3 reasons why spine surgery will continue moving to ambulatory surgery center settings

Currently there are more than 160 outpatient spine surgery facilities in the U.S., and the spine Ambulatory Surgery Center (ASC) market is expected to grow 200%1 over the next few years.

While setting up a spine program at your ASC is complex due to the nature of the procedures and the high cost structure associated with equipment, devices and other factors, now is a prime time for ASC administrators to establish a spine program to accommodate patient demand. All major stakeholders — doctors, patients, payers — cite improved outcomes and cost savings, and therefore are becoming increasingly comfortable with the migration of procedures into ASCs. Here are important considerations for spine ASC administrators to ensure spine surgery centers are set up for success:

  1. More types of spine procedures are moving to ASC settings.
    As more types of spine procedures are performed in an Ambulatory Surgery Center, safety measures and protocols are making it possible for them to be performed outside of a traditional hospital setting. In 2020, Medicare moved six procedures off its inpatient only list, but they have not yet moved to the ASC-approved list. This move demonstrates the continual migration of acceptance of procedures that were once thought to only be possible in an inpatient setting.

  2. Infection rates are lower in outpatient facilities than in hospitals.
    As more spine procedures have been performed in outpatient settings, major stakeholders have recognized the benefits. Minimally invasive techniques and technology have quickly advanced, making it possible for spine surgery to be done safely outside of a traditional hospital setting and decreasing the amount of time patients need to stay within the facility.

    In 2020, the pandemic accelerated the preference of spine surgery in an ASC as patients wanted to avoid hospitals due to increased risk of exposure to COVID-19 and other healthcare acquired infections. A recent study2 by the Journal of the American Medical Association showed that in hospital settings, 8.95 out of 1000 patients developed a surgical site infection (SSI) 30 days post-surgery. In an outpatient setting, 4.84 out of 1000 patients developed a surgical site infection SSI 30 days post-surgery. Since they also stay at the ASC for a shorter duration of time than at a hospital, patients' risk for a healthcare acquired infection is also significantly lower.

  3. Operational costs are generally less and more straightforward at ASCs.
    In addition to patient care benefits to outpatient spine surgery, there are operational benefits as well. Procedures in ASCs are costing 45 to 50 percent less than in hospitals, and payers are more willing to enter into contracts. For administrators and surgeons, it's advantageous that capital investment is less complicated to obtain than it was in traditional hospitals. Equipment can be requested when it's needed instead of jumping through red tape that's so common in traditional health care systems.

    One challenge administrator should consider is that by standing independent from a hospital, it may require dedicated marketing to bring patients to your facility. By explaining the benefits of surgery done in your ASC and partnering with well-established surgeons, patient volume should increase.

By providing spine procedures in ASCs, administrators are meeting the demands of its patients. Trends indicate all types of surgery will continue migrating to outpatient settings — spine surgery included.

For more insights on performing orthopedic procedures in your ASC, visit here.


1 https://www.beckersspine.com/orthopedic-spine-practices-improving-profits/item/49274-the-business-of-moving-spine-cases-to-surgery-centers.html

2 https://pubmed.ncbi.nlm.nih.gov/24549551/

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