'Advocacy is critical for our profession and our patients': What we heard this week

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Healthcare providers have given Becker's insight on a number of topics, ranging from payer challenges to growth opportunities for their specialties.

Nine insights shared with Becker's this week:

'The government pays us less than they pay their plumber': Anesthesia leaders on reimbursement challenges
Scott Harper, MD. Assistant Professor of the Department of Anesthesiology and Perioperative Medicine at University of Alabama at Birmingham: Government payers pay us ridiculously low rates because they know they can get away with it. Every group in the country has a hospital contract that requires them to accept Medicare. As a result, Medicare doesn't have to negotiate in good faith with us. Currently, Medicare pays us about $45 per hour. Think about that — the government pays us less than they pay their plumber!

How Walmart and Amazon's healthcare moves may affect ASCs
Alfonso del Granado. Administrator of Covenant High Plains Surgery Center (Lubbock, Texas): My wish would be for an independent, portable health electronic record under the patient's control, one that they can take to every point of care and require providers to document within. I do not believe healthcare systems will work on this because it would be a conflict of interest to enable patients to seek care elsewhere. I also do not see the government being able to drive this initiative with the current climate of public mistrust. It would take a behemoth organization, such as Amazon or Walmart, to create a market-based solution that I, for one, would be happy to accept if it reduced errors and decreased my labor costs in obtaining a complete and thorough history.

The great equalizer: Why these 3 GI physicians are excited about AI
Joseph Feuerstein, MD. Beth Israel Deaconess (Boston): One of the most exciting technologies emerging in the field now is the use of artificial intelligence to aid in polyp detection. While this is definitely not a replacement for careful, high-quality screening by a skilled endoscopist, it is a wonderful aid to complement the endoscopist's skill in finding and removing polyps.

The goal of all colon cancer screening programs is to provide the highest-quality colonoscopy with resection of all polyps to prevent colon cancer. AI provides a potentially equalizing platform that will enhance all endoscopists' ability to detect polyps. Each iteration of the AI is likely to improve and provide even better results over the next few years.

4 physicians share what they wish they knew going into their career
C. Ann Conn, MD. Advanced Pain Institute (Hammond, La.): I've always had the mindset of an early adapter, and when I started practicing, I did not understand the significant barriers to payment for new procedures. The atmosphere can make it difficult for patients to access the newest treatments. Because of this, I came to understand that advocacy is critical for our profession and our patients. The decision-makers in government are often unaware of both the issues we face as providers and the specific sufferings of our patients, and, of course, these problems are interconnected. Therefore, it is important that we speak out to improve the situation.

Fewer surgeons, more assistants: 7 predictions for orthopedic surgery
Davis Hurley, MD. Orthopedic Centers of Colorado (Denver): We will continue to see exponential growth in orthopedic procedures shifting to the ASC setting and away from traditional hospital settings. We know that shifting cases to ASCs remains the single biggest opportunity to reduce the total cost of care and realize the Quadruple Aim of quality outcomes, a better experience for patients and providers, all at a lower total cost of care. For context, Orthopedic Centers of Colorado has performed 67 percent of our cases in ASCs so far this year. Our partner, Surgical Care Affiliates, has experienced significant growth in spine and total joints in its ASCs, including a 29 percent growth in total joints in the first four months of 2021 alone.

Payer problems: 7 reimbursement issues at ASCs
Grant Foley. Executive Director of Midwest Center for Joint Replacement (Indianapolis): We are and have been monitoring the direction of direct contracting and bundled payment programs for the past few years. With the high number of sales calls we receive from deal makers in the market, it's always tough to gauge the true volume or value an agreement will bring to an organization. Most of them are simply searching for the lowest-cost procedure and are unable to deliver much in return.

4 physicians share their biggest career takeaways
Edward DelSole, MD. Geisinger Musculoskeletal Institute (Scranton, Pa.): The biggest takeaway of my career so far has been the critical role of teamwork and leadership. As an early practicing surgeon, I have learned rapidly the importance of assembling strong, supportive clinical teams in order to create a successful practice. Residents and fellows should be actively learning how to build and lead teams in their office and in their operating room. Young surgeons should actively seek to collaborate clinically and academically with colleagues inside and outside of their organizations to make an excellent surgical plan and in some cases execute it well. A successful spine practice has unique and complicated features, and surgeons have to be able to rely on all the people around them in order to provide the highest quality patient care.

Outlook for cardiology over next 5 years
Kami Dinkel. CEO of Vascular Labs of the Rockies (Denver, Colo.): I predict that as more cardiovascular ASCs open across the U.S. and prove that these cases are not only safe and cost-effective but a preferred environment by the patients, outpatient centers will become the preferred site for nonacute cardiac and vascular care. I believe vendors will support further technology to help support the outpatient centers to increase what we are able to do safely in the outpatient setting, allowing further expansion of appropriate procedures. I believe that referring providers, payers and patients will see and understand the value these centers provide, increasing payer alignments and patients' requests for such centers. I believe that there will be expansion of inclusion criteria of allowable coronary interventional procedures (it is very limited right now) as well as the addition of [electrophysiology] procedures in the ASC setting as well.

6 pivotal growth opportunities for GI
Joe Feuerstein, MD. Beth Israel Deaconess Medical Center (Boston): The biggest opportunity for growth at this time is the huge backlog in procedures that was created by COVID-19. Numerous centers have huge backlogs of cancer-screening procedures, as well as symptom-based procedures that have been delayed due to COVID-19. Some studies out of Canada and Europe note that it will take years to fully accommodate all the scopes that were delayed secondary to COVID-19. At this time though, this can be seen as an opportunity for growth and expansion for some centers to facilitate more expedited endoscopic procedures.

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