Orthopedic ASCs are physicians' biggest growth opportunity, surgeon says

Orthopedic procedures have increasingly shifted to the ASC setting in the last 10 years as technology and patient education advance. 

Kevin Bonner, MD, an orthopedic surgeon and the director of the Jordan-Young Institute in Virginia Beach, Va., spoke with Becker's about how the increased migration of orthopedic procedures to the outpatient setting is one of the biggest growth opportunities for physicians. 

Editor's note: This piece was edited lightly for brevity and clarity. 

Question: What's one regulatory change you wish CMS would implement to benefit physicians? 

Dr. Kevin Bonner: I think CMS should be more nimble when it comes to changes in the ASC-covered procedures list for procedures which have been shown to be safe and available to non-Medicare patients in the ASC setting. One example is shoulder arthroplasty. Recently, there have been a lot of back-and-forth changes when it comes to the inpatient-only list and ASC-CPL, which has led to confusion. I think CMS can be quite thoughtful and accomplish their goals, but at the same time address changes that should not be very controversial in a more timely fashion. Honestly, the goals of CMS and physicians are aligned in my mind in that we all only want to provide safe care to our Medicare patients but at the same time allow them access to lower-cost facilities when appropriate.

Q: What's the biggest opportunity for growth for physicians in the next five years?

KB: It's clearly not profound when I say that continued transitioning of a significant percentage of arthroplasty procedures to the outpatient ASC setting is where we will see continued growth. The key is optimizing patient selection, which prioritizes safety while providing high-level cost-effective care and patient satisfaction. Additionally, I feel there is an opportunity for orthopedic surgeons to develop nonoperative arthritis treatment clinics that provide responsible evidence-based care. Unfortunately, many of these clinics are currently being opened and marketed without any actual oversight from orthopedic or rheumatology experts. For obvious reasons, many patients are allured to nonorthopedic providers to receive "novel" treatments promising to cure arthritis pain without the need for surgery. It is important that these nonoperative options are discussed and implemented responsibly. I feel there is an opportunity for orthopedic practices to offer these types of programs going forward.

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