ASCs playing increasingly important role in joint arthroplasty

ASCs are playing an increasingly important role in total joint arthroplasty procedures performed in the U.S., according to the American Joint Replacement Registry's 2023 annual report on hip and knee arthroplasty procedural trends and patient outcomes. 

There are now 42,228 procedural cases reported by ASCs annually, an 84% increase from the year prior, according to the report sent to Becker's on Nov. 3. 

As total joint replacements migrate to the ASC setting, procedures performed in the inpatient setting are falling rapidly. 

The volume of orthopedic procedures occurring in the outpatient setting is now 33 times higher than the volume of procedures in the inpatient setting.

From 2019 to 2023, the number of knee replacement procedures occurring in the outpatient setting increased by 293%. 

Additionally, the margins for hip and knee replacements occurring in the outpatient setting are much better than margins for the inpatient setting. 

For the last three years, hospitals have averaged losses for every inpatient primary hip replacement they have performed, and over two years have averaged losses for every inpatient primary knee replacement. 

In 2023, the average margin for outpatient hip replacements was $3,466, while the average margin for outpatient knee replacements was $2,879. 

Major orthopedic practices, including Irvine, Calif.-based Hoag Orthopedic Institute, are turning to ASCs as leaders realize they could be the future of orthopedic and spine surgery. 

"Our sixth ASC is slated to open later this summer in Aliso Viejo, located in the southern county part of Orange County, Calif., improving access to high-quality musculoskeletal care in an area that doesn't have a lot of hospitals or ASC facilities. Our business model continues to embrace ASC growth for outpatient orthopedic and spine surgery. Over the last three years, the growth in our outpatient orthopedic and spine surgery procedures has increased more than we even anticipated. ASCs provide an important role in our geographic expansion into strategic areas," Hoag CEO Kim Mikes, BSN, RN, told Becker's. 

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