Becker's ASC Review

98 HIP ARTHROPLASTY UnitedHealth: Moving total joints to ASCs could yield $3B in annual savings By Angie Stewart M innetonka, Minn.-based United- Health Group on Dec. 10 pub- lished new research touting the major advantages of moving routine joint replacements from hospitals to ASCs. Five key insights from the report: 1. Shiing half of all routine joint replacements from hospital inpatient settings to ASCs could yield $3 billion in annual savings — $2 billion for privately insured individuals and employ- ers, 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. Migrat- ing half of all routine inpatient joint replace- ments 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 replacement 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 pri- vately insured patients were performed in hospitals. 5. UnitedHealth Group conducted a case study of Birmingham, Ala.-based Surgi- cal 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 re- placement programs are operating safe, scal- able models that achieve high-quality results for knee and hip replacement surgeries." n Boston hospital performs 1st augmented reality-guided total hip replacement By Patsy Newitt O rthopedic surgeons at Boston-based New England Baptist Hospital performed the first augmented reality total hip replacement at a hospital. The AR-guided total hip replacement received FDA clear- ance in January and is the first intraoperative AR guidance platform for joint replacement to display 3D models of patients' anatomy, implants and instruments inside the body in real time, according to a March 31 release. NEBH's Stephen Murphy, MD, invented the system and performed the hip replacement alongside Daniel Ward, MD, and Carl Talmo, MD. The AR-guided system is also the first FDA-cleared surgical platform for joints to be contained entirely within a head- mounted device. Unlike robotic and traditional naviga- tion systems, there aren't any large external workstations, cameras or screens, so it can be easily deployed across operating rooms. n How 2 Tennessee orthopedic practices are capitalizing on total hips By Eric Oliver M emphis, Tenn.-based providers Campbell Clinic and OrthoSouth jumped on CMS' decision to allow ASCs to perform outpatient total hip replacements, the Memphis Business Journal reported Jan. 20. Campbell Clinic has performed outpatient total joints since 2013. The practice expects to perform a "couple hundred" total hip replacements this year, with volume increasing in subsequent years. OrthoSouth, too, anticipates a "surge of volume coming" in 2021, but doesn't believe it'll be as strong as when total knee replacements were first approved. The practice performed about 25 percent of its total knee replacements on Medicare patients in 2020, but believes the total hip replacement patients will have more limiting factors. n

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