Orthopedics and cardiology are projected to drive the lion's share of future savings resulting from the care migration toward ASCs, but the two specialties are shifting at different rates, according to professional services firm ZS.
Why cardiology isn't moving to ASCs as rapidly as orthopedics:
1. The cardiology procedures that are safe and approved for the ASC setting generally don't create high enough volume to fill a surgeon's day, which is important to the ASC business model.
2. There is far more variation among cardiology specialists than there is among orthopedic surgeons, so securing sufficient cardiology volumes would require aligning many different types of providers.
3. Cardiology involves a wider range of medical risk and more life-threatening procedures than orthopedics.
4. More than 70 percent of cardiologists are employed by hospitals and healthcare systems, compared to just 17 percent of orthopedic surgeons.
5. ASC reimbursement for cardiology procedures is less favorable for cardiology than for orthopedics. For instance, total knee arthroplasty in the ASC is reimbursed at about 63 percent of the inpatient rate, whereas Medicare reimburses the average pacemaker in an ASC at about 25 percent of the inpatient rate.