Which procedures are moving to the ASC setting?

From cardiology to minimally invasive spine procedures, four ASC leaders joined Becker's to discuss which procedures they see moving to the outpatient setting. 

Editor's note: These responses were edited lightly for length and clarity. 

Les Jebson. Regional Administrator at Prisma Health (Greenville, S.C.): 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.

Javier Marull, MD. Associate Professor of Anesthesiology at UT Southwestern Medical Center (Dallas): Advancements in medical technology such as minimally invasive techniques and quicker recovery options are making certain procedures, like angioplasty and stent placements, increasingly suitable for ASCs. Also, spine surgeries and total joint replacements are continuing to expand in ASCs.

Angela Ross. Director Of Surgical Services at Charlotte (N.C.) Eye Ear Nose & Throat Associates: The Ambulatory Surgery Center Association reports more than 80% of surgeries are performed at ASCs. Service lines like gastroenterology and ophthalmology have been highly successful veterans in the ASC world for years but others like cardiology, orthopedics and pain procedures are becoming more and more prevalent. As the focus continues to migrate towards increased value in tandem with reduction of expenses, the sheer cost of care in an inpatient setting will continue to drive procedures into the ambulatory world. We will see more and more of those historically inpatient procedures in the cardiac and orthopedic sectors move into ASCs, and most especially those whose reimbursements are supported with legislative changes and CMS reimbursement increases visible on CMS reimbursement fee schedules. By 2030, it is postulated more than 80% of all hospital outpatient department cardiovascular procedures could be allowed in ASCs per Medicare's covered procedure list inclusion.

Andrew Weiss. Administrator of Summit Surgical Center (Voorhees, N.J.): We have seen an increase in gynecology cases over the past two years. We are performing our due diligence for adding robotic general and GYN surgery as well; I see that as our next frontier.

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