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.

At the Becker's 23rd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, taking place June 11-13 in Chicago, spine surgeons, orthopedic leaders and ASC executives will come together to explore minimally invasive techniques, ASC growth strategies and innovations shaping the future of outpatient spine care. Apply for complimentary registration now.

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