6 Reasons Why the Financial Future Is Bright for Orthopedic ASCs

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Orthopedic ASCs are a smart business development strategy for your health system because …

1. Many patients prefer to schedule their surgeries at ASCs.

As price transparency takes hold, more patients understand that they pay less out-of-pocket when they choose an ASC.

But cost savings is just one factor drawing surgery shoppers to ASCs. In HOPDs, scheduled surgery patients risk being bumped during times when the hospital gets an influx of patients who need surgery urgently. Schedule bumps happen much less frequently in an ASC. Wait times are shorter, and the patient leaves the facility for the comforts of home sooner. Most importantly, post-surgical complication rates in HOPDs and ASCs are about the same–so patients get similar outcomes even as they save time and money in an ASC, AAOS observes. 

The scope of surgeries is narrower at an ASC than an HOPD. Clinical staff can provide the more specialized care that earns higher patient satisfaction, AAOS adds. 

2. Orthopedic procedures are fueling ASC growth.

Between 2018 and 2025, the percentage of ASC procedures that are orthopedic procedures is increasing by about 16 percent (from 52 percent of all ASC procedures in 2018 to 68 percent in 2025, according to Bain. Orthopedic-related ASC growth is third behind cardiology (23 percent) and spine (20 percent) over the same time period.

Orthopedic procedures performed in outpatient settings will grow dramatically over the next decade. Outpatient surgeries involving hip and knee replacements for osteoarthritis will increase 34 percent by 2032, Sg2 predicts.

3. Orthopedic procedures continue to come off of inpatient-only (IOP) lists.

Orthopedic procedures have been shifting from inpatient to outpatient settings more quickly than procedures in other specialties, according to MedTechDive. For many patients, surgical outcomes in outpatient settings are as good as or better than surgical outcomes in inpatient settings.

Total knee replacements became outpatient surgery options in 2020, and total hip replacements got the outpatient green light in 2021. Also off the IPO list are partial knee, total ankle, and total shoulder replacements. Experts expect CMS to remove partial hip replacement, revision hip replacement, and revision knee replacement in the coming years, according to Sg2.

4. Total joint replacements cost less in ASCs, and surgical outcomes are just as good.

Total knee replacements and total hip replacements cost 40 percent less when performed in ASCs, according to a 2019 study.

5. Orthopedics generates strong revenue.

Each orthopedic surgeon generates $3,286,764 for a health system annually. That’s slightly below the average for each interventional cardiologist ($3,484,375 annually) and well above the next highest-earning specialty average (gastroenterology at $2,965,277), according to Merritt Hawkins.

6. ASCs make good financial sense for patients and payers.

If outpatient surgeries for non-complex, commercially-insured patients were performed in ASCs instead of HOPDs, their out-of-pocket costs would decrease by 59 percent, UnitedHealth Group estimates. That’s an average $684 savings per outpatient procedure.

Medicare beneficiaries usually see similar out-of-pocket savings when they choose to have orthopedic procedures performed in ASCs instead of HOPDs.

Payers benefit from ASCs because the facility fees are lower.

Want to know more? Contact us to learn how to build an optimal business development strategy for the orthopedic ASC your health system is planning.