Ken Pettine, MD, founder of The Spine Institute and Loveland (Colo.) Surgery Center, gave a presentation titled "Everything You Need to Know to Successfully Perform Spine Surgery in an ASC" at the 9th Annual Orthopedic, Spine and Pain Management-Driven ASC Conference in Chicago on June 10, 2011. Dr. Pettine's goal for the future is moving 50 percent of inpatient spine surgeries into ambulatory surgery centers. For this to happen, Medicare must update guidelines so spine can be profitable in an ASC and more surgeons will need to build confidence in their ability to perform cases safely and efficiently in ASCs.
To move spine into outpatient centers, ASCs need the appropriate equipment, contracts and surgeons on board. To recruit spine surgeons, ASC administrators can present data about the safety and efficacy of spine in other ASCs and entice them through shared income. Insurance contracts for spine can be attractive to payors because implant carve-outs bill 10 percent over retail price while hospitals bill significantly higher. Surgery centers can gain an even higher return if they negotiate discounts with device companies.
In the 284 outpatient spine cases Dr. Pettine has performed, he reports no complications, although his ASC has a 23-hour convalescence center. He recommends ASCs start slow with less complicated cases, such as decompressions, and moving to the more complicated procedures from there. Spine surgeries performed at the hospital are a significant expense and surgeons stand to leave money on the table if they perform procedures there instead of an ASC, he says.
Related Articles on Spine Surgery:
Dr. Richard Hynes: Why a Spine-Focused ASC is Important for the Future of Minimally Invasive Spine Surgery
Dr. Joan O'Shea: How to Achieve Great Results for Spine Surgery in an ASC
Dr. Robert Nucci: Minimally Invasive Outpatient Lumbar Fusions and Multi-Level Outpatient Cervical Disc Replacements
To move spine into outpatient centers, ASCs need the appropriate equipment, contracts and surgeons on board. To recruit spine surgeons, ASC administrators can present data about the safety and efficacy of spine in other ASCs and entice them through shared income. Insurance contracts for spine can be attractive to payors because implant carve-outs bill 10 percent over retail price while hospitals bill significantly higher. Surgery centers can gain an even higher return if they negotiate discounts with device companies.
In the 284 outpatient spine cases Dr. Pettine has performed, he reports no complications, although his ASC has a 23-hour convalescence center. He recommends ASCs start slow with less complicated cases, such as decompressions, and moving to the more complicated procedures from there. Spine surgeries performed at the hospital are a significant expense and surgeons stand to leave money on the table if they perform procedures there instead of an ASC, he says.
Related Articles on Spine Surgery:
Dr. Richard Hynes: Why a Spine-Focused ASC is Important for the Future of Minimally Invasive Spine Surgery
Dr. Joan O'Shea: How to Achieve Great Results for Spine Surgery in an ASC
Dr. Robert Nucci: Minimally Invasive Outpatient Lumbar Fusions and Multi-Level Outpatient Cervical Disc Replacements