ChristianaCare spine surgery center approved by state

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 ChristianaCare and Delaware Neurosurgical Group PA joint spine surgery center cleared final approval of Delaware Health Resources Board on Thursday, paving the way for the project at the hospital’s Wilmington campus.

“This partnership is about delivering the right care, at the right place, with an expert team and an unwavering focus on value,” ChristianaCare Chief Physician Executive Ken Silverstein said in a prepared statement. “It builds on a long history of collaboration between two expert teams … we’re proud to launch this new service at the Roxana Cannon Arsht Surgicenter in the heart of Wilmington, which has been delivering an outstanding surgical experience for decades.”

This partnership, named Center for Spine Surgery LLC, will oversee renovations at ChristianaCare’s Roxana Cannon Arsht Surgicenter on the Wilmington Hospital campus. 

The 32,000-square-foot facility will have six operating rooms, six overnight rooms and a post-surgical recovery space and 23-hour stay capacity for spine surgical patients. Opening is slated for January 2022.

The Center for Spine Surgery will be owned equally by ChristianaCare and Delaware Neurosurgical Group PA, a leading neurosurgical practice in the region for 35 years. The board to oversee the center will include three people from each organization, with Dr. Pawan Rastogi of Delaware Neurosurgical Group named board president.

“We are thrilled to partner with ChristianaCare to deliver comprehensive spine surgical services in the Roxana Cannon Arsht Surgicenter,” Rastogi said in a prepared statement. “Our patients will continue to experience exceptional physician expertise, comprehensive services and a strong commitment to making a significant difference in their day-to-day lives.”

The Center for Spine Surgery will perform a full range of spine procedures (low-acuity to high-acuity), and more complex procedures such as, but not limited to, multilevel cervical fusions, posterior cervical, thoracic and lumbar fusions. 

Inpatient spine surgery at ChristianaCare will remain available for people who need urgent or emergency care, and for cases in which outpatient spine surgery is not medically appropriate.

This partnership arrives at a time when 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, according to documents filed with the Delaware Health Resources Board. With the new facility, officials predict that the caseload will rise another 70% in its first year and  130% by 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.

Through the newly-formed partnership, ChristianaCare and Delaware Neurosurgical Group will be evenly splitting more than $12 million in costs including equipment, startup costs and working capital such as salaries for staff and costs potentially incurred through the licensing process.

ChristianaCare will fund its half through cash on hand while Delaware Neurosurgical Group will pay its share through financing and a line of credit, according to the application.

Renovations to the ChristianaCare’s Arsht Surgicenter are budgeted at $1 million, while equipment costs are budgeted more than $3.1 million.