High-acuity procedures on the move: 10 things to know

The continued migration of higher-acuity procedures from HOPDs to ASCs accelerated throughout 2024, according to VMG Health’s “ASCs in 2024: A Year in Review” report.

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Here are 10 things to know from the report:

1. Orthopedics, cardiology and advanced spine procedures were specialties identified as driving significant growth among ASCs, mainly due to technological advancements and increased demand for cost-effective care. 

2. Brentwood, Tenn.-based Surgery Partners CEO Eric Evans highlighted during its Q3 2024 earnings call that, “total joint cases in our ASCs continue to grow at a disproportionate rate, with just over 50% increase in case volume in the quarter.” He also emphasized that this growth is expected to continue as hip, knee and shoulder surgeries increasingly shift to ASCs.

3.  Dallas, Texas-based Tenet Healthcare CEO Saum Sutaria noted that orthopedic volumes in USPI centers grew 23% year-over-year, reinforcing Tenet’s focus on expanding high-acuity service lines in a Q2 2024 earnings call, according to the report. 

4. Nashville, Tenn.-based HCA Healthcare also noted this shift. CEO Sam Hazen reported consistent growth in high-acuity services, such as cardiac surgeries, across their outpatient network.

5. As higher-acuity procedures shifted into ASCs, lower-acuity procedures began transitioning into office-based procedural settings, according to the report. This was driven by advances in minimally invasive technologies and cost-containment strategies in ophthalmology, dermatology, pain management and minor orthopedic procedures.

6. Cataract removals and minor hand procedures were highlighted as procedures that are becoming more common in office-based settings due to “[s]treamlined protocols and reduced reliance on general anesthesia.”

7. The report also highlighted a shift in CMS policy in the 2025 ASC covered procedures list, which has a stronger focus on dental and regenerative therapy procedures, rather than adding more high-acuity offerings. 

8. “This change reflects CMS’ effort to diversify the range of services available in ASCs, broadening access to lower-acuity procedures while balancing patient safety and cost-effeciency,” reads the report. 

9. While these additions expand the range of services for ASCs overall, industry leaders are still advocating for the list to include more high-acuity procedures. 

10. The continued shift of high-acuity procedures to ASCs is likely to continue as ASCs become better equipped to manage them safely, a shift driven largely by enhancements to technology in ASCs.

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