Becker's Spine Review

January_February Issue of Beckers Spine Review

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30 OUTPATIENT SURGERY Hospital-Based Surgery Centers to Hold 59.5% Market Share in ASC Market: 8 Things to Know By Mary Rechtoris The global ASC market is expanding rapidly, according to a Future Market Insights report. Here are eight things to know: 1. By 2027, the market is expected to increase at a 4 per- cent compound annual growth rate. 2. The report noted the multispecialty centers segment likely held a 65 percent market share by the end of 2017. 3. By 2027, the multispecialty center market is likely to total nearly $76.03 billion, increasing at a 4.4 percent compound annual growth rate. 4. The hospital-based ASC modality type likely held a 59.5 percent market share by the end of 2017. 5. The hospital-based ASC modality type is likely to total $69.7 billion by 2027, increasing at a 4.4 percent com- pound annual growth rate. 6. By service type, the surgical services segment is antici- pated to total $77.66 billion by the end of 2027. 7. The gastroenterology specialty area will increase at a 4.7 percent compound annual growth rate through 2027. 8. Companies operating in the market include Regent Surgical Health, AmSurg, Hospital Corporation of Amer- ica, Tenet, Surgical Care Affiliates, Ambulatory Surgical Centers of America, Surgery Partners, Medical Facilities Corp., Healthway Medical Group and Community Health Systems. n NYU Langone Unveils Ambulatory Care Center in Brooklyn — 7 Notes By Megan Wood N YU Langone Health opened a new am- bulatory care center in Brooklyn, N.Y. Here are seven notes: 1. The new center is called NYU Langone Ambulatory Care Bay Ridge. 2. The ambulatory center is now accepting orthopedic patients. Surgeons special- ize in hand and wrist sur- gery; hip and knee recon- struction; spine surgery; sports medicine; trauma surgery and pain medicine. 3. NYU Langone Ambulato- ry Care Bay Ridge will also provide the following ser- vices: • Cardiology • Ear, nose and throat • Gastroenterology • General breast surgery consultations and fol- low-up appointments • Obstetrics, gynecology • Internal medicine • Podiatry • Reconstructive and cos- metic plastic surgery con- sultations and follow-up appointments • Rheumatology 4. Within the months follow- ing the center's opening, NYU Langone Ambulatory Care Bay Ridge will open an on-site imaging center, equipped with MRI scans, CT scans, Ultrasound imag- ing and X-ray imaging. 5. The 35,000-square-foot ambulatory center will en- compass four clinical floors. 6. Sixty-plus physicians and staff will likely provide ser- vices at the center. 7. NYU Langone expects the ambulatory center to be fully operational by the sum- mer of 2018. n ing into purchasing an additional robot for orthopedic surgeries. e center, however, is entirely out-of-network. Reimbursement outlook 14. CMS removed total joint replacements from the inpatient-only list in 2018, and while some physicians and administrators are excit- ed about the move, others are skeptical. Payers typically set reimbursement as a percentage of Medicare, which could push commercial pay- er rates lower than they previously were, de- pending on where CMS sets the fee schedule. Medicare could also lump implants into one global fee for total joint replacements, which could limit an ASC's ability to negotiate im- plant carve-outs with commercial payers. 15. Certain procedures have migrated back into the hospital because reimbursement was too low. Several sports medicine procedures, depending on the market and payer, are mi- grating back to the hospital, and total joint re- placements could experience a similar trend. 16. Insurance companies tightened their re- strictions around approving total joint re- placement cases. Surgeons are likely to receive denials for patients who would have been good surgical candidates in the past based on medical necessity guidelines, and while surgeons can appeal the decision, appeals are sent to peer reviews with non-orthopedic spe- cialists. e Michigan-based ASC reported canceling cases because of last minute denials from the insurance company. 17. Total joint and spine systems remain a significant expense for spine cases in the ASC setting, and reimbursement doesn't always cover the high-end devices even with a carve- out. At the centers where these procedures are performed successfully, ASC owners and operators shop around for the best contracts and require manufacturers to provide evi- dence-based literature on new devices. n

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