Becker's ASC Review

21 Thought Leadership 'There is a lot more business to do': Dr. Daniel Lieberman on spine ASC growth By Laura Dyrda C OVID-19 has accelerated the trend to outpatient spine surgery, according to Daniel Lieberman, MD, medical director of Phoenix Spine & Joint. In this excerpt from an interview with Becker's Spine Review, Dr. Lieberman outlines what the next five to 10 years looks like for outpatient spine. Question: What do you see as the next big trend in spine for ASCs? Dr. Daniel Lieberman: Over the last five years we've seen real energy pulling away from deformity correction and multilevel fusion surgery, and the entire field of spine surgery moving into much more focused interventions based on structure. I think the next horizon is focused interventions based on symptoms. What patients really are concerned about is their pain. Our surgery centers offer endoscopic dorsal rhizotomy, so ultra-min- imally invasive surgeries that eliminate pain are really the next horizon. It's almost like we're going to see spine surgery absorb and move into more of a pain management approach, rather than a structural correction approach. Q: How do you see hospitals competing with ASCs post-pandemic? DL: Hospitals are not going to stay on the sidelines. ey can't let their golden egg leave the goose. ey're going to have to be heavily involved in ASCs, so they're going to be another stakeholder that will get even more fired up and involved in our industry. Q: How are you looking at growth in 2021? DL: We're seeing rapid growth in the number of surgeons who want to operate primarily in an ambulatory setting. Our physi- cian recruitment is exponentially higher than it has ever been. We initially thought the transition to the ASC environment was going to take place over the next five to 10 years, but now I think it's going to over the next one to five years. So, we're opening a new surgery center in Gilbert, Ariz. — our biggest center yet. We've already recruited most of the physicians we need to fill it. We're seeing this as a new period of growth for ASCs, coming on top of an old period of growth. e ASC market has been getting bigger and stronger for years and we see that continuing to increase in the future. ere is a lot more business to do. n Moving total joints to ASCs could yield $3B in annual savings, UnitedHealth says By Angie Stewart M innetonka, Minn.-based UnitedHealth Group on Dec. 10, 2020, published new research touting the major advantages of moving routine joint replacements from hospitals to ASCs. Five key insights from the report: 1. Shifting half of all routine joint replacements from hospital in- patient settings to ASCs could yield $3 billion in annual savings — $2 billion for privately insured individuals and employers, and $1 billion in savings for Medicare beneficiaries and the federal government. 2. ASCs are also advantageous in terms of patient safety and low infection risk. Migrating half of all routine inpatient joint replacements to ASCs could result in more than 500,000 fewer hospitalizations. 3. Surgical site infections follow up to 2.5 percent of hospital joint replacements. As a result, as many as 26,000 joint replace- ment patients each year have longer hospital stays and require further treatment. 4. More than 1.2 million hip and knee replacement surgeries were performed in the U.S. in 2019. In 2018, about 90 percent of joint replacement surgeries for privately insured patients were performed in hospitals. 5. UnitedHealth Group conducted a case study of Deerfield, Ill.-based Surgical Care Affiliates, which operates over 230 ASCs in the U.S. At SCA centers that performed 25 or more joint replacements in 2019, for every 1,000 patients receiving a hip or knee replacement in 2018 or 2019: • 993 patients were infection-free and discharged without requiring a hospital visit • Four patients required a hospital visit within 24 hours of discharge, including visits for underlying conditions • Fewer than 0.3 percent of patients developed a surgical site infection "Because ASCs specialize in the procedures they perform, they can concentrate on optimizing safety and quality outcomes for patients," UnitedHealth Group's research concluded. "ASCs with established joint replacement programs are operating safe, scalable models that achieve high-quality results for knee and hip replacement surgeries." n

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