quality alternative. But Saul Epstein, co-administrator of ParkCreek Surgery Center in Coconut Creek, Fla., predicts ASCs could turn out to be a cost center for ACOs. "When an ACO is paid a lump sum for a patient's care, surgery will be seen as a cost center," he says. Mr. Flower thinks ACOs require different mindset than ASCs are used to. While an ACO will be concerned about the entire continuum of care, the ASC is used to focusing on one single niche, he says.
3. Technology is trending toward minimally invasive techniques. An improvement in orthopedic technology has allowed for nearly all subspecialties to include minimally invasive procedures. In some areas, such as knee arthroscopy, the procedures are fairly common, while in others, such as spine surgery, the minimally invasive procedures are still relatively new. The trend toward minimally invasive surgery is a positive change for orthopedic surgeons because they are able to provide better outcomes for their patients, if the surgeries are done properly. "By doing spine surgeries through smaller incisions, there is less damage to the muscle and tissues," says Stefan Prada, MD, a spine surgeon with Laser Spine Institute in Tampa, Fla. He performs minimally invasive endoscopic spine surgery on his patients. "When you do smaller incisions, there has been shown to be less bleeding, less risk for infection postoperatively and quicker recovery time."
There have also been a several advances in joint replacement surgery which have been able to increase the longevity of the implant, reduce the risks of surgery and improve patient outcomes, says James J. Purtill, MD, an orthopedic surgeon at Rothman Institute in Philadelphia. Advancements in orthopedic and spine technology allow surgeons to provide better care for their patients than in the past. Surgeons can also take the lead in developing new technologies in several surgical areas, especially biologics, to improve the future of orthopedics.