Editor’s note: This interview was edited lightly for brevity and clarity.
Question: What is the biggest threat to outpatient migration?
Les Jebson: The single greatest threat is not in bricks and mortar, or implants and supplies or payer reimbursements. Instead, it is systemic national shortages of perioperative professionals, starting with certified registered nurse anesthetists, surgical technologists and registered nurses. Those that create a team-based care environment, offer flexible staffing and benefits and tight orchestration of procedure scheduling at specific locations will be better positioned to deal with this threat.
Q: What procedures are moving to the outpatient setting?
LJ: For the proverbial long-term horizon, I believe that we will see a convergence of imaging/procedural and surgical suites. For the short-term horizon, I believe we will see a continued migration of vascular and cardiac procedures to the ASC arena. In both scenarios, there has to be a willingness and collaborative spirit with payers in orchestrating these shifts. In orthopedics, an aggressive migration to more outpatient and 24-hour spine cases along with a consistent trajectory of more total joints. Shoulders will be the largest growth area once Medicare approves.
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