Could big spine surgeries ever go outpatient? Some surgeons are already taking them there

They are all speaking at the 21st Annual Becker's ASC Conference in Chicago on Friday, Oct. 24. Mr. Hayek will give a presentation titled "The State of the ASC Industry"; Ms. Jones will then speak in "Achieving Success and Overcoming Adversity"; then, Dr. Bray and DISC COO Karen Reiter are speaking on "Advanced High Acuity Procedures for ASCs."

But that's not all. These three leaders are intertwined more deeply. SCA recently announced a new joint venture with DISC, which currently includes two ambulatory surgery centers and numerous specialists across spine, orthopedics, pain management and conservative treatments, in a mutually beneficial relationship. Dr. Bray, a neurosurgeon with a special interest in minimally invasive spine surgery, is connected with Ms. Jones in that he diagnosed and treated the tethered cord syndrome that could have ended her career.  Dr. Bray performed the spine surgery at DISC, which is the official medical services provider for Red Bull’s athletes in North America.

"Lolo's case is a great example of what I think is happening in medicine right now," says Dr. Bray. "It represents the movement of higher acuity cases into the surgical environment. People don't usually think of an intradural tether release as an outpatient procedure, but we do. Our partnership with SCA will help bring our model for higher acuity cases to other centers as well."

DISC has a benchmarking system for higher acuity cases to achieve better outcomes. The ASC's complication rate is lower than in the hospital setting, and surgeons can perform procedures for less than they would cost in the hospital. DISC's expertise in higher acuity cases made them an attractive partner for SCA, and SCA's focus on clinical quality was attractive to Dr. Bray and his colleagues as DISC plans future expansion.

"DISC was brought up as a 'Mom & Pop' business and we were able to run it well, but it got to the point where a company with some serious expertise in business management, and the ability to enter into the world of insurers, contractors and risk management was invaluable," says Dr. Bray. "We selected SCA for their reputation and management skills."

Now, Dr. Bray is working with SCA on a two-fold plan to increase patient flow at both ASC locations and beyond. They hope to replicate DISC's success in new geographic regions and share the operators' expertise. DISC has developed a treatment protocol for its patients, as well as advanced infection prevention system.

DISC's model also focuses on physician practice development through co-branding and marketing efforts. Surgeons at DISC provide care for elite and professional athletes, as well as celebrities.

"SCA was willing to sit down and put a lot of effort into the future model for our centers to ensure that we will provide and expand on the same high quality care before making the complete transition," says Dr. Bray.

Dr. Bray's philosophy is that increasing quality will also improve cost-efficiency for the total episode of care by decreasing readmissions, re-operations and costs associated with failed back surgeries.

After so many years as an independent center, joining SCA will be a transition for Dr. Bray and his partners, but one he's looking forward to. The new structure allows him more time with patients and in the operating room while the ASC positions itself for future longevity. He thinks more ASCs will look for similar partnerships to manage the business and risk-management aspects of healthcare.

"We had to consider how to position ourselves to do what we wanted to do," says Dr. Bray. "We want to position ourselves as a flourishing entity that can provide high-level care. You are going to see outpatient total hip and knee programs expand at ASCs."

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