The future of ASCs is specialized, CEO says

Michael Boblitz, CEO of Tallahassee (Fla.) Orthopedic Clinic, connected with Becker's on July 28 to discuss the benefits of specializing care.

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

Question: What trend should ASCs jump on next to be successful?

Michael Boblitz: Quality, outcomes and financial performance are critical success factors for ambulatory surgery centers. The concept of the clinically focused factory is well-documented and demonstrates specialization leads to more efficient care with reduced variation and better outcomes. A historical challenge with surgical care whether that be in the hospital or an ASC is the multispecialty model makes it extremely difficult to compete.

Spine and joint replacement services have historically been performed predominantly in the hospital setting mingled with the wide range of surgical specialties that span well beyond orthopedics. At Tallahassee Orthopedic Clinic these services now reflect 75 percent [of cases] plus outpatient case mix.

A key trend for the ASC model is to replicate the environment for spine and joint replacement surgery to realize the benefits of specialization: superior efficiency, less variation, less length of stay and better outcomes. This involves designing a spine and joint replacement surgical center that affords the ability to care for complex patients that require a 23-hour stay, along with the comprehensive range of robotic solutions that span the O Arm Spine Imaging System, Mako and Rosa, which orthopedic surgeons require for best practice. The broader benefits reflect the patient being back in the comfort of their home in a matter of hours, along with a 30 to 40 percent lower cost for the payer and employer. At the same time this solution provides a needed relief valve for the hospitals that must prioritize the higher cost complex and emergent patient population.

I see orthopedics evolving into two ASC models in the future which operate in parallel to one another. This design yields the benefits on specialization of staff, resources and destination level facilities:

1) Spine and joint surgery centers

2) Outpatient orthopedic surgery center to service the other orthopedic divisions

With recent reports now indicating orthopedics ranks second in total cost of care in the commercial payer environment (behind cancer and now ahead of cardiovascular), the time has come for a better model to bend the curve and improve value.

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