Financial stressors, including lower reimbursement rates, inflation and rising overhead costs, are forcing independent physicians and surgeons to make big changes.
To keep up, some surgeons are choosing to retire early, some are heading into the private equity route and others are moving to hospital systems.
H. Kurtis Biggs, DO, founder of the Joint Replacement Institute in Naples, Fla., recently joined the Becker’s Ambulatory Surgery Centers podcast to share how the reimbursements are altering the way surgeons and physicians practice.
Note: Responses were lightly edited for clarity and length.
Question: What are you focused on and excited about going forward in the rest of 2025?
Dr. H. Kurtis Biggs: I took it upon myself to work through the process of designing, creating and bringing to market a hip replacement femoral component using a curved anatomic stem. We now have 60 patients who have had the device, which has now been FDA approved to utilize for hip replacement that will slowly be brought to market across multiple surgeons as we try to bring that device into the forefront. So that’s something personally for me that’s been exciting and been fun to be part of and being able to start with a napkin drawing, get it manufactured, FDA approved, implanted in a patient and actually receive a patent for the design has been very exciting. So I look forward to that and how that growth happens in the next couple years.
Q: Whenever you’re dishing out new and improved or innovative products, what does reimbursement look like?
KB: Anything that I implant, I do not receive any financial benefit for any implant that I use that I designed. I am only receiving payment as far as a royalty is concerned when another surgeon uses it. As far as the reimbursement, reimbursement is a great transition of where the next big problem is for accessibility to patients. So for us as surgeons, what we receive from Medicare is around $1,300 for a hip or knee replacement, just an average between the two. We’ll receive another 20% of that fee from supplemental or secondary insurance. Because of inflation, our overhead averages around anywhere from 65 to 70% of our business in private practice. So for us as surgeons, it’s not a very tenable situation, and changes have to be made.
Looking at other options and how to change that, whether that’s going to be a concierge service that’s offered to the patients to provide accessibility and additional features, or dropping Medicare and going to a straight fee-for-service, change is coming up. The current situation probably won’t last for very much longer before people either have to retire early, become owned by private equity or they have to go on to be employed by a hospital system. That way, the hospital system can pay the surgeon based off of their other ancillaries of which they get paid for at a higher rate than we do in private practice. We have surgeons that are moving to that model, whether it’s fee-for-service after dropping Medicare, or they’re going to a concierge type service where they have accessibility to the surgeon for a fee. So those changes are coming. They’re gonna be pretty big in the next two years. I think there’s a lot of private practitioners who have to make that big decision, which direction that they want to head, whether they want to become employed or stay self-employed is all very dependent on how they handle that.
The post The financial decision weighing on independent surgeons appeared first on Becker’s ASC.
