CMS on July 19 proposed a number of changes that would have a significant effect on outpatient orthopedics next year.
Chief among them are plans to reinstate the inpatient-only list, increase ASC pay 2.3 percent and return 298 musculoskeletal-related procedures to the inpatient-only list in 2022.
David Jacofsky, MD, chairman and CEO of Phoenix-based The CORE Institute, shared his thoughts on the reasoning behind CMS' proposed changes and why due diligence is critical when considering site-of-care changes.
Question: What are your thoughts on CMS' proposal to return 298 musculoskeletal procedures to the inpatient-only list? How will this affect orthopedic care in 2022?
Dr. Jacofsky: Neither the importance of driving increased value in healthcare, nor the importance of placing the right patient in the right site of service for the right procedure, can be overstated. The goals of CMS in helping create a regulatory environment that permits highly-trained surgeon specialists the ability to treat patients at a site in the patient's best interest is both admirable and critically important for the shift to value-based care.
However, care redesign requires time, outcomes studies and thought leader consensus to be done properly. Therefore, CMS allowing physicians the full range of site of service options is the place to start, but rapid overhauls of the reimbursement landscape related to care redesign that decrease surgeon options and can affect outcomes and patient safety must be done in a consistent, evidence-based manner and should occur at a rate of change that the provider community can manage effectively.