What to expect in outpatient orthopedics: Dr. Frank Pompo weighs in

This summer, Frank J. Pompo, MD, an orthopedic surgeon at the Litchfield Hills Surgery Center in Torrington, Conn., performed the ASC's first unicompartmental knee replacement.

Becker's ASC Review recently caught up with Dr. Pompo and asked for his thoughts on outpatient procedures, CMS' proposed rule and the future of the ASC industry.

Note: Responses have been lightly edited for style and clarity.

Question: What are the current trends you're seeing right now in outpatient orthopedics?

Dr. Frank Pompo: There has been significant growth over the past couple of years, including transitioning total joint replacement from the inpatient to the outpatient setting.. When I was a resident, a patient who had an anterior cervical discectomy and fusion would stay in the hospital one to two nights; now, it is an outpatient procedure. Total knee replacements, which were commonly three- to four-night inpatient status as recently as 10 years ago, now commonly only stay one night in the hospital or are now performed in the surgery center. While I think there will always be a role for elective surgery being done in the inpatient setting, we will see a greater percentage of orthopedic surgery being done in the outpatient setting.

Q: What’s your reaction to CMS’ proposed decision to pay for total knee replacements in ASCs?

FP: I think that this is great news for doctors and great news for patients. I believe there is a high percentage of Medicare patients who would be healthy enough and willing to undergo total knee replacements in the ASC setting. I feel that being able to go home after surgery is extremely beneficial, as patients are able to sleep in their own bed, eat their own food and recover in an environment that is much more familiar to them than a hospital or short-term rehabilitation facility.

Q: What do you think the ASC industry will be like in three to five years?

FP: With the emphasis on value-based care, continuing to improve efficiency in the delivery of high-quality services. I think that the proportion of surgeries done at ASCs as well as the proportion of larger cases done at ASCs is going to continue to increase, especially as patients become more comfortable with the idea of having elective joint and spine surgeries and going home the same day.

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