Becker's Spine Review

33 ASC What procedures are migrating to ASCs? By Patsy Newit F rom high-acuity spine to cardiac procedures, five ASC leaders joined Becker's to share what procedures they see moving to the ASC setting. Editor's note: Responses were edited lightly for clarity and brevity. Cherise Brown. Administrator of Andover (Kan.) Surgery Center: In the near future we will see more orthopedic, spine and cardiac procedures in the ASC setting. CMS recently added several cardiac procedures to the ASC covered procedure list, including diagnostic and interventional coronary procedures, peripheral vascular interventions, and placement of pacemakers and defibrillators. Quality of care, recovery time, physician autonomy and cost will continue to drive more procedures to the ASC setting. Eric Anderson, MD. Pain Management Physician in Lewisville, Texas: I think there will be an increase in the size and scope of ASC development, utilization and type of cases expanding in the pain management space; for certain cases. I think pain management implants, devices and minimally invasive treatments will continue to see preference in the ASC setting as CMS has already started preferring this route for spinal cord stimulator systems, for example. Brenda Carter. Administrator of Wilmington (N.C.) Surgcare: e future looks bright for more total joint cases in the ASC, along with spine and cardiology. e push to the ASC creates a better patient experience, reduces costs and can ease the burden on overwhelmed, understaffed hospital facilities. However, insurance carriers will need to revisit the procedures previously only allowed in the hospital setting to create an easy transition to ASCs. As the carriers have historically been slow to respond to changing trends, this may initially present some challenges. Harry Aslanian, MD. Advanced Endoscopist at Yale School of Medicine (New Haven, Conn.): ere has been interest in moving endoscopic ultrasound procedures to the ASC setting. is is a feasible option should the payment structure promote a change to an ASC setting. Myrna Loida Chang, RN. Director of Surgical Services at HCA- Good Samaritan Hospital (San Jose, Calif.): I can see the following moving to ASC: total knees, one level spine surgeries, one level anterior cervical discectomy and fusions, and mastectomies. n UW-Madison orthopedic head steps down after proposed ASC denied By Carly Behm T homas Zdeblick, MD, who was chair of orthopedics at the University of Wisconsin-Madison, resigned after his plan for a majority physician-owned ASC was denied, the Wisconsin State Journal reported Sept. 12. Dr. Zdeblick's proposed ASC would be in the Madison, Wis., area, and 62 percent of it would be owned by UW physicians. The ASC would be 7,000 square feet and have two operating rooms. Dr. Zdeblick, who has been orthopedics chair since 2000, told the State Journal the proposed ASC would help solve staffing-related capacity issues in UW Health's operating rooms. Robert Golden, MD, dean of UW School of Medicine and Public Health, did not endorse the plan, and Dr. Zdeblick stepped down as chair of orthopedics June 27. According to letters the newspaper received in open records requests, Dr. Golden told Dr. Zdeblick the ASC would "deprive" the health system of "potential revenue," the report said. Dr. Golden also argued that Dr. Zdeblick's plan to have UW physicians own the ASC would violate state law and UW-Madison's policies against using school positions for personal gain. Dr. Zdeblick remains an orthopedics professor and director of the UW Spine Center. He told the State Journal he plans to retire in 2022 and is no longer pursuing the ASC. In 2011, his relationship with Medtronic and physician payments from the company were the subject of scrutiny. Tammy Scerpella, MD, is interim chair of orthopedics. n

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