Here are three leader's recent thoughts on spine surgery's migration to the outpatient setting:
Paul Perry, MD. Orthopedic surgeon at Tri-State Orthopaedic Surgeons (Evansville, Ind.): The migration of total joint arthroplasty and spine surgery to an outpatient/short-stay setting is well underway but in my opinion is still in the early innings. On the other end of this spectrum, some surgical cases are migrating to an in-office site of service, particularly in pain procedures, as well as hand and foot cases. ASCs must adapt to this transition in important ways which will require increasing investment in facility infrastructure and staff training. The same is true of in-office procedure capabilities. This is a top-of-mind issue as our practice looks to the future of healthcare and the future of our surgical practice. This migration has legs as it is a strong value proposition for our patients and for third-party payers.
Kevin Bozic, MD. President of American Academy of Orthopedic Surgeons: The shift from inpatient to outpatient makes orthopedic surgeons less relevant to hospitals. Historically, we relied on hospitals for medical directorship, co-management agreements and other types of support. We will have to replace those with other things, as we transition out of hospitals and into ASC settings. Another big challenge with that is adapting to the new way healthcare will be organized and paid for. We are seeing more consolidation in the industry under health systems and private equity.
Brian Bizub. CEO of Raleigh (N.C.) Orthopaedic: Valued-based healthcare and inpatient surgical procedures migrating from the inpatient-only list to the outpatient list is creating a shift for hospitals to broaden their market share by shifting to ASCs. Although, hospital owned ASCs receive reimbursements for implants versus ASCs, which only receive a facility fee, creates a paradigm to maintain both ACCs and ASCs. However, hospitals are now more willing to partner with physician-owned ASCs to create a larger portfolio and extend their long-term vision and strategy in the healthcare space based on consumer demand and preferences. Hospitals and physicians' practices have shifted to a more retail model that responds to the consumers' preference and a more personalized experience. In my opinion, hospitals will continue to grow in the ASC environment to maintain a share hold in growth in their communities. Independent ASCs are less expensive to consumers than hospital-owned ASCs, and the financial investment in joint ventures with physicians creates cost consciousness, increases surgical volumes and drives patient satisfaction.