Key Trends for Ambulatory Surgery Centers in 2018
[Pages:25]Key Trends for Ambulatory Surgery Centers in 2018
Don Phalen
Vice President Business Development, Regent Surgical Health
Mark Murphy
Chief Strategy Officer, St Joseph's Hospital
MOVING TOWARDS VALUE-BASED CARE
Total Joints Replacement
Cardiovascular Centers
ValueBased Care
Bundled Payments
Employed Physician Ownership
HOPD Conversions
? Shift to Value ? IP ORs are considered cost center and targets for reduction.
? Reimbursement Shifts ? CMS approving new procedures and narrowing gap b/w ASC and Hospital Rates. Move toward bundled payments and risk-based contracts.
? Outpatient Capabilities ? Technology, smaller incisions, and advances in anesthesia and pain management techniques encourage more cases to go outpatient.
? Physician Preference ? Better alignment of incentives with Physician Ownership. Physicians have better control and material financial returns.
? Patient Preference ? Provides lower costs for those with high deductible plans. ASCs tend to be more convenient, less crowded, and less confusing than hospitals.
HOW FAST
ARE YOU MOVING TOWARDS
VALUE-BASED CARE?
MOVING TOWARDS VALUE-BASED CARE
CMS is aggressively pushing to have "Value" replace "Volume"
Target percentage of Medicare FFS payments linked to quality and alternative payment models in 2016 and 2018.
All Medicare FFS (Categories 1-4) FFS linked to quality (Categories 2-4) Alternative payment models (Categories 3-4)
20 MAJOR HEALTH SYSTEMS & PAYORS pledge to convert
75% OF BUSINESS to valuebased arrangements BY
2020 According to chairman of the taskforce, CEO Richard Gilfillan, MD, of Trinity Health
Total Joint Replacements in Outpatient Setting
HISTORY OF JOINTS IN THE OUTPATIENT SETTING
INITIAL HEADWINDS TO CHANGE ? Payors ? Surgeons ? Clinical Staff
Strong leadership was required to overcome challenges
# of Procedures
PROJECTED GROWTH IN THE OUTPATIENT SPACE
? By 2030, annual total hip and knee joint replacements are expected to grow from $1M to $4M
? 45% of procedures could be outpatient by 2025
2,500,000 2,000,000 1,500,000 1,000,000
500,000 0
Outpatient Joints Inpatient Joints
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