THE BUSINESS OF HEALTHCARERedesigning Health Care Organizations The Influence of Government Policy and Methods of PaymentSharan, Alok D. MD, MHCDS*; Schroeder, Gregory D. MD†; West, Michael E. MBA, CPA†; Vaccaro, Alexander R. MD, PhD†Author Information *Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY †The Rothman Institute at Thomas Jefferson University, Philadelphia, PA A.D.S. is a consultant for Paradigm Spine; G.D.S. receives travel/accommodations/ meeting expense reimbursement from Medtronic and AO Spine; M.E.W. has stock/stock options in Universal Research Solutions and Cross Current; and A.R.V. is a board member for AO Spine, Innovative Surgical Design, and Association of Collaborative Spine Research, as well as a consultant for DePuy, Medtronics, Stryker Spine, Globus, Stout Medical, Gerson Lehrman Group, Guidepoint Global, Medacorp, Innovative Surgical Design, Orthobullets, Expert testimony, Ellipse, and Vertex. A.R.V. is an employee of Rothman Institute and has received royalties from Medtronics, Stryker Spine, Biomet Spine, Globus, Aesculap, Thieme, Jaypee, Elsevier, and Taylor Francis. A.R.V. has stock/stock options in Replication Medica, Globus, Paradigm Spine, Stout Medical, Progressive Spinal Technologies, Advanced Spinal Intellectual Properties, Spine Medica, Computational Biodynamics, Spinology, Small Bone Innovations, Cross Current, In Vivo, Flagship Surgical, Cytonics, Bonovo Orthopaedics, Electrocore, Gamma Spine, Located Based Intelligence, FlowPharma, R.S.I., Rothman Institute and Related Properties, Innovative Surgical Design, and Avaz Surgical. The authors declare no conflict of interest. Reprints: Gregory D. Schroeder, MD, The Rothman Institute at Thomas Jefferson University, 925 Chestnut St, Philadelphia, PA 19107 (e-mail: [email protected]). Received September 23, 2015 Accepted October 2, 2015 Journal of Spinal Disorders and Techniques: December 2015 - Volume 28 - Issue 10 - p 379-381 doi: 10.1097/BSD.0000000000000336 Buy Metrics Abstract Over the last 5 years, there has been a growing trend toward consolidation in the health care field. As reimbursement moves from a fee-for-service model to a value-based model, there will be continued pressure on physicians to either be a hospital employee or to be in a large multidisciplinary practice. This is largely due to the Accountable Care Act, which directs payers to utilize population-based cost analyses, rather than an individual patient-based analysis. To succeed in this environment, practices will have to break down traditional organizational barriers to create evidence-based algorithms for the treatment of individual diagnoses from the initial onset of symptoms until the resolution of symptoms. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.