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Spine and Healthcare Reform: 3 Surgeons Weigh In

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Three spine surgeons discuss what aspect of healthcare reform will have the biggest impact on spine this year.
Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. We invite all spine surgeon and specialist responses. Next week's question: What types of innovation would you like to see in the operating room in the next five years?

Please send responses to Heather Linder at hlinder@beckershealthcare.com by Wednesday, Feb. 6, at 5 p.m. CST.


Vincent Arlet, MD, Orthopedic Spine Surgeon, KneeFootAnkle Center of Kirkland (Wash.): Decreased reimbursement for very technically demanding surgeries, [such as] scoliosis surgery in the elderly.

Jeffrey Goldstein, MD, Director of Spine Service, NYU Langone Medical Center's Hospital for Joint Diseases: Expanding access to healthcare is a positive for patients who previously did not have insurance coverage. There are many questions which are now unanswered. Will demand outweigh supply? Will it take longer for patients to receive treatment? Will providers be overburdened? Additionally the medical device tax and taxes on pharmaceutical companies may increase costs to patients (consumers) and dampen innovation.

Regulation and reimbursement changes may affect the number of physicians who choose to participate in certain programs. As private insurers prepare for the Affordable Care Act, we are seeing health insurance rates rise. On the other hand, greater demand for spinal care should help drive treatments that are more efficient and predictable. There will be continued focus on treatments whose outcomes have been proven with high level evidence. Payors will continue to seek out healthcare providers and institutions that provide cost-efficient safe patient care with improved outcomes.

Jeffrey Wang, MD, UCLA Spine Center: I think healthcare reform is a process that will take place over the next several years. It is an evolution, and spine practitioners are learning more each year. I see that health systems are bracing for the change and trying to comply with the new rules. On a personal basis, the one aspect that our institution will face this year is the implementation of electronic medical records. We have not gone completely electronic, and our big push is for the implementation of a system-wide EMR. This will be a huge factor for us this year and consume a large amount of our time and efforts this year.

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