Amid the continued migration of high acuity procedures from hospital outpatient departments to ASCs, robotic technology has caught the attention of ASC leaders looking to invest in the future of their practices.
The equation seems simple: the high upfront cost of robotics investment can allow practices to perform surgeries more efficiently, which can in turn increase the number of procedures a practice can conduct.
But the equation could be more complicated in specialties that have seen declining reimbursements despite higher patient volumes per beneficiary, such as cardiology, urology, OB-GYN, internal medicine, pulmonology, radiology, gastroenterology and anesthesiology, among others.
"What is in view here is the rate a procedure [or] surgeon generates margin relative to other procedures [or] surgeons," James Whiteside, MD, professor at the Brody School of Medicine at East Carolina University in Greenville, N.C. Dr. Whiteside is the chair of the department of obstetrics and gynecology and the chief of service of ECU Health.
"In the setting of a hysterectomy, the use of expensive disposables to include the robot adds nothing to the reimbursement, and where some surgeons take more time with this approach, the rate of return is poor," Dr. Whiteside added. "This is especially true in surgical centers where the supply costs alone for a robotic hysterectomy can exceed the Medicare average payment."
This could have specific effects on gastroenterology, which accounts for 10 of the 25 procedures most often performed at ASCs, where robots are taking center stage for potential industry investments.
"The big thing continues to be the growth in minimally invasive surgery to deliver better outcomes and widen patient access," William Sellers, MD, chief of colorectal surgery at St. Charles Hospital in Port Jefferson, N.Y., and St. Catherine of Siena Hospital in Smithtown, N.Y., told Becker's. "There's newer and better robots coming out in the market. … [A]nd that technology continues to expand."