Becker's ASC Review

42 ORTHOPEDICS 6 questions on the future of outpatient orthopedics with Dr. Randall Schultz By Rachel Popa W . Randall Schultz, MD, is an orthopedic surgeon at Texas Orthopedics in Austin. Here, he shares his thoughts on outpatient orthopedics. Note: Responses have been lightly edited for style and clarity. Q: What changes or opportunities are you expecting to see for outpatient total joints in the coming years? Dr. Randall Schultz: I expect we will see increasing volume in outpatient centers as competition on cost and quality increases with value-based payment programs and employer-based insurance programs. Additionally, our ability to optimize patients preoperative will improve and increase volume through the centers. "Don't cherry pick — make more cherries!" Q: Are there any kind of overarching trends that you're seeing right now in outpatient orthopedics? RS: ere is an interesting divergence in the world of joint replace- ment with a move to more expensive, computer and robotic-based procedures while we are simultaneously seeing market pressures to reduce costs and improve quality. Q: How do you hope the ASC industry will change in the coming years? RS: I think it will be increasingly recognized as a viable competitor to the hospital experience. Oen physicians have a greater role in own- ership and administration of these facilities, and this oen leads to quality improvements and better patient experience. It is important that ASCs maintain the same regulatory standards and not put profits in front of safety. Q: Is there any new technology you're looking forward to on the horizon? RS: I think we have just seen the tip of the iceberg in the world of preoperative optimization. e ability to identify modifiable risk fac- tors and correct them preoperatively will lead to increasing volume of patients who are healthy and fit enough to have their procedures performed in a lower cost, ambulatory setting. Q: Do you have any tips or things to know before start- ing a total joint program? RS: Variation is the enemy of any program. Creating consistency and developing clinical pathways with engaged provides are the funda- mentals to creating a successful program. Q: Do you think private equity will have an impact on the orthopedic specialty? Why or why not? RS: I think we will see it become more prevalent (and are seeing) it in the marketplace due to declining reimbursement and increas- ing overhead costs. Unfortunately, I think the shi from physician ownership of practices will ultimately decrease satisfaction for both the providers and the patients. n Wyoming orthopedic practice erecting $11M surgery center By Angie Stewart L aramie, Wyo.-based Premier Bone & Joint Centers has an $11 million surgery center and physical therapy building in the works, according to Colorado Real Estate Journal. What you should know: 1. The 21,000-square-foot surgery center will provide services ranging from basic procedures to total joint replacements. It will feature three operating rooms and a physical therapy gym. 2. The new facility is being built on PBJC's existing site in Laramie. The current building will remain in opera- tion during construction. 3. Vertix Builders recently topped out the surgery center. n North Carolina passes over major providers, grants CON to spine surgery center, orthopedic practice By Eric Oliver T he North Carolina Department of Health and Human Services approved certificate-of-need applications from Wake Spine and Specialty Sur- gery Center and Triangle Orthopaedics Surgery Cen- ter, passing over some of the region's largest health- care institutions, Triangle Business Journal reports. What you should know: 1. Raleigh-based Wake Spine received approval to develop a new ASC in Raleigh with one operating room and three procedure rooms. The ASC will cost $5.6 million. 2. Raleigh-based Triangle Orthopaedics wanted to add two operating rooms to its existing surgery center for $5.6 million, but received conditional approval to add only one OR. 3. The health department denied applications from Durham-based Duke Health, Chapel Hill-based UNC Health Care, and Raleigh-based WakeMed. 4. The state said in its decision document that Wake Spine and Triangle Orthopedics had the "more effec- tive alternatives" and were conditionally approved. n

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