Surgical advancements that facilitate low-cost, high-quality outpatient care have prompted insurers and providers to reexamine where care is delivered. With the U.S. outpatient surgical procedure market expected to hit $144 billion by 2026 — up from $122 billion in 2018 — it's clear that a shift is taking place.
In the first weeks of 2020, several developments indicated as much. HCA Healthcare CEO and Director Samuel Hazen reported that 15 percent of the total joints done at HCA facilities are in the outpatient setting. Surgery Partners CEO Wayne DeVeydt outlined the value proposition of ASCs during the 38th Annual J.P. Morgan Healthcare Conference, explaining that Medicare pays less for the same procedures in outpatient settings versus inpatient.
More tangibly, Blue Cross Blue Shield of Minnesota implemented a policy steering colonoscopy patients away from hospital outpatient departments and into ASCs. As more insurers look to adopt similar policies, several hospitals and health systems have reconfigured their services, often increasing their focus on outpatient care.
Here are six organizations taking action due to changing utilization:
Buffalo, N.Y.-based Kaleida Health is putting a hospital tower up for sale in response to declining use. The hospital's inpatient admissions have fallen 33 percent since 2012. Its outpatient and inpatient surgery volumes have dropped 54 percent and 63 percent, respectively.
As part of bankruptcy proceedings, Yakima, Wash.-based Astria Health will close Astria Regional Medical Center in Yakima and migrate services to its ambulatory care and outpatient locations.
Philadelphia-based Holy Redeemer Health System opened its first outpatient care center in Philadelphia, an 11,000-square-foot center. Holy Redeemer operates six other outpatient care centers in the region.
Lawrenceburg, Ind.-based Highpoint Health laid off 31 employees in late January amid significant financial challenges, including a drop in patient volume. In an interview with The Ohio County News, Highpoint President and CEO Michael Schwebler cited competition and a rising number of inpatient procedures moving to the outpatient setting as reasons for low patient admissions.
WhidbeyHealth in Coupeville, Wash., is recruiting surgeons to increase its outpatient surgery volumes and revenue. The organization hopes to minimize losses stemming from declining inpatient stays.
The University of Illinois Hospital & Health Sciences System in Chicago plans to build a $191 million outpatient center to fill a growing need for outpatient services.
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