4 key trends in spine in 2021 — Access to care, outpatient migration & more

Alan Condon -   Print  |
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Spine surgeons expect another challenging year in 2021 as they continue to weather the effects of the COVID-19 pandemic and brace for significant cuts from CMS.

Four key trends that will affect spine surgeons, vendors and patients next year:

1. Reimbursement. Next year is set to be another challenging one for physicians — especially those in surgical specialties, many of whom will see steep reimbursement cuts as outlined in CMS' Medicare Physician Fee Schedule. In 2021, surgeons are facing an almost 10 percent drop in the conversion factor and the resulting Medicare reimbursement cuts to many surgical specialties. As commercial payers typically base their reimbursement rates on Medicare rates, additional cuts will be in the pipeline.

2. Access to care. The aging population in the U.S. signals that more Medicare patients will require orthopedic care in the coming years, with the case mix continuing to shift away from commercial payers. Surgeons believe incoming CMS rules — decreased payments and new prior authorization requirements — will further limit patient access to care as practices may take on less Medicare patients.

3. Outpatient migration. CMS is removing 67 spine codes from its inpatient-only list in 2021 and plans to completely phase out the list by 2024. Patient demand, increasing adoption of minimally invasive techniques and CMS and commercial payers encouraging more cases to be done in an outpatient setting will accelerate outpatient spine surgery migration. The future looks bright for the ASC industry, which continues to bring additional cases to the outpatient setting.

4. Vendors. Analysts tipped the big spine device companies to recover quicker than others next year. Industry growth is expected to accelerate by the second half of 2021, but smaller device companies will likely face stiffer competition with the more established vendors. Given the tough financial year for hospitals, they will look to cut costs wherever possible in 2021, with smaller vendors likely to be top of the chopping block.

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