In The News

The recent pivot in Congress towards a narrower focus in healthcare legislation marks a significant shift in policy-making dynamics, with immediate implications for healthcare providers across all specialties, including those within spine and orthopedic care. This transition from broad, ambitious reforms to a more streamlined legislative agenda reflects the challenges of reaching consensus in a diverse political landscape and underscores the critical importance for healthcare providers to stay informed and adaptive. Here's a closer look at how these changes affect providers and the healthcare industry at large.

In a significant stride towards improving healthcare access and transparency, Congress has once again entered the prior authorization debate. The aim is to streamline and enhance the process through which insurers can deny access to covered services. With the House Ways and Means lawmakers advancing a bill as part of a larger health package, the focus is on overhauling and accelerating prior authorization decisions for Medicare Advantage plans. This move has garnered widespread support from both House members and senators, signaling a potential breakthrough in the effort to reshape healthcare access in the United States.

Texas employers and healthcare providers are preparing for a significant transformation in health plans due to the recent passage of House Bill 711. This new legislation, which takes effect immediately, empowers employers to guide their employees towards higher-performing healthcare providers. While existing anti-steering and anti-tiering provisions in contracts will remain valid until the end of the year, brokers and benefits managers must incorporate the implications of this law into their upcoming health plans. In this blog post, we will delve into the details of the legislation and explore its potential impact on the healthcare landscape in Texas.

In the constantly evolving landscape of healthcare, two significant models of care have emerged as key strategies to manage cost while striving to improve patient outcomes: Managed Care, which rose to prominence in the 1990s, and today's Value-Based Care. With specific focus on Musculoskeletal (MSK) (Bone, Joint and Spine) care delivery in narrow networks, this blog post compares these two models, their evolution, and potential impact on healthcare.

Spinal surgeries are complex procedures that require the utmost precision and care to ensure optimal outcomes. Intraoperative neuromonitoring (IONM) has emerged as an essential tool for spinal surgeons, providing real-time feedback and monitoring of the nervous system during surgery. In this blog, we will explore the importance of IONM in spinal surgeries and its benefits for both surgeons and patients.

Private equity firms have been showing increasing interest in the healthcare industry, with a particular focus on orthopedic and other specialty practices. While these firms can provide financial resources and operational support, there are pros and cons to partnering with a private equity (PE) firm. In this blog, we'll explore the advantages and disadvantages of a PE partnership in the healthcare industry and help you determine if it's the right choice for your practice.

Clinical integration is crucial for managing quality outcomes in musculoskeletal bundles. Musculoskeletal bundles, which refer to the comprehensive, episode-based payments for specific procedures like joint replacement or spinal fusion, aim to promote better coordination, reduce costs, and improve patient outcomes. Clinical integration is a means to achieve these goals through the following ways:

As an orthopedic surgeon, providing the highest quality of care to your patients is always your top priority. While surgical technique and expertise are certainly important, monitoring quality metrics is also crucial to ensuring positive outcomes for your patients. In this blog, we'll explore some key quality metrics that orthopedic surgeons should be monitoring to improve quality outcomes.

I want to take a moment to express my gratitude for your partnership in the MPOWERHealth Clinically Integrated Network. We recognize the challenging healthcare landscape that providers face, particularly in negotiating contracts with payors, and we appreciate your commitment to providing high-quality care to your patients.

As an orthopedic surgeon, you know how important it is to provide your patients with the best possible care. But providing high-quality care can be challenging, especially when you have a large patient population or complex cases. That's where care management can be incredibly helpful. In this blog, we'll explore the five key benefits of care management for patients and how it can help you as an orthopedic surgeon.