Adding total joints to an ASC is becoming a lucrative prospect as the Baby Boomer population ages and technology improves. According to data1 from the Advisory Board Market Scenario Planner, the number of joint replacements done in the ambulatory setting is estimated to grow 96 percent in the next five years.
During a March 4 webinar hosted by Becker’s ASC Review and sponsored by Cardinal Health, Marvella Thomas, RN, MSN, senior consultant for Cardinal Health, and Sheila Knoepke, vice president of supply chain for Leawood, Kan.-based NueHealth, discussed the ways ASCs can capitalize on total joints, and the steps to get there.
Benefits of adding total joint replacements to an ASC
Many aging adults who wish to remain active later in life are great candidates to undergo joint replacements in the outpatient setting. In addition to growing demand, payer trends are also pushing more total joint procedures into the ASC setting. On Jan. 1, CMS' decision to pay for outpatient knee replacements in the ASC went into effect, with more procedures expected to be covered in the future. Additionally, overhead is lower in an ASC, making procedures cost less.
"And in turn, the claim is lower, providing an opportunity for lower margins and higher revenue, benefitting the payer and the [ASC]," Ms. Knoepke said.
Lastly, lower infection rates and a more streamlined operational environment make surgery centers appealing options for surgeons and their patients.
Four steps to integrating total joints in an ASC
Build a business case: Every facility is different, so the market where it is located needs to be assessed before adding total joint cases. Areas to focus on when building a business case include state rules and regulations, the potential patient base, certificate of need requirements and return on investment.
Get buy-in: Getting support from physicians and staff is critical for establishing a total joint program. Everyone needs to be included in the planning process, including physicians, OR staff, anesthesiologists and pre- and postoperative staff.
"Physicians need to feel comfortable with sending patients home a few hours after surgery, and need to be assured plans have been implemented for a smooth and safe transition for their recovery at home," Ms. Thomas said.
Develop a care plan. Key things to include in a care plan are special considerations for patients that might need more care after surgery, pain management, patient education and recovery tracking milestones.
"Determine ahead of time what quality indicators you’re going to be using at your facility," Ms. Thomas said. "Patient and caregiver education and expectations are key elements of your program."
Measure your performance. Case costing is important to tracking financial and clinical performance. Supply and staffing costs should be monitored consistently to ensure every case is as profitable as possible.
Conclusion
While total joints are an attractive prospect for ASCs, it’s necessary to have the right plans and processes in place to be successful.
"If you don't understand or measure something, it can get out of control really quickly," Ms. Knoepke said. "You need to decide if [total joints] are a good investment because you will have some upfront costs."
To learn more about Cardinal Health, click here. To watch the full webinar, click here.
1 https://www.advisory.com/research/data-and-analytics-group/market-scenario-planner