1 obstacle is draining physician offices and their patients 

Adam Bruggeman, MD, serves as the chief executive officer and a surgeon at San Antonio-based Texas Spine Care Center.

Dr. Bruggeman will serve on the panels "Prior Authorizations, Denials and More: Big Payer Trends in Spine and Orthopedics" and "Amazon, Walmart, Apple in Healthcare: What Surgeons Need to Know" at Becker's 19th Annual Spine, Orthopedic & Pain Management-Driven ASC Conference. As part of an ongoing series, Becker's is talking to healthcare leaders who plan to speak at the conference, which will take place in Chicago from June 16-18. 

To learn more and register, click here.

Question: What issues are you spending most of your time on today?

Dr. Adam Bruggeman: Prior Authorization is a drain on physician offices and their patients with limited utility. In Texas, we have shown how burdensome the process is and how few cases are ultimately denied. The costs are extensive. We are also just beginning the work on a long-term fix to physician compensation. There is a strong irony that the AHA claimed that 4 percent increases in compensation could not keep up with the actual cost of delivering care. Yet, physicians were begging not to have a 9 percent reduction in their compensation. Insurance companies are showing increasing profits year-over-year as for-profit, publicly traded companies, yet they are strangling the delivery of healthcare to the point of potential no return. We must develop long-term solutions to stabilize the industry.

Q: What are your top challenges and how will they change over the next 12 months?

AB: We are working diligently to integrate mental health into the preoperative process in our office. The challenge is helping insurance companies to recognize the dramatic impact the mental health of our patients has on long-term outcomes and opioids. We will continue dialogue to create awareness and reduce costs.  

Q: How are you thinking about investments and growth in the next two years?

AB: We continue to invest in the practice, but the short-term outlook for the economy is difficult to predict. The good news is that healthcare tends to be a strong industry even in a downturn economy. The bad news is that this has been proven in times when patient out-of-pocket expenses were relatively small. With increasing deductibles, copays and coinsurance, will patients continue to seek healthcare, or will they instead shift those dollars towards gas, housing or other expenses that continue to skyrocket?

Q: What are you most excited about right now? 

AB: I work with a group where we are trying to help practices remain or go back to being independent through a clinically integrated network. This push toward employment and loss of control of the practice has had a significant detrimental impact on the delivery of healthcare. With nearly 3 of every 4 physicians employed today, I see a pendulum swing back toward physician independence. I am excited to see the migration back to independent practices. Companies designed around this concept stand to see significant growth.

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