Here are 10 predictions and key trends for outpatient surgery and ASCs, including key specialties and outpatient growth, through 2027.
1. Over the next decade, inpatient discharges are expected to decrease 2 percent while outpatient volumes will likely grow 15 percent across the U.S., according to Sg2 predictions. As the government and payers scrutinize costs and push the shift to value-based care, outpatient surgery is expected to see an overall 11 percent increase from 2017 to 2022.1
2. Inpatient orthopedic and spine surgeries are expected to deceases 3 percent over the next 10 years while spine surgeries including spinal fusions are expected to increasingly head to the outpatient setting. Orthopedics and spine are expected to grow 35 percent in the outpatient setting over the next 10 years, according to Sg2.
3. Consumers will drive choice in the outpatient setting for orthopedic and spine care. This will dampen growth in rehab follow-up visits and shift care away from the hospital and emergency department setting.2
4. Cardiovascular care is declining in the inpatient setting, but the shift to outpatient is limited because the patient population is typically older and needs additional care support. However, interventional cardiology and electrophysiology procedures could go outpatient with continued technology advances and payment approvals.
5. The shift to outpatient care among gynecology procedures is expected to accelerate over the next several years. Inpatient gynecology is expected to drop 28 percent in the next decade while hysterectomies will become more common as an outpatient procedure.
6. Since CMS has begun removing high-revenue procedures like knee replacements from the inpatient-only list, there will likely be an increase in competition for outpatient care. The Advisory Board reports a renewed interest in ASCs and health systems examining their ambulatory footprints.3
7. Non-provider organizations have an increased interest in outpatient surgery and ASCs as the industry moves toward value-based care. New market entrants and out-of-industry players such as private equity firms or insurance companies will become competitors in the space as well, according to Advisory Board.
8. The ASC market is expected to grow at a 4 percent compound annual growth rate from 2017 to 2027, according to Future Market Insights. The hospital-based ASC segment is expected to hit $69.7 billion by 2027, and multispecialty ASCs are expected to dominate reaching $76.8 billion over the next decade.4
9. ASC surgical volume in 46 of the 50 largest markets in the U.S. grew 10 percent from 2015 to 2016, and market factors are expected to continue pushing for growth.5 "We're seeing the symptoms of a changing marketplace nationally," said Managing Director of Franklin Trust Ratings John Morrow. "As payment reforms collide with consumer sentiment, and technology pushes outpatient care to new limits, lower priced settings are disrupting traditional care models. Hospitals and ASC operators need to understand the market stage and transitions taking place in their service line markets as they mature."
10. In the 50 largest markets, the overall ASC surgical procedure volume increased 22.9 percent nationwide, with 35.8 million outpatient procedures occurring in hospital-based outpatient departments and ASCs annually. GI procedures grew 19.4 percent from 2015 to 2016, while eye procedures jumped 2.8 percent.
1. Sg2: Sg2 2017 Impact of Change Forecast: Finding Growth. Posted May 5, 2017; Accessed April 2, 2018: https://www.sg2.com/health-care-intelligence-blog/2017/05/sg2-2017-impact-change-forecast-finding-growth/
2. Sg2: Sg2 2017 Impact of Change Forecast: Finding Growth. Posted May 5, 2017; Accessed April 2, 2018: https://www.sg2.com/health-care-intelligence-blog/2017/05/sg2-2017-impact-change-forecast-finding-growth/
3. Advisory Board: Our 2018 growth predictions: What planners should watch for. Posted Feb. 15, 2018; Accessed April 2, 2018: https://www.advisory.com/research/market-innovation-center/the-growth-channel/2018/02/2018-growth-predictions
4. Future Market Insights: Ambulatory Surgical Centres Market to Garner US$113,046.7 Mn By End of 2027 – Future Market Insights. Posted Sept. 27, 2017; Accessed April 2, 2018: https://globenewswire.com/news-release/2017/09/27/1133626/0/en/Ambulatory-Surgical-Centres-Market-to-Garner-US-113-046-7-Mn-By-End-of-2027-Future-Market-Insights.html
5. Franklin Trust Ratings: Ambulatory Surgical Care Growth: ASC Surgical Volumes Grow in 46 of 50 Largest Markets while Hospitals Lose Share. Released Feb. 2, 2018.