Here are four pieces of good news and three pieces of bad news affecting the ASC industry at the moment.
Good news
1. CMS added 11 procedures to the ASC-covered list that were not included in the proposed rule, including total shoulder arthroplasty.
"When I think of my patient population, I see my patients recovering from shoulder replacement similarly to total knee and total hip replacement," Anupam Pradhan, MD, chair of orthopedic surgery at Dallas-based Southwest Joint Replacement and Sports Medicine, told Becker's. "I think the change was appropriate and probably overdue. This will help drive some of those patients to an outpatient setting."
2. Also in its final rule, CMS finalized a 3.1% payment rate for ASCs. The rate is based on the projected hospital market basket increase of 3.3%, reduced by 0.2% for the productivity adjustment.
3. Orthopedic surgeries are skyrocketing at ASCs. The number of orthopedic procedures in outpatient settings was 33 times higher than the volume of inpatient procedures, according to the American Joint Replacement Registry's 2023 annual report.
4. Payers are increasingly looking to ASCs as a way to decrease costs. UnitedHealthcare’s 2023 site-of-service policy, for example, could push procedures to the ASC setting.
Bad news
1. Rising anesthesia costs and a declining number of providers are burdening ASCs. Many leaders are concerned about how it will affect their ability to provide care.
"Today's shortage of anesthesia providers has been compounding for years and has turned into an incredible challenge for all," Andrew Lovewell, CEO of Columbia (Mo.) Orthopaedic Group, told Becker's. "Not only is it difficult to find anesthesia coverage, finding coverage that understands and embraces the priorities and workflow of an ASC are seemingly impossible."
2. High labor costs and worker shortages have been affecting ASCs' ability to staff their centers. In the last year, 56% of ASCs have seen an increase in volume, but 68% of facilities are still having a more difficult time recruiting experienced operating room nurses, according to a 2023 survey from ORManager.
3. Physicians are increasingly leaving the field: 40% of physicians said they had interest in leaving their current organization within two years, according to a survey from the American Medical Association. ASCs could have an edge over hospitals because they have smaller staffs and often do not report to massive health systems. They also can offer a work-life balance typically unavailable in hospital or health system settings.