Orthopedic Procedures in ASCs: 3 Keys to Improving Case Profitability
Dr. Redler began by sharing some of the challenges facing surgeons in ASCs. The biggest ones include reducing the time required to perform procedures, increasing the range of cases that can be performed in the ASC setting, and keeping implant and disposable supply costs as low as possible.
Reducing procedure time
Ensuring ORs can be turned over frequently helps improve an ASC's profitability. To ensure timely turnover, ASCs should limit the activities performed in the OR to surgery only. For example, nerve blocks should be placed before the patient is moved into the OR. Nerve blocks, instead of regional anesthesia, also reduce the time a patient spends in the post-anesthesia care unit, Dr. Redler added. "It is not only good care for the patient, but makes economic sense as well," he said.
He also mentioned the importance of marking the site (left or right extremity) that will be treated during surgery. If a procedure is performed on a wrong site, it can be detrimental for the ASC. "Wrong site surgery can be eliminated in orthopedic surgery by following best guidelines," he said.
Dr. Redler added that anesthesiologists should also mark the site of regional blocks, explaining that wrong site blocks are one of the more common types of wrong site procedures. Blocks can be started before the patient enters the OR, thereby reducing the total OR time.
Increasing range of cases
Minimally invasive techniques have greatly increased the range of orthopedic cases that can be performed in an ASC, said Dr. Redler "A lot of procedures these days that were normally done as an open procedure…now can be done minimally invasive," he said.
Spine cases have also been moving to outpatient centers, he said, adding that spine surgeons perform one- and two-level anterior cervical discectomies. The start-up costs for spine cases are high and may exceed $100,000 for a single set of equipment required for these cases. However, payment for spine cases is higher than other orthopedic cases and presents a significant opportunity for revenue generation, said Dr. Redler.
Reducing implant, supply costs
Finally, orthopedic ASC leaders must focus on keeping supply costs in check. Dr. Redler encouraged the use of volume and preferred vendor discounts. He also encouraged physician owners to come to a consensus on supplies used for each case as doing so will allow the center to purchase a greater volume (ideally of a lower-cost supply) from a fewer number of vendors.
© Copyright ASC COMMUNICATIONS 2014. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.
To receive the latest hospital and health system business and legal news and analysis from Becker's Hospital Review, sign-up for the free Becker's Hospital Review E-weekly by clicking here.
- Is your office culture killing or helping revenue? 3 ways to find out
- Do I Really Need an Investment Advisor? The 9 Reasons Physician-Investors Underperform Without Professional Management
- Do I Really Need an Investment Advisor? The 9Reasons Physician-Investors Underperform Without Professional Management
- 3 market drivers of the movement of spine, total joint cases to ASCs
- Novel techniques for managing postoperative pain following orthopedic and spinal procedures performed in ambulatory setting