ChristianaCare joint spinal surgery center nears approval

ChristianaCare is partnering with Delaware Neurosurgical Group to renovate an existing space at its Wilmington Campus to create a spine surgery center. | PHOTO COURTESY CHRISTIANACARE

WILMINGTON — The joint ChristianaCare and Delaware Neurosurgical Group surgery center was recommended for approval by Delaware’s health care services review board earlier this week.

If approved by the Delaware Health Resources Board next week, ChristianaCare will renovate its existing Roxana Cannon Arsht Surgicenter at its Wilmington Campus and reopen it as a Center for Spine Surgery by January 2022. The 32,00-square-foot facility is proposed to feature six operating rooms, five overnight rooms with 23-hour-stay capacity for patients and a post-surgical recovery space.

“The data shows that the need for this is projected to increase, based on the baby-boomer population that’s going to use it,” Health Resources Board Chair Brett Fallon said during Wednesday’s review meeting. “When you’re able to specialize and have consistent workflows and able to focus on what those particular patients need, it seems to me this will bring quality care as it’s what they’re doing day in and day out.”

ChristianaCare may have the infrastructure to handle the breadth of surgical procedures, but the Center for Spine Surgery will partner with one of the region’s leading medical practices to align resources for procedures that a growing number of patients need, while also freeing up the hospital’s resources.

The Delaware Neurosurgical Group, which focuses on conditions of the spine and spinal cord, has eight physicians in the Delaware region. Open credentialing will be offered to other qualified surgeons outside the Delaware Neurosurgical Group and ChristianaCare at the proposed facility. In all, the proposed surgery center will bring 20 employees, with a target of 27 employees by the end of its fifth year.

If approved, the Spine Surgery Center will perform the full scope of spine procedures, including more complex procedures such as multilevel cervical fusions and lubar fusions. It will be the only single-focus spine surgery center within Delaware and the surrounding area.

Spine surgeries, particularly fusion and non-fusion procedures, are on track to grow across the country. In 2018, trade publication Becker’s ASC Review reported that there were 675,000 spine surgeries performed per year, and inpatient spine care is targeted to drop by 18% in the next decade. Concurrently, outpatient care is expected to rise by 23%.

ChristianaCare reported that it performed 1,700 spine surgeries and related pain management cases in 2019. With the new facility, officials predict that the caseload will rise another 70% in its first year and ultimately 130% in the third year.

Delaware’s health care systems are racing to answer the state’s aging population needs, and ChristianaCare’s venture hopes also to target that demographic. The Delaware Population Consortium shows that New Castle County’s population of 65 and older is expected to hit 91,707 in 2025 — a 17% increase from 2020.

Nearly 78% of ChristianaCare’s discharges come from New Castle County and represent 58% of the health care system’s spine and pain management discharges in Fiscal Year 2019, according to ChristianaCare’s application. While ChristianaCare does see patients from parts of New Jersey and southern Pennsylvania, most of its spine cases outside New Castle County were patients traveling from Kent and Sussex counties and neighboring Cecil County, Md.

ChristianaCare’s proposed center could fill the gap between high-acuity and extensive cases and those who need surgery, as there are multiple specialty centers in Delaware that handle pain management and low-acuity cases, according to the application.

In addition, ChristianaCare is also eliminating its inpatient-only (IPO) list, which guarantees Medicare payment for inpatient procedures, over the course of the next three years to comply with recent updates to the federal low-income health care insurance program.

Renovations to the ChristianaCare’s Arsht Surgicenter are budgeted at $1 million, while equipment costs are budgeted more than $3.1 million, according to the application. Both ChristianaCare and Delaware Neurosurgical Group are splitting the total cost of the facility evenly.