Becker's Spine Review

47 OUTPATIENT SURGERY 10 things to know about spine surgery in ASCs for 2019 By Rachel Popa H ere are 10 key facts and studies on outpatient spine surgery and spine procedures in ambulatory surgery centers: 1. Over 145 ASCs in the U.S. offer minimally invasive spine surgery. 2. Around 90 percent of patients who un- derwent anterior cervical discectomy and fusion at an ASC consumed less than or equal to the 30th percentile of oral mor- phine equivalents, compared to 57 percent of hospital patients. 3. A study published in Military Medicine ex- amined the return-to-duty rates for military patients who underwent minimally invasive spine surgery in an ASC. All of the partici- pants returned to duty three months postop- eratively. Patients experienced a significant reduction in self-reported pain and disability 12 months postoperatively. 4. As more spine surgeries transition to the outpatient setting, surgeons and research- ers continue to study the cost differences be- tween inpatient and outpatient procedures. Aer examining the national administrative data, researchers found more modest cost savings for outpatient spine surgery than in- patient spine surgery. 5. A study published in Spine investigated the adverse event profile of cervical total disc replacements performed in the outpa- tient versus inpatient settings. Study authors found no difference in perioperative compli- cations between the inpatient and outpatient CTDRs. 6. Research published in Neurosurgery found outpatient spine procedures are just as safe as — or safer than — procedures performed in an inpatient setting. 7. CMS released a new tool allowing patients to compare the average payments of select orthopedic and spine procedures in hospital outpatient departments and ASCs. A few examples of reimbursement for spine procedures: Total disc arthroplasty with discecto- my (22856) ASC: • Average Medicare pays: $8,970 • Average total cost: $11,213 • Amount patient pays on average: $2,243 HOPD: • Average Medicare pays: $14,031 • Average total cost: $15,371 • Amount patient pays on average: $1,340 Sacroiliac joint fusion (27279) ASC: • Average Medicare pays: $9,965 • Average total cost: $12,456 • Amount patient pays on average: $2,491 HOPD: • Average Medicare pays: $14,031 • Average total cost: $15,371 • Amount patient pays on average: $1,340 Anterior cervical discectomy (22551) ASC: • Average Medicare pays: $5,870 • Average total cost: $7,337 • Amount patient pays on average: $1,467 HOPD: • Average Medicare pays: $8,783 • Average total cost: $10,123 • Amount patient pays on average: $1,340 8. Baptist Medical Park Surgery Center, an ASC in Pensacola, Fla., is the first surgery center in the Southeast to purchase Mazor Robotics' Renaissance System. Mark Giovanini, MD, a surgeon who is using the Renaissance System for all SI fusion procedures, said the technol- ogy provides patients with the full advantages of spinal surgery with the convenience of an outpatient facility. 9. Bill Stewart, area vice president of val- ue-based purchasing for DePuy Synthes, a Johnson & Johnson company, said spine is a specialty to watch in ASCs. "What we've seen with spine is that surgical procedures are migrating outpatient, typically one- to three-level ACDF and discectomy. But lumbar spine is much slower to move outpa- tient. What we've seen with lumbar spine is a small number of sites are doing it. A lot of that is because it's capital intensive to do lumbar spine," he said at Becker's ASC 25th Annual Meeting: e Business and Operations of ASCs in Chica- go Oct. 18, 2018. 10. Anterior cervical discectomy and fusions are safe in the outpatient setting for properly selected patients, according to research the New York City-based Hospital for Special Surgery presented at the American Academy of Orthopaedic Surgeons Annual Meeting in Las Vegas, March 12-16. "e results suggest that multi-level ACDF can be performed safely in the outpatient setting without an increased risk of compli- cations in appropriately selected patients," said Hospital for Special Surgery's Sheeraz Qureshi, MD. "Specifically, the patient's age, additional health conditions and number of levels being fused should be taken into con- sideration when deciding whether to perform multi-level ACDF in an outpatient setting." n OrthoNY opens $5.3M surgery center — 5 insights By Eric Oliver A lbany, N.Y.-based OrthoNY opened OrthoNY Surgical Suites, a $5.3 million outpatient surgery center in Clifton Park, N.Y., Albany Business Review reported. What you should know: 1. The surgery center has four operating rooms. 2. OrthoNY built the Clifton Park location to expand into the suburban market. 3. OrthoNY expects to perform 3,162 surgeries there in the first year and 3,320 procedures by year three. 4. The surgery center could make up to $6.17 million in annual revenue by the third year it's open. 5. The group will perform general orthopedic surgeries to start and will even- tually offer total joint replacements. n

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