Swiss medtech company Distalmotion took to LinkedIn Oct. 6 to break down the integration of a surgical robot into an ASC.
The company has built its pitch for the robot around the outpatient setting, specifically ASCs, boasting a small 125-square-foot footprint, no OR retrofit costs and a mobile platform to move between rooms.
By May, ASCs affiliated with Chicago-based CommonSpirit Health, Scottsdale, Ariz.-based HonorHealth, Deerfield, Ill.-based SCA Health and Brentwood, Tenn.-based Surgery Partners had adopted Dexter.
Distalmotion is not alone. Device maker Intuitive Surgical has also called ASCs robotics’ next frontier, and orthopedic robots from Stryker, Smith+Nephew and DePuy Synthes are increasingly turning up in outpatient joint facilities.
Yet as robots move into the outpatient space, ASC leaders are beginning to ask hard questions: What does a robot actually cost, and who pays for it? Does the use of a robot improve patient outcomes and operational efficiency, or are they just a marketing tool? Who is buying robots? And do patients care?
Here are nine things to know before buying:
- ASCs earn the least for robotic cases. Freestanding ASCs are reimbursed less than hospitals and HOPDs for the same procedure, and using a robot does not change that math. Payers have not yet adjusted rates to cover the technology’s costs.
- Upfront costs are falling, but costs aren’t. Manufacturers now offer leases, per-procedure pricing, volume rebates and robot placement in exchange for sole-source implant deals. Some leaders argue the expense simply shifts into implant pricing or per-case fees.
- Robots add to an already squeezed margin. ASC executives have named robotics, in addition to implants and AI, as technologies driving procedure costs up while reimbursement lags.
- The clinical benefit is still under debate. Some orthopedic surgeons question whether robots add much beyond existing computer navigation, and whether they slow cases down. Outcomes and infection data remain a sticking point.
- Efficiency is where the math can work. Centers that track cost, OR time and margin per minute have found robotic cases can be financially viable. Health systems have also used ASC robots to move lower-acuity gynecology and hernia cases out of crowded hospital ORs.
- Some ASC robot programs are paying off. When Indianapolis-based Community Health Network placed a da Vinci robot in a hospital-affiliated ASC, the program did more than 300 cases in its first year, double its goal of 150. Patients gave the center a 96% satisfaction rating, and the system was able to use the freed OR time to add about 150 complex cases a year.
- Adoption keeps climbing. ASCs are adding da Vinci systems for general surgery and gynecology Mako, Velys, Cori and Rosa robots for joints, and spine robots for outpatient fusions. Hospital-affiliated centers and joint ventures lead, but independent ASCs are leasing robots, too, often to fill open block time.
- Surgeon recruitment is a major driver. Younger surgeons trained on robots increasingly expect to use one when choosing a center. Some fellowship trainers worry that reliance is eroding manual skills.
- Patient demand is real, but hard to measure. ASC leaders say patients like the idea of robotic surgery and weigh technology when choosing a facility, making robots a marketing tool. Skeptics say few patients ask, and those who do usually
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
