6 numbers making spine surgeons nervous


From fighting CMS policy proposals to challenges with rising COVID-19 cases, spine surgeons have faced multiple hurdles since 2020.

Six numbers reflecting challenges ahead for spine surgeons:

1. CMS' inpatient-only list: CMS' 2022 proposal would put 71 spine procedures on the inpatient-only list. ASC administrators have described the proposal as "an obvious step backwards," and if implemented, the move would challenge outpatient migration for spine surgery.

2. The COVID-19 delta variant: The delta variant of COVID-19 is growing in the U.S. putting a strain on hospitals and health elective procedures at many centers. COVID-19 cases are rising in 42 states, USA Today reported Aug. 24.

3. Prior authorizations: A survey from the American Medical Association found 85 percent of all physicians described burdens associated with prior authorizations as high or extremely high. A July 1 rule from CMS requiring prior authorization for cervical fusions went forward despite opposition from surgeons and physician societies.

4. Undervalued spine care: The work relative value units assigned to open decompression and interlaminar stabilization are undervalued, according to a study from the International Journal of Spine Surgery. Open decompression and interlaminar stabilization had a 13.5 work relative value units while the most comparable procedure, laminectomy, has a 15.37 wRVU.

5. Orthopedic surgeon shortage: By 2025, orthopedic surgeons are expected to be in high demand. By 2025, there will be an estimated 24,350 orthopedic surgeons in the U.S., but a projected demand of 29,000, according to Merritt Hawkins' 2021 Review of Physician and Advanced Practitioner Recruiting Incentives.

6. Recovering pre-pandemic salary: Less than half of physicians expect to reach pre-pandemic income levels in the next year, according to Medscape's "Physician Compensation Report 2021." Forty-two percent of physicians believe they will return to pre-pandemic income within the next year, and 41 percent expect to hit that figure in the next two to three years.

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