How ASCs Bring Innovation to Outpatient Spine Surgery 

Posted Feb 28, 2024 under:

ASCs Leading Innovation in Spine Care Delivery

ASCs continue to advance orthopedic care by moving complex procedures into cost-effective outpatient settings without compromising outcomes.  

Very high resolution 3d rendering of four human vertebae.

ASCS Driving Outpatient Migration in Spine Surgery

ASCs push boundaries of possibility in orthopedic care while remaining both patient-centered and cost-effective.

Outpatient spine surgery has transformed over the last decade as procedures requiring extended hospital stays have shifted into specialized ambulatory settings that lower costs without compromising outcomes. Ambulatory surgery centers (ASCs) now perform over 50% of common outpatient spine procedures, including lumbar laminectomies, anterior cervical discectomies, and spinal fusions. This dramatic shift towards the ambulatory space promises better care and value for patients while supporting physicians, payers, and the field of orthopedic healthcare.  

Read on to discover ways ASCs are revolutionizing outpatient spine care. 

Innovative Surgical Techniques

ASCs have pioneered the adoption of advanced surgical techniques that allow patients to undergo spine procedures without overnight stays safely. Notably, these advancements include robotic surgeries, CT-guided navigation for implant positioning, and minimally invasive surgery (MIS) approaches that use advanced tubular retractors with built-in microscopes to access the operation site through tiny skin openings.  

“Robotic surgery has also made it technically possible to do more challenging cases with less invasive procedures,” Steven Hochschuler, M.D. said. “When you minimize the incision and the muscle trauma, you can significantly reduce post-procedure pain and disability which is often the primary reason for prolonged hospitalizations.” 

Finally, regional anesthesia techniques can now facilitate rehabilitation within 24 hours, even for major spine operations. Targeted epidural nerve blocks avoid the extended effects of general anesthesia (such as nausea) that can delay recovery. Patients are typically able to remain awake – but comfortable – during relatively short procedures.  

“When you go from using general to regional anesthesia in the spine, you get a 50% reduction in your length of stay,” notes Alok Sharan, M.D.  

However, while these innovations show incredible potential, their use requires extensive hands-on learning.  

“It’s one thing to come out with a new technique, and another to make sure surgeons are trained to use it,” Dr. Sharan states. “ASCs provide the perfect training ground for surgeons to master these highly complex techniques within a specialized environment.”  

Cost Savings

As the cost of healthcare continues to rise, performing spine surgery in an ASC rather than a traditional hospital setting results in remarkable savings that benefit patients, providers, and health insurance payers. According to recent estimates by Blue Cross Blue Shield, laminectomies performed in ASCs save patients an average of $320 in out-of-pocket costs compared to hospital settings. Other outpatient procedures that have migrated to ASCs result in similar patient savings.  

These low costs provide incentives for payers as well – studies estimate that on average, surgeries performed at ASCs cost 60% less than those done at a traditional hospital. Currently, around half of all outpatient spine surgeries still occur in hospital environments. This suggests enormous potential for future cost savings if the migration of spine procedures into specialized ASCs continues to trend upwards.  

Strategic Joint Venture Structures

While ASCs allow physicians greater autonomy and influence over patient care, scheduling, and daily workflows, running an independent ambulatory surgery facility can pose immense staffing, licensing, and administrative burdens. 

Joint ventures with leading ASC management companies like SCA Health can provide specialized, holistic operational expertise that balances physician autonomy with seamless behind-the-scenes support. This blending of expertise allows independent physicians to excel at outpatient orthopedic care while specialized management teams handle the complexities of overseeing daily business operations. This symbiotic relationship leads to greater collective potential – maximizing patient care and business growth that neither partner could achieve alone. 

Integrated Patient Care

Many leading ASCs have invested in integrated care models that customize the entire patient experience, leading to faster recoveries and greater patient satisfaction. By integrating specialty-trained nurses, pharmacists, therapists, and operational support staff directly within orthopedic ASCs, coordination creates a structured care delivery system spanning from pre-surgery optimization to the operating suite to post-discharge medication and mobility support. 

By delegating medication counseling, screening, and therapy to dedicated teams, physicians can focus more of their attention on patient care and avoidance of complications. This team-based integrated model significantly increases patient satisfaction because of a “greater sense of personalized care and contact.” 

The Future of Outpatient Spine Surgery 

As outpatient migration from hospitals to ASCs accelerates across orthopedics and other specialties, spine surgeons are leveraging technology to push the boundaries of what is possible outside traditional hospital walls. While the ASC space promises to be one of the best avenues for cost-effective, patient-centered care, physician leadership and innovation will ultimately shape the future of outpatient spine surgery.  

Resources: 

National Library of Medicine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6790806/; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10562071/; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676761/; https://pubmed.ncbi.nlm.nih.gov/37144568/ 

Bonezone: https://bonezonepub.com/2022/10/10/5-reasons-why-spine-procedures-are-moving-to-ascs/ 

Becker’s ASC: https://www.beckersasc.com/asc-news/outpatient-spine-surgery-innovation-key-concepts-for-adding-cases.html 

Orthoworld: https://www.orthoworld.com/whats-driving-growth-of-ascs-in-the-spine-market/ 

SCA Health: https://insights.sca.health/insight/article/8-reasons-physicians-should-partner-with-sca-health 

Integration Academy: https://integrationacademy.ahrq.gov/playbooks/behavioral-health-and-primary-care/implementing-plan/educate-patients-and-families-about-integrated-ambulatory-care 

McKinsey & Company: https://www.mckinsey.com/industries/healthcare/our-insights/walking-out-of-the-hospital-the-continued-rise-of-ambulatory-care-and-how-to-take-advantage-of-it 

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