Why Dr. Robert Masson aims to participate in BPCI Advanced bundled payments for spine

Robert Masson, MD, Founder of Masson Spine Institute and Director of Ocoee, Fla.-based Orlando Health Health Central Hospital NeuroSpine Center of Excellence, plans to participate in the CMS Medicare Spine BPCI Advanced program. He is working with a convener to participate in the program and will perform participating Medicare cases at Orlando Health Health Central Hospital.

The spine bundles program will initiate on Oct. 1 and aim to deliver high quality, cost-effective spine care. The model period will run through December 2023, and CMS will provide a second application opportunity in January 2020. The voluntary model includes single retrospective bundled payments and one risk track for 90-day episodes of care.

The payments will be tied to performance on quality measures, and preliminary target prices are provided before the first performance period of each model year. Here, Dr. Masson discusses BPCI Advanced and where he sees bundled payments headed.

Question: Why do you want to participate as a first adopter in the Medicare Spine BPCI Advanced program?

Dr. Robert Masson: I have been building towards a performance-based spine surgery platform for 20 years, and definitely think that rewards for performance and risk for lack thereof are here to stay. I definitely think that surgeons at large need to be rewarded for taking great care of their patients, to incentivize them to focus on that which matters most: quality, sustainable cost containment and efficiency of care as the ultimate bundle.

Q: How did you build the practice so it could support early adoption? What are the key factors allowing you to participate?

RM: We moved the practice out of the big trauma metro hospital and [became] hyper focused on community/designation-based microspine surgery platforms. My minimally invasive platform iMAS was built out of this growth period and we started building a 360 degrees of care program at our hospital in the Orlando Health Hospital System, Orlando Health Central Hospital in West Orlando.

Since that time Health Central has won top 10 awards in orthopedic and spine surgery, and we have earned JCAHO Center of Excellence status in orthopedic joint replacement and in spine surgery. We track complication, outcome, performance, functionality and quality of stay data on each patient and in spine have a cumulative length of stay average of 1.6 days over several years despite predominantly being a reconstruction practice from an inpatient perspective.

Key elements for success include:

1. Common messaging from arrival to discharge
2. Dedicated team members at every point of contact in the facility
3. Direct communication from hospital "team members" and practice team members
4. Clear prehabilitation protocols and preparation for arrival to surgery
5. Extensive patient education pre-episode of care
6. Entirely microsurgical spine surgery platforms to reduce the trauma of surgery

Q: Where do you see the biggest opportunity for spine surgeons to succeed with bundled payments in the future?

RM: Simplify office management, reward best outcomes and processes, improve time management, simplify patient care and ultimately improve the quality of their practice, all the while improving revenue. We are gradually transitioning away from quantity towards better and rewarding quality practice measures. Overall our practice happiness is improving as a result of these measures.

More articles on spine surgery:
NeoSpine welcomes Dr. Alex Mohit: 4 things to know
Top 10 neurological surgery residency programs from Doximity
9 spine, neurosurgeons on the move in July


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