Becker's ASC Review

69 12th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference + The Business of Spine - call (800) 417-2035 Dr. Scioli: Total joints can be performed efficiently in an outpatient set- ting when a systematic approach is taken and when each person involved knows what his or her role is. Logistically, the surgicenter affords the greatest amount of flexibility and adaptation, which should translate into a stream- lined experience. Nothing should be left to chance. Q: What data do ASCs need to show to prove total joints can be performed safely in an outpatient setting? Dr. Riordan: First, ASCs must realize that surgeons, nurses, administrators, patients and their families, regulators, legislators, insurers and even hospitals are each groups to which we must be able to demonstrate our competency. Knowing this, we are then able to build the processes that meet each of their needs or concerns. ASCs must then demonstrate, in measurable fashion, safety and efficiency combined with high patient satisfaction. Unaffiliated hospitals naturally may find this as a competitive activity. They are in the unenviable position of needing to justify why patients need to be exposed to the less satisfying, higher cost and particular risks of hospital versus ASC care. ASCs, most criti- cally, need to prove that they deserve the opportunity to expand service lines. Important data is that which allows comparison to other care delivery mod- els, complications and pain control included. Dr. Scioli: ASCs need to pool data to prove that when joint replacements are performed as outpatient procedures they are more effective and less costly than when performed as inpatient procedures. The complication rates should be equal to, or better than, the same procedure when performed as an inpatient. Q: Are total joints trending outpatient or inpatient, and why? Dr. Burgoyne: Joint replacements are most definitely trending towards an outpatient model. At the most basic level, long inpatient stays are simply not necessary. Often my patients are bored, requesting discharge by the second day after surgery. The reality is that there is not much we do for patients dur- ing their two- to three-day hospital stay. If their pain is well controlled with the regional anesthesia, they are usually sitting around waiting for the one to two hours of therapy they receive. Why not sit at home and come in for outpatient therapy daily instead? Dr. Riordan: Clearly outpatient joint replacements are trending upward. Our experience, as well as that of other facilities in our region, is that an exciting increase in patient and surgeon demand for this service is occurring. ASCs are ideally positioned to lead this movement that lowers costs, controls com- plication rates, improves satisfaction and is preferred by patients. Q: Are insurance companies coming onboard with outpatient joint replacements? Dr. Scioli: The insurance companies will be more inclined to endorse these procedures being performed as an outpatient procedure once adequate data exists to support the practice as being safe and effective. Medicare and Med- icaid should allow for certain criteria to exist such that special cases could be done as an outpatient procedure. In time, outpatient joint replacement will gain the traction it needs to become routine. Dr. Riordan: Insurers were initially cautiously supportive or sitting on the sidelines as interested observers. Lately, insurers have contacted us regarding our outpatient joint program, requesting data, asking to gain an understand- ing and even promoting our model in their other markets. Dr. Burgoyne: Medicare has acknowledged this trend and is revisiting their policies in regards to payment for outpatient joint replacements. Once they allow for outpatient arthroplasties, it is likely other insurance companies will follow suit. With rising costs and the large volume of procedures to be per- formed in the coming years, I think this shift to outpatient care is crucial to maintaining access to these vital procedures. n info@physiciancontrol.com or call 404.920.4950 www.physiciancontrol.com At IMS affiliated ASCs, physician owners are involved with decision making for the organization, a rare concept in today's ASC environment. IMS specializes in development and management solutions for all types of ASCs. Our emphasis on physician control and our no-nonsense ap approach set us apart from traditional ASC management companies. Our experience allows us to finalize transactions quickly, so you can focus on what matters: your patients. Let us show you how partnering with IMS can enhance your center's success through physician control. Interventional Management Services Less Red Tape. More Time For What Matters. Medicare-Certified ASCs Grow 12% From 2007 to 2012 By Carrie Pallardy T here were 5,357 Medicare-certified ambulatory surgery centers in the United States in 2012, according to the 2014 MedPAC is- sues report to Congress. Here are 12 statistics on the number of ASCs in the country and net percent growth in number of centers from 2007 to 2012. 2007 • 4,798 ASCs • 5.9 percent growth 2008 • 5,001 ASCs • 4.2 percent growth 2009 • 5,111 ASCs • 2.2 percent growth 2010 • 5,203 ASCs • 1.8 percent growth 2011 • 5,291 ASCs • 1.7 percent growth 2012 • 5,357 ASCs • 1.2 percent growth n

• Cover