Michael Bohan, MD, an orthopedic surgeon and co-founding partner at Myrtle Beach, S.C.-based Carolina Orthopaedics and Carolina Coast Surgery Center, shared his thoughts with Becker's ASC Review about total joint replacement in the ASC setting and his own center's experience with them.
Although CMS recently postponed adding total joints to the ASC payable list, Carolina Coast Surgery Center has been performing TJR procedures for the last two years through commercial payers. Based on that experience and his estimates, Dr. Bohan believes when CMS adds TJR to the ASC payable list, total joints will continue to expand in the outpatient arena.
He estimates that up to 30 percent of Carolina Orthopaedics’ medicare total joint cases could be appropriately performed in their ASC.
On an industry-wide scale, Dr. Bohan believes it will take some time for physicians to identify the proper patient pool that is ideal for outpatient total joint surgery. Patients need to be healthy and motivated at the very least, he notes, to be good candidates for the ASC arena. He added that a lot of work needs to be done prior to surgery to screen patients and set appropriate expectations.
Once the industry narrows down the patient pool, Dr. Bohan anticipates, “we will see a trend over the next few years toward improved access for appropriate medicare patients to outpatient total joint replacement.”
Despite his center's current commercial-only patient base, total joints have been successful for Carolina Coast Surgery Center. According to Bohan, it has been a win-win for patients and physicians alike. "Patients love it. Our surgeons and staff love it. And it has been profitable for our surgery center," Dr. Bohan says.
One reason behind the success is that Carolina Coast Surgery Center was constructed with total joint replacement in mind. Therefore, it was a fairly seamless transition when the center decided to begin performing the procedures.
As for existing centers looking to add total joints, Dr. Bohan says the retrofitting process could be more difficult. He urged administrators or officials planning to construct a new center to consider the possibility of adding total joints at the time of development.
Dr. Bohan will be speaking at the Becker's 16th Annual Future of Spine + The Spine, Orthopedic and Pain Management-Driven ASC Conference. To learn more and register, click here.