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Organizational Structural Design in Spine Care

Sharan, Alok D. MD, MHCDS; Schroeder, Gregory D. MD; West, Michael E. MBA, CPA; Vaccaro, Alexander R. MD, PhD, MBA

doi: 10.1097/BSD.0000000000000529

For a company to provide high value to its customers, its organization design is critical. As health care transitions to a value-based model, it is critical that spinal care organizations are structured in such a way that they can maximize value to both the patient and the payers. This article will discuss the 3 most common ways that an organization can be structured, and the benefits and problems of each design in spinal care.

*WESTMED Spine Center, Yonkers, NY

The Rothman Institute, Thomas Jefferson University, Philadelphia PA

Dr Schroeder has received funds to travel from AOSpine and Medtronic. Dr Vaccaro has consulted or has done independent contracting for DePuy, Medtronic, Stryker Spine, Globus, Stout Medical, Gerson Lehrman Group, Guidepoint Global, Medacorp, Innovative Surgical Design, Orthobullets, Ellipse, and Vertex. He has also served on the scientific advisory board/board of directors/committees for Flagship Surgical, AO Spine, Innovative Surgical Design, and Association of Collaborative Spine Research. Dr Vaccaro has received royalty payments from Medtronic, Stryker Spine, Globus, Aesculap, Thieme, Jaypee, Elsevier, and Taylor Francis/Hodder and Stoughton. He has stock/stock option ownership interests in Replication Medica, Globus, Paradigm Spine, Stout Medical, Progressive Spinal Technologies, Advanced Spinal Intellectual Properties, Spine Medica, Computational Biodynamics, Spinology, In Vivo, Flagship Surgical, Cytonics, Bonovo Orthopaedics, Electrocore, Gamma Spine, Location Based Intelligence, FlowPharma, R.S.I., Rothman Institute and Related Properties, Innovative Surgical Design, and Avaz Surgical. He has also served as deputy editor/editor of Spine. In addition, Dr Vaccaro has also provided expert testimony. A.D.S.: consultant for paradigm spine.

Reprints: Gregory D. Schroeder, MD, The Rothman Institute, Thomas Jefferson University, 925 Chestnut St., Philadelphia, PA 19107 (e-mail:

Received February 1, 2017

Accepted February 16, 2017

© 2017 by Lippincott Williams & Wilkins, Inc.