Orthopedic and spine surgery continues to make headway in ASCs, but there are some hurdles that leaders must overcome for successful migration in the year ahead.
Four takeaways:
1. Orthopedic and spine migration to ASCs is accelerating, however; outcomes must keep up. Minimally invasive spine surgery and total shoulder replacement are two areas of orthopedics expected to grow in ASCs, Scott Sigman, MD, said during a panel at Becker’s 31st Annual The Business & Operations of ASCs Meeting. As the pace grows, physicians should still keep outcomes and postoperative care top of mind.
“It’s just amazing the efficiency that can be maintained at an ASC versus a large hospital, which is beholden to so many different specialties,” Dr. Sigman said. “At this point, it’s going to be about reimbursement as we move forward … A lot of our great sports medicine orthopedic surgeons are actually pivoting to spine surgery now because of the minimally invasive processes that are available. I really want to emphasize that as these cases are moving to the ASC … we have to make sure that the patient outcomes are matching and continuing to go upwards.”
2. Medicare policy changes are opening the door to grow orthopedics and spine in ASCs. CMS lifted about 300 codes from the inpatient-only list, and more than 200 of those are focused on orthopedics. Ben Auzenne, a senior ASC sales director with Johnson & Johnson, said he’s thinking ahead to the opportunities to expand procedures in ASCs and how leaders can prepare.
“From an orthopedic perspective, it means that we need to prepare ourselves for the ability to bring more procedures and more specialization within the ASC,” Mr. Auzenne said. “And really what that means to vendors as well, how we can best serve [ASCs]. We’re coming in with new products and new opportunities, and that brings a long tail on both the front and back end that says you’ve got new specialties that you’re training. What support do we have from a vendor standpoint to be able to say, ‘This is what the procedure looked like in the operating room, and this is what it’s going to look like in your ambulatory surgery center.’ The trays don’t look the same, the equipment doesn’t look the same in the room, the staff doesn’t look the same in the room. How do we transition procedures that were previously performed in a hospital and then bring them into the ASC? From our perspective, we see continued movement there.”
3. AI is emerging as an infrastructure tool to get patients in the door, but patients still prefer hearing from a human. AI isn’t replacing staff, but it’s been a valuable tool for seamlessly connecting patients to the right care and to manage scheduling, said Jon Wang, founder and co-CEO of Assort Health.
“We’re really excited to see how AI creates a more seamless journey for the patient over time,” Mr. Wang said. “Let the AI agent engage with the patient ahead of time, so that we can collect that data, and see exactly what happens in a call too. We’re able to create more visibility and transparency from the provider side, and empower them to be able to interact with 500 patients in one click rather than having to have in person go out and call every single person manually. And in the spirit of serving patients right, being able to screen them better and help them engage with their practice 24/7 in multiple languages. These types of things really elevate that patient experience. It’s that direction that the industry will be moving toward in the future.”
However patients still tend to prefer physicians who aren’t fully reliant on AI, and building trust with the technology is an important focus in the future, he said. He referenced a study where most patients preferred physicians who didn’t leverage AI in the practice, highlighting a gap.
“When we deploy our AI agents we have patients rate them right after the experience, and they get rated, on average, higher than a human,” Mr. Wang said. “But then as soon as we tell them that an AI is talking to them, we see, you know, 40% to 50% of patients immediately want to talk to a human. It’s natural. [Healthcare] is supposed to be human first. So how do you earn that trust over time, and both from the provider and from the patient perspective?”
4. Robotics and navigation are becoming table stakes, but business models and integration are lagging. Robotic technology for orthopedics and spine are advancing, but they remain a capital pain point for many ASCs. Daniel Mulconrey, MD, a spine surgeon with Midwest Orthopaedic Center, pointed out that there’s also more to just making the technology an option alone, especially for spine surgery where navigation and robotics are helpful with more acute cases.
“Bringing in navigation and a robot won’t get you where you need to be,” Dr. Mulconrey said. “You need to create a system around that, and that’s just one tool in managing that patient … It’s going to be physician-driven, and it’s also going to be patient-driven. Patients ask for these technologies. How it will work and interplay with ASCs is to be determined. It will look different than it does now, but how will that morph? I’m uncertain at this point, but it’s part of a broader conversation I think we’re gonna have.”
