Where orthopedics and spine is headed in ASCs

Three spine and orthopedic surgeons recently spoke with Becker's about the future of spine and orthopedics in ASCs

Question: Where are orthopedics and spine headed in ASCs?

Editor's note: Responses were edited lightly for brevity and clarity. 

Michael Katz, MD. Sports Medicine Physician (New York City): We are in the midst of an industrial revolution in order to facilitate the use of ASCs for orthopedic and spine surgery. There will be new inventions, new protocols and the novel use of existing anesthesia protocols. The well-run ASCs will be bought up by hospital systems. New ASCs will seemingly flourish by making use of private equity funding. At some point, there will be too many ASCs and the latecomers will struggle.

Philip Louie, MD. Medical Director of Research and Academics at Virginia Mason Franciscan Health (Seattle): In short — we are headed in a very exciting direction! Especially in my world of spine surgery, we are finding more ways to bring care for patients in the ASC setting that has been shown to demonstrate improved outcomes (in the properly indicated patient undergoing minimally invasive spine procedures), improved patient satisfaction/experience, decreased costs and greater efficiencies compared to the traditional hospital/medical center settings.

Here are three trends:

  • Expanding the surgeries that can be safely performed. There are two main drivers — enabling technologies have improved the visualization, access and safety of our surgeries. And collaboration with our anesthesia colleagues has been and will remain critical in the preoperative care at these ASCs.
  • Greater access. Given the demonstrated benefits described above, we will see more ASCs built, thus providing additional access for patients and surgeons alike. The growth of ASC access will also improve the quality, safety, efficiency and value of surgeries being performed in ASCs.
  • An improved understanding of how ASCs fit into the value-based care equation that is dominating our healthcare landscape. Patient care and outcomes will always be the most important factor. But, in a world where we are seeing a shift to value-based healthcare and reimbursement, we will also need to re-evaluate how spine surgical care is delivered and billed.

Bruce Prager, MD. Orthopedic Surgeon at the Orthopedic Center of Arlington (Texas):  More procedures are being done at ASCs for several reasons: ease of scheduling, better patient experience, less chance of getting a hospital-acquired infection, physician ownership in ASCs, lower costs to the patient and third party payer, quicker turnaround between cases, more input from the surgeons to the administration and better staffing.

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