The ambulatory surgical centre (ASC) market in the United States is experiencing unprecedented growth, particularly within the field of orthopaedics, where advancements in technology and changing patient preferences are reshaping care delivery. Since the Centers for Medicare & Medicaid Services (CMS) removed certain orthopedic procedures from the inpatient-only list, the number of outpatient surgeries has surged, signalling an evolving landscape for medical practices and device manufacturers alike.
Currently, orthopaedic surgery is classified among the fastest-expanding sectors of outpatient surgery. According to CMS data, outpatient orthopedic procedures in ASCs saved the agency billions in healthcare costs annually and have the potential to save even more by shifting eligible cases from hospital settings. As this shift continues, companies producing orthopaedic devices that can adapt to the needs and efficiencies of ASCs are expected to thrive.
The most notable trend is the climb in total joint replacements being carried out in ASCs. Since 2018, when CMS began to permit total knee replacements in outpatient facilities, the uptake for these surgeries in ASCs has skyrocketed. By 2023, over 25% of Medicare-approved total knee replacements were performed in these centres. Device manufacturers are now encouraged to develop joint implants that are lightweight and easy to use, focusing on creating streamlined instrument packaging and bundled solutions to enhance productivity while reducing costs.
Robotic-assisted technologies also play a pivotal role in the expansion of outpatient procedures. Such systems, which have shown capability in reducing revision rates and improving implant alignment during knee replacements, have gained widespread approval from CMS for reimbursement in ASCs. Industry stakeholders emphasise the importance of developing compact, cost-effective robotic systems tailored to meet the specific requirements of ASCs.
However, navigating the reimbursement environment set out by CMS presents ongoing challenges for ASCs. Recent policies, while expanding the list of CPT codes applicable to ASCs, have increasingly tied reimbursement rates to value-based care models. As reported, the 2024 payment rule offered only a modest increase of 2.8%, yet this change could bolster confidence within the ASC sector. As such, companies like Johnson & Johnson MedTech are engaging with surgery centres to showcase how their products align with quality metrics suggested by Medicare.
Patient satisfaction has become imperative, significantly influencing reimbursement criteria. ASCs are focusing on enhancing the patient's journey and experience, adapting tools like the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey for outpatient settings. Customised knee implants and postoperative tracking applications represent some innovations aimed at improving patient outcomes and satisfaction ratings.
In alignment with contemporary sustainability goals, ASCs are implementing practices to reduce operational costs while fulfilling environmental responsibilities. CMS has begun incorporating sustainability metrics into its ASC Quality Reporting (ASCQR) programme. Advances, such as reusable surgical instruments and eco-friendly packaging, not only help centres reduce waste but also appeal to increasingly eco-conscious patients.
Moreover, the integration of artificial intelligence (AI) and data analytics is expected to revolutionise ASC operations. CMS’s expansion of reimbursement codes for remote patient monitoring incentivises the adoption of AI-driven tools for both preoperative assessments and postoperative tracking. Companies such as Smith+Nephew and Medtronic are pioneering AI platforms that enhance surgical planning, marking a significant evolution in operational efficiency.
Spine procedures represent another rapidly growing area within the ASC market, with over 35% of spine surgeries anticipated to take place in outpatient settings by 2024. The ongoing expansion of CMS-approved spine surgeries, including cervical fusions and lumbar decompressions, is expected to contribute to this growth further.
Training and continuous education for surgeons and ASC staff are vital as new technologies emerge. The CMS Quality Payment Programme (QPP) promotes competencies in surgeon performance, encouraging investment in ongoing training and education. Companies like Enovis are responding by hosting workshops and virtual training to ensure professionals are adept with the latest advancements.
Overall, the ASC landscape is on the brink of substantial transformation driven by changes in CMS policies, evolving patient expectations, and significant technological advancement. As the orthopaedic sector prepares for changes anticipated by 2025 and beyond, companies must closely monitor these trends and establish strategic partnerships with surgery centres to facilitate success in this dynamic environment.
Source: Noah Wire Services