Reduced Stark limitations, more Centers of Excellence: How Dr. Ciro Randazzo sees value-based care developing in spine

Alan Condon -   Print  |

Ciro Randazzo, MD, is a neuroendovascular specialist and chief of neurosurgery at Hudson Regional Hospital in Secaucus, N.J.

Here, Dr. Randazzo provides his insight on how value-based care will develop in spine and goals for his practice in 2020.

Question: How do you expect value-based care to develop in spine?

Dr. Ciro Randazzo: I believe value-based care will lead to further development of multidisciplinary Spine Care Centers of Excellence. In New Jersey and New York, we are already seeing multispecialty groups including primary care physicians, chiropractors, physiatry, pain management and spine surgeons forming to streamline care. Current attempts by the federal government to reduce Stark limitations on referrals will dovetail with these efforts to promote more efficient care of spine patients.  

Q: What impact do you see bundled payment programs having on the field in the next five years?

CR: Bundled payments will also lead to further consolidation of physicians into multispecialty spine care groups to streamline diagnosis and treatment. Physicians and providers will attempt to consolidate diagnostic, ancillary and treatment services under one organization to minimize costs and maintain revenue. 

Q: What strategies can spine surgeons employ to deal with declining reimbursements?

CR: Physicians can:

  • Join or form a multispecialty group to increase revenue pool
  • Become involved in providing ancillary services to increase revenue pools
  • Renegotiate contract and contract terms with payers to maximize reductions in payments and not being averse to leaving contracts whose reimbursement is non-sustainable
  • Reassess costs of practice operation and trimming fat wherever possible
  • Renegotiate call contract reimbursements as the reimbursement for emergency cases shrinks and it becomes more difficult to sustain a practice off of these payments

Q: What goals do you have for your practice in 2020?

CR: We will be opening our new two-room surgical center in Paramus, N.J., in January so we would like that to be fully utilized within three to six months. We are also continuing to attract other specialties to our multispecialty practice to increase the breadth of options available to patients. We also aim to improve patient access to our providers to grow our volume and maximize reimbursement by assuring our collections are appropriate to our contracts so we are leaving less on the table.

More artices on spine:
Dr. Nicholas Grosso on why his practice avoided PE investment and how consolidation will impact orthopedics
49 orthopedic devices receive FDA 510(k) clearance in November
Dr. Terrence Kim, Cedars-Sinai see robotic spine surgery as the way of the future

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