April 22, 2022
Definitive Healthcare, LLC a healthcare analytics and market intelligence firm based in Framingham, Massachusetts, has issued a whitepaper describing the expanding role of ambulatory surgery centers in orthopedic healthcare and among its findings is that the ambulatory surgery center (ASC) procedure volume jumped 47% between 2020 and 2021.
The study, which was authored by Definitive Healthcare Senior Product Marketing Manager Ashley Volling, focused on four key indicators which, in the author’s view, indicate the “acceptability for this change: positive clinical outcomes, overall economic savings, market acquisition and growth activity.”
Starting with general shoulder surgery, Volling documented the growing gap between procedures conducted in the ASC setting to procedures in the hospital setting. Between 2017 to 2021 “ASCs have consistently performed a higher volume” of shoulder surgeries and the gap between the two is “becoming larger.” From that data Volling anticipates that “more procedures will move to ASCs” and that the gap “for other procedures will increase.”
Volling also pointed out that the average monthly increase in ASC claims increased 47.1% in 2021 compared to 2020. That is especially noteworthy in light of the COVID-19 pandemic . Even though hospitals have resumed elective procedures, noted Volling, “ASC procedure volumes continue to increase as a potentially preferred venue.”
Next Volling compared ASC total joint replacement surgery clinical outcomes within hospital patient outcomes. First, Volling looked at a “small population of clinical outcome data” from total knee replacement surgery and total hip replacement surgery.
From that small data set, she wrote that 30- and 90-day readmission rates and other post-surgical complications were noticeably lower when the joint replacement surgery was performed in the ASC setting. While the amount of data was small, Volling did comment that study results shed light on “the sort of further study that can and should be done on a broader set of procedures, to fully identify what can safely be performed in an ASC care setting.”
Volling then examined overall economic savings. Most readers are probably not surprised to learn that ASCs are more cost efficient than hospitals and the numbers cited in the whitepaper add support to that indicator. The whitepaper cited a study by the Ambulatory Surgery Center Association indicating that “there is an overall reduction in healthcare costs of more than ‘$38 billion per year due to the availability of ambulatory surgery centers (ASCs) as an appropriate setting for outpatient procedures.’”
One of the drivers behind the cost savings offered by ASCs is the “the disparity in reimbursement rates between hospitals and ASCs.” Data cited on rotator cuff repair surgery indicated “ASCs are typically reimbursed at 53% of the rate being reimbursed to HOPDs [hospital-based outpatient department].”
The final indicator supporting ASCs growth is both the acquisition of ASCs by larger organizations and the opening of new ASCs. The whitepaper pointed to United Surgical Partners International’s (a Tenet Healthcare subsidiary) 2021 acquisition that gave it an ownership interest in 92 ASCs. It also cited another source indicating that in 2021 an additional 258 ASCs opened across the U.S.
The Definitive Healthcare ASC Whitepaper author, Senior Product Marketing Manager Ashley Volling, has more than 15 years of marketing experience in the medical device and pharmaceutical industries.
The growth of ASCs has increased access to care for patients, especially during the pandemic, which also heightened the financial challenges that many independent orthopedic practices were already facing.
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