Increasing competition for outpatient care, growth in orthopedic and spine surgeries and value-based purchasing decisions will shape the ASC industry in 2019, according to Mizuho OSI Enterprise Business Director David Parks.
Mr. Parks discussed these topics and more with Becker's ASC Review:
Note: Responses have been lightly edited for style.
Question: Looking into next year, what do you think will be the biggest opportunities for ASCs?
David Parks: Some of the biggest opportunities for ASCs will be growth in orthopedic and spine surgeries, as these surgeries are moving from a hospital setting to an outpatient setting with new technologies allowing for less invasive procedures and quicker recoveries. Overall, the industry is expecting 35 percent growth in outpatient [spine and orthopedic procedures] over the next 10 years, becoming the largest shift in 2019.
Additionally, as we see more hospital-owned ASCs, these systems will need the ability to balance patient cases based on clinical appropriation in order to capitalize on the advantages of the ASC market.
Q: What do you think will be the top challenges for ASCs in 2019?
DP: Because CMS has recently begun removing high-revenue procedures like knee replacements from the inpatient-only list, there will likely be an increase in competition for outpatient care.
Reimbursement declines are consistent in both the acute and ASC setting. However, ASCs provide a more cost-effective solution as well as a more efficient and convenient option for the patient regarding these procedures. The average net cost for outpatient procedures in an ASC is about 56 percent of costs in a hospital-based environment. Capturing optimal financial advantages without compromising outcomes is a vital balancing act for the success of an ASC.
Q: What new industry trends do you expect to emerge in 2019? Will we see the continuation of major trends we've seen in 2018?
DP: The ASC market is estimated to reach $40 billion by 2020, driven by lower outpatient surgery costs, improved safety through technology and the baby boomer and gen X population groups finding themselves needing joint replacements.
In 2019, we are going to continue to see hospitals opening up their own outpatient centers, as has been the trend in 2018. As competition increases, ASCs are going to have to find ways to differentiate themselves. One way this could be done is through the technology offered in an ASC. For instance, specialty surgical tables can help reduce surgical and recovery times, while improving patient safety. Overall, these benefits create an environment to reduce operating costs and improve patient satisfaction and convenience.
ASCs will also continue to seek cost containment with the addition of on-site labs, preoperative work ups, physical therapy and — for the more at-risk patient — patient postoperative evaluation services.
Q: With the industry pivoting toward value-based care, how can ASCs streamline operations to ensure they deliver care in the most efficient way possible?
DP: As the industry moves toward value-based care, ASCs are making sure they're working with companies and vendors that are also working to have their equipment meet this model. Implementing integrated technology into the surgical suite, like the solutions Mizuho OSI has developed, not only streamlines workflow for surgeons and operating room staff, but allows technology to work together to make activities such as intraoperative X-rays easier. For example, some surgical tables, such as the ProAxis by Mizuho OSI, allow surgeons to conduct an X-ray right on the table without having to move the patient from their current position. This leads to significant safety improvements as the patient is moved less, and immense time savings for the surgical team. Implementing these strategies around procedures such as orthopedics can help lower the cost of care, while improving quality.
Q: What else can ASCs do now to build a solid foundation for future success?
DP: ASCs can find what programs differentiate their facility and harness this to stand out from competition. An example of this is anterior approach hip replacement programs. The anterior approach is gaining popularity not only among surgeons, but patients are also requesting the procedure as well. Offering the anterior approach to total hip replacement and having technology, like Mizuho OSI's Hana Table, that supports an efficient practice when performing the procedure not only benefits the patient and surgeon by increasing patient safety and reducing surgeon fatigue, but it also helps with the bottom line of ASCs. In 2019, we'll see an emphasis on better technology and its impact on patient and surgeon safety.
Incorporating technology with advanced surgical techniques that maximize patient outcomes and improve the surgical experience are key to establishing the reputation as a preferred provider.