New business models could spur robotic growth at ASCs

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Many spine and orthopedic surgeons have been lauding the advantages of robots in the operating room, but the high cost of these systems has prevented many ASCs from investing in the technology.

Surgical robots are more prominent in hospitals, which have significantly more capital and are always looking to grow their market share by showing that they have the latest and greatest technologies.

As investors in ASCs, surgeons are far more introspective on how much money they put up front for such expensive purchases, according to Martin Roche, MD, director of hip and knee arthroplasty at HSS Florida in West Palm Beach. 

"It's all about efficiency, outcomes and where patients want to go, as well as what they're having done," said Dr. Roche.

The issue is value on investment, and as medical device companies look to sell their robots to ASCs as well as hospitals, new value-based business models are being developed to expand their target market.

"[Medical device companies] may link it to how many cases you do, which can help pay it down, and develop various at-risk models," Dr. Roche said. "I think orthopedic companies are drawing up different types of business models because they see robotics as the future as well."

Many ASC administrators believe they have to get on the robotic bandwagon for two main reasons: to attract the best surgeon talent and to bring more cases to their surgery center.

"Robotics is not going to help surgeons who are comfortable doing the same case nonrobotically; it's just going to add expense," Alfonso del Granado, administrator of Covenant High Plains Surgery Center in Lubbock, Texas, told Becker's. "But in terms of bringing, for example, total joints, total knee and hip replacement, if I don't get a robot, I can't get those cases in. All of the surgeons in town who do outpatient joint replacement are doing it robotically."

Mr. Granado also noted a significant drop in the cost of consumables for some total joint robots. "So even though it will eat into our margin, we'll still have a margin. Better to have 20 percent of 100 cases than 100 percent of zero cases."

While ASCs consider the value of investment in surgical robots, another factor to contemplate is the clear marketing advantage that a robot brings to their centers.

Patients, in an increasingly consumerized healthcare marketplace, are shopping around for not just the best surgeons and practices, but the latest technologies, too.

"Patients are asking about [robots], said Taylor Cera, COO at Orthopaedic Surgery Center in Youngstown, Ohio." Traditionally, I think patients just went to their same surgeon for most all [musculoskeletal] injuries. We are seeing a trend that patients are seeking out surgeons that use robotics for total joint surgery."

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