More total joint replacements are migrating to the outpatient and Ambulatory Surgical Center (ASC) setting and more studies are showing the procedures can be performed safely in the outpatient setting.
Here are 7 things to know about the procedures and ASCs.
1. More than 500 ASCs offer total joint replacements in the U.S.
2. California has the most ASCs performing total joint replacements, with 50 centers. Florida is No. 2, with 42 centers, followed by Maryland and Texas which each have 32 centers performing total joint replacements.
3. Less expensive, less risk: Total joint surgery is more affordable and safer in an ASC. A study from New York City-based Hospital for Special Surgery and Philadelphia-based Rothman Orthopaedics suggests there isn't increased risk for patients undergoing outpatient joint replacements performed in the ASC setting when compared with the inpatient hospital setting. Surgery cost for the ASC group was 40 percent less than the hospital group detailed in the study.
4. During the COVID-19 pandemic, many states placed limits on performing elective procedures to support clinicians treating patients with the virus. When states allowed ASCs to resume elective procedures, more surgeons became interested in performing total joint surgeries in ASCs because the facilities didn't treat COVID-19 patients. The pandemic in some cases accelerated the shift from the inpatient to the outpatient setting.
5. Total knee replacement became eligible for Medicare payment in the ASC setting in 2020, and Medicare added total hip replacements in 2021.
6. Sg2, a healthcare strategy and advisory firm, projected 37 percent of total joint surgeries would be outpatient by 2022, with that number rising to 51 percent by 2026.
7. Surgery centers are increasingly acquiring robotic technology for total joint surgeries for more accurate procedures. In some cases, the technology can also be used as a surgeon recruitment tool for those who are familiar with the technology in the hospital. However, robotic technology is a large expense and may not make sense for all centers.