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Building a Successful ASC Total Joint Program: Pathways to Success

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At the 12th Annual Spine, Orthopedic and Pain Management Driven ASC Conference + The Future of Spine, Walter Spires Jr., founder and principal of Spires Advisory, discussed his experience with building a successful total joint program in an ASC on June 13.

He laid out some pathways to successful execution of a total joint program in an outpatient setting.

Surgeon alignment. "This needs to be surgeon-driven," he said. A program should be built around a lead "alpha dog" surgeon who really is driven to see the outpatient program succeed. "If you have to talk someone into something, that's not a good place to start," he said.

Legal-regulatory review. ASCs need to be aware of their state's length of stay laws, Mr. Spires said.

Payer strategy. Payers in some states or metro areas are not willing to reimburse for a total joint surgery in an ASC, which is something administrators need to consider carefully before moving forward. Mr. Spires also gave some sound advice, saying "If you're not carving out implant costs, you will lose your shirt."

Patient selection. ASCs need to establish patient selection criteria before starting up a total joint program. The criteria should address acuity and patient enthusiasm as well as the support system they would have at home post-surgery.

Facility readiness. Some ASCs are older and do not have OR space necessary for surgeons to perform total joints, Mr. Spires warned.

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