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July 18, 2018 | Orthopedics • Value-Based Care
Traditionally, surgeries were performed in hospitals, but advancements in technology, anesthesia and pain control now allow physicians to perform certain procedures in a surgical center.
Outpatient, or ambulatory, surgical centers are a cost-effective option for many procedures, but not every patient’s procedure is eligible for a surgical center.
Convenience: Because you do not need to be admitted to the hospital, you can go home the same day as your procedure. This is often more convenient for many patients and is a great option for children who are nervous about being away from home.
Predictable scheduling: Hospitals have to accommodate for emergencies, which means scheduled surgeries might get delayed. Surgical centers are not emergency facilities, so most procedures are able to stay on schedule.
Lower costs: Surgical centers are much more cost effective for insurance companies and for patients because they don’t have the high overhead costs of hospitals. In fact, the cost of a procedure at surgical center is typically 45-60 percent less than the same procedure in a hospital setting, according to the Surgery Center Network.
High-quality care: Surgical centers are required to meet certain standards determined by the federal government to ensure patient safety and satisfaction, including steps to reduce infection rates.
Experienced staff: Staff are often more proficient in outpatient procedures because they perform the same types of surgeries constantly. Surgical center staff also have experience performing procedures on and caring for patients with conditions like diabetes, high blood pressure, sleep apnea and others.
Effective pain management: Because all procedures at a surgical center are outpatient, nurses, surgeons and anesthesiologists frequently have a better focus on postoperative pain control.
Different factors influence a patient’s eligibility for surgical centers. These include:
Patient age: Your age can affect your eligibility for outpatient procedures. Older adults in poor health, for example, may take longer to heal after surgery. Your doctor can evaluate your health to determine if age is a limiting factor.
Risk factors for surgical complications: Surgical centers are equipped and prepared to handle some surgical complications, but they might not be able to handle all emergencies. If you are at risk for serious complications, you may need to have your surgery at a hospital.
Complex procedures: Surgeries that require patients to stay for more than one night are not eligible for a surgical center. Transplant and cardiac surgeries, for example, are usually reserved for a hospital setting.
Insurance coverage: Your insurance provider may not cover certain procedures in surgical centers, or some surgical centers may not be in your insurance network. Make sure you understand your coverage when choosing a surgical location.
Many different orthopedic procedures qualify for an ASC. These include but are not limited to:
Some patients may also qualify for outpatient joint replacements.
Talk to your doctor about whether you are a candidate for outpatient surgery. Your doctor will be able to weigh the risks and benefits and come to a conclusion with you about what is best for your situation.
“Outpatient Surgery.” Johns Hopkins Medicine. https://www.hopkinsmedicine.org/healthlibrary/conditions/surgical_care/outpatient_surgery_85,P01404
“ASCs: A Positive Trend in Healthcare.” Advancing Surgical Care. https://www.ascassociation.org/advancingsurgicalcare/aboutascs/industryoverview/apositivetrendinhealthcare
“Clinical and Cost Implications of Inpatient Versus Outpatient Orthopedic Surgeries: A Systematic Review of the Published Literature.” US National Library of Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4703913/
“2018 Final Rule OPPS Addenda.” Centers for Medicare and Medicaid Services.” https://www.cms.gov/apps/ama/license.asp?file=/Medicare/Medicare-Fee-for-Service-Payment/HospitalOutpatientPPS/Downloads/CMS-1678-FC-2018-OPPS-FR-Addenda.zip
“Common Ambulatory Surgery Center Procedures.” Proliance Orthopedic Associates. http://www.prolianceorthopedicassociates.com/patient-resources/common-ambulatory-surgery-center-procedures/
The Live Better Team
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This information is not intended to replace the advice of a medical professional. You should always consult your doctor before making decisions about your health.