10 must-reads for ASCs adding total joints

Here are Becker's ASC Review's top 10 total joint-related articles from 2018:

1. Total joints are still booming. The Hartford Business Journal outlined the growth of outpatient orthopedic care in Connecticut and across the country. Andrew Caputo, MD, an orthopedic surgeon, told the Hartford Business Journal many procedures are being performed on an outpatient basis rather than inpatient. The American Academy of Orthopaedic Surgeons projects the number of total knee replacements performed in the U.S. will increase 189 percent to 1.3 million by 2030, and then increase to 2.6 million in 2060. By comparison, 680,000 total knee replacements were performed in 2014, according to the AAOS.

2. Total joints continue to move outpatient. There are a variety of reasons why total knee replacements are becoming outpatient procedures, according to the Healthcare Financial Management Association. For instance,payment models that push the risk to providers encourage cost reductions and better outcomes. Low cost and the opportunity to recover at home make outpatient surgery appealing to patients. Increases in standardization for total knee replacements has increased care management.

3. Surgery centers are high-quality, low-cost options. Jim Ballard, MD, and Chris Nanson, MD, the physician partners at the Beaverton-based Oregon Surgical Institute, an orthopedic ASC focused on total joint replacement, spine and pain management, discussed how the changing healthcare system is driving total joint replacement to the ASC setting with Westchester, Ill.-based Regent Surgical Health. Surgery centers are typically considered the high-quality, low-cost care site, which is one of the reasons total joint replacement is migrating to the ASC, Dr. Nanson said.

4. Data collection is imperative. Daniel Hoeffel, MD, an arthritis and joint reconstruction specialist practicing in the Minneapolis-St. Paul, Minn., area, shared his insights on the importance of data collection in outpatient arthroplasty in the ASC Association's Physician Focus newsletter. As the popularity of total joint arthroplasty increases due to economic and efficiency factors, accurate outcome and processes are needed. Measuring outcomes through standardized care pathways and achieving simple data collection from EHRs and patients should be the goal for outpatient total joint arthroplasty providers.

5. How to add total joint procedures and lower infection rates. Springfield (Ill.) Clinic's ASC and endoscopy center expanded its services to include outpatient joint replacement procedures such as total knee and shoulder replacements. The ASC also installed a Xenex LightStrike Germ-Zapping Robot that is used to disinfect operating rooms. The robot works by using UV light to kill bacteria. The LightStrike robot has been shown in clinical trials to reduce the rate of infections by 46 to 100 percent.

6. Insight from a total joint surgeon. James Van Horne, MD, an orthopedic surgeon specializing in outpatient hip and knee replacements who practices at the Grants Pass, Ore.-based Paragon Orthopedic Center, shared his thoughts on the benefits of outpatient joint surgery at ASCs with DePuy Synthes and the Johnson & Johnson Institute. Dr. Van Horne said performing outpatient total joints is beneficial for both patients and surgeons. The procedures cut costs for patients and allow them to recover faster, and they let surgeons provide quality care.

7. How many ASCs with total joints do large management companies have? The number of ASCs with total joint replacements is growing among both independent centers and ASC chains. More than 215 ASCs across the country offer total joint replacements, including at least 150 affiliated with ASC companies.

8. Compare total joint costs in ASCs vs. HOPDs. CMS released a new tool allowing patients to compare the average payment of select procedures in hospital outpatient departments and ASCs. The Procedure Price Lookup Tool shows the national averages for the amount Medicare pays an ASC or hospital, as well as the national average copayment amount a patient without Medicare supplemental insurance owes in each setting. This article lists how five orthopedic procedure costs compare in HOPDs and ASCs.

9. Key insights on outpatient joint replacement. Brian P. Flanagan, MD, an orthopedic surgeon practicing at Crystal Lake, Ill.-based Centegra Physician Care-McHenry County Orthopedics shared three insights on outpatient joint replacement surgery with the Northwest Herald.

10. Insights on physician alignment and payer negotiations for total joints. When it comes to total joints in ASCs, it is no longer a question of, "Is it possible?" but rather, "How is it reimbursed?"

More articles on orthopedics and TJR:
1 year, 2.7K outpatient surgeries: How Michigan Orthopaedic Surgeons is capitalizing on the shift to outpatient surgery
Dr. Alejandro Badia, founder & CMO of OrthoNOW discusses outpatient orthopedic surgery in ASCs
Quality of recovery similar in outpatient, inpatient total knee arthroplasty surgery: 4 study insights

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