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Maximizing Profitability in ASCs: How Total Joint Procedures Can Drive Revenue Growth

If you’re looking for ways to take your surgery center’s profits to the next level in 2023, look no further than total joint replacements. While there are currently 580 ASCs in the United States offering these high-acuity procedures, total joints have strong volume potential and are proving to be a financially beneficial opportunity for outpatient facilities.¹ 
 
Here are the top four reasons why total joint procedures are migrating to the outpatient setting in 2023 and why they represent a promising investment opportunity: 

1. Total joint procedures are on the rise in the United States. 

Over two million hip and knee surgeries were performed in 2020 despite the initial impact of the COVID-19 pandemic.² This trend is expected to continue to rise over the next decade due to an increasing number of individuals over the age of 60. 

While orthopedic procedures had already shifted to the outpatient setting prior to the pandemic, the ASC setting became an increasingly popular choice for total joints after outpatient total knee replacements becoming eligible for Medicare in 2020, followed by total hip replacements in 2021.  

As patients are increasingly empowered to make choices about their healthcare providers, recent consumer surveys have shown 78% of orthopedic patients prefer ASCs over hospital or hospital outpatient (HOPD) settings due to lower costs and higher quality of care.³

2. Total joint replacements are more affordable in an ASC. 

ASCs offer a highly cost-effective alternative to traditional inpatient procedures, providing benefits for both patients and insurance providers. In fact, total joints currently cost up to 40% less in an ASC compared to the hospital setting. On average, the total expense of a total joint procedure is $11,677 in an ASC, while the total inpatient fee comes to $19,361.⁴  

By shifting routine total joint procedures from hospitals to ASCs, it’s estimated that the healthcare industry could see an annual savings of $3 billion; these savings would include $2 billion for privately insured individuals and employers, as well as $1 billion for Medicare beneficiaries and the federal government.⁵

3. ASCs are improving the patient experience for total joint surgeries.  

Although the surgical process of performing total joint procedures is similar across healthcare settings, patients who choose ASCs enjoy a significantly shorter length of stay compared to their hospital-based counterparts. On average, ASC patients can expect to be discharged within 8 hours of their surgery, while hospital-based patients typically require a stay of around 24 hours for total hip or total knee surgery.⁶ 

Patients who receive care in the outpatient setting spend more time recovering in the comfort of their own homes, which not only improves their overall experience, but also reduces the risk of hospital-acquired infections and other conditions. 

This shortened length of stay is largely due to the outpatient industry’s specialized focus on specific procedures. ASCs have been able to implement efficient processes that facilitate patients’ quick and safe recovery after surgeries such as specialized pre-operative assessments, optimized anesthesia protocols, and dedicated post-operative care. Additionally, ASCs often employ a multidisciplinary team of healthcare professionals who work together to coordinate care and ensure the best possible outcomes for patients. This not only allows patients to return to their daily routines sooner, but it also contributes to cost savings and increased efficiency for the healthcare system.

4. Total joints offer long-term growth for ASCs. 

Orthopedic patients are recognizing hospital settings can be more expensive, have longer wait times, and require a longer recovery period than the outpatient setting. In 2022, orthopedic surgeries were the most common among ASCs nationwide, representing 37% of the total volume of ASC procedures, and that number is expected to rise significantly in the coming years.⁷  

While the volume of orthopedic cases migrating to the outpatient setting is certainly significant, total joints also offer the highest reimbursement rates among outpatient procedures due to their complexity, specialized equipment, and costly implants.  

The American Academy of Orthopedic Surgeons predicts that ASCs will perform 68% of all orthopedic surgeries by the mid-2020s, with 51% of joint replacements being performed on an outpatient basis by 2026.⁸ By incorporating total joints, ASCs can tap into a lucrative and growing market while also providing patients with a more convenient and personalized experience. 

Adding a new line of service to your ASC can be complicated from a compliance and managed care contract standpoint, but total joint replacements are proving to be a smart investment for surgery centers looking to maximize profits in 2023 and beyond. 

Are you looking for ways to improve your revenue cycle management? Take the first step towards optimizing your revenue cycle process by requesting a revenue assessment from our team of RCM experts. Request a demo.

References:

References:

  1. Talian, B. (n.d.). 580+ ASCs with total joint replacements | 2023. www.beckersasc.com.  https://www.beckersasc.com/lists/580-ascs-with-total-joint-replacements-2023.html
  2. Siddiqi, A., Levine, B. R., & Springer, B. D. (2022). Highlights of the 2021 American Joint Replacement Registry Annual Report. Arthroplasty Today, 13, 205–207. https://doi.org/10.1016/j.artd.2022.01.020
  3. Providers, E. how individuals select orthopedic, & Strategy, W. F. D. T. D. to H. Y. B. Y. C. (n.d.). What Do Consumers Want from Orthopedic Care? Www.advisory.com.
    https://www.advisory.com/Topics/Orthopedics/2020/01/What-Do-Consumers-Want-from-Orthopedic-Care
  4.  No increased risk of complications for joint replacement in ambulatory surgery setting. (n.d.). EurekAlert! https://www.eurekalert.org/news-releases/517261
  5. New Research Highlights the Safety and Cost Savings Associated with Ambulatory Surgery Centers. (n.d.). Www.unitedhealthgroup.com.  https://www.unitedhealthgroup.com/newsroom/research-reports/posts/2020-12-10-research-ambulatory-surgery-centers-490916.html
  6. Newitt, P. (n.d.). Orthopedic revenue, case mix for ASCs. Www.beckersasc.com.  https://www.beckersasc.com/orthopedics-tjr/orthopedic-revenue-case-mix-for-ascs.html
  7. Wallace, C. (n.d.). Orthopedics, pain most common specialties for ASCs in 2022. Www.beckersasc.com. https://www.beckersasc.com/asc-news/orthopedics-pain-most-common-specialties-for-ascs-in-2022.html
  8. Outpatient Total Joint Replacement. (n.d.). Www.orthoinfo.org
    https://orthoinfo.aaos.org/en/treatment/outpatient-joint-replacement-surgery/#:~:text=In%20fact%2C%20many%20surgeons%20now