Vladimir Sinkov, MD, spine surgeon at Southern Hills Hospital in Las Vegas, recently spoke with Becker's to discuss orthopedics and spine in ASCs.
Editor's note: These responses were edited lightly for clarity and brevity.
Question: Where are orthopedics and spine headed in ASCs?
Dr. Vladimir Sinkov: The trend of moving orthopedic and spine surgery cases from hospital setting to ASCs will continue as surgeons and anesthesiologists continue improving protocols for postoperative recovery and as surgical techniques become less invasive. One hindrance to that trend could be that less invasive techniques typically require more capital expenditure for equipment and disposables (as in minimally invasive spine surgery), which may be more difficult to handle for an ASC financially due to smaller margins than a hospital.
Q: Will there be more or fewer independent orthopedic and spine ASCs five years from now? Why?
VS: If the current trend of declining reimbursement and rising overhead/salary costs will continue, there will be greater consolidation of ASCs into large organizations (such as United Surgical Partners International). Hospitals will also continue partnering with ASCs to offset surgical case "leakage" to outpatient settings. The end result will be greater consolidation and fewer independent ASCs. Those centers that want to stay independent will have to innovate in terms of keeping costs down, improving quality to stay competitive and exploring better payment/reimbursement models outside of the traditional health insurance setting.