Michael Chmell, MD, is the medical director of Rockford-based Ortho Illinois Surgery Center. Here, he shares the top opportunities for orthopedic growth in ASCs:
Note: Responses have been lightly edited for style and clarity.
Question: What is the biggest opportunity for growth you see for ASCs in 2019? As an ASC leader, how do you hope to capitalize on growth opportunities?
Dr. Michael Chmell: In terms of orthopedics, I continue to see total joint replacement and spine surgery as our growth leaders. With growing experience, the indications for outpatient surgeries are expanding. Insurers, with the data from this experience, are recognizing the benefits of such procedures being done at ASCs. Patient demand for outpatient joints and spine, likewise, is growing. This combination should provide excellent opportunities for further growth.
One untapped area for growth, at least in our ASC, is orthopedic trauma in terms of ankle, tibia and humerus fractures. These are on my agenda for 2019.
Q: What are the greatest challenges you expect to face in 2019?
MC: The greatest challenge for myself, as well as all ASCs going forward, is to contain costs on the larger cases being performed in their relative infancy at ASCs, such as total joint replacement and spine surgery. I believe that hospitals in the past lost control of these costs, specifically on implants. The key going forward is that physician-owned ASCs will have the end user controlling costs, as both the user and the owner.
A second challenge, also in its infancy, are bundled payments in their various forms, particularly for total joint replacement. Many options are out there — from surgeon/facility to 90-day, all-inclusive payments. Selecting plans will require much data and input from other sources not directly related to ASC ownership, such as anesthesia, home health and physical therapy.
Q. How do you see the ASC industry growing in the next five to 10 years?
MC: Ten years from now, I expect all but the most complex orthopedic procedures to be performed on an outpatient basis. I also expect further innovations to occur that we currently do not anticipate. I have been a medical director for 15 years and would not have expected to see the cases that we do now to be done daily on an outpatient basis.
None of us can truly predict what the industry will be like in 10 years, however, I think that it will continue to expand.
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For a deeper dive into ASC industry trends, attend the Becker's 17th Annual Future of Spine + Spine, Orthopedic & Pain Management-Driven ASC in Chicago, June 13-15, 2019. Click here to learn more and register