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Archive March 2015 XVI, No. 3

Outpatient Total Joints: A Growth Opportunity?

More and more facilities are adding outpatient total joints — should you be one of them?

Kendal Gapinski

Kendal Gapinski, Contributing Editor


outpatient total joint OUTPATIENT GROWTH Have you considered adding an outpatient total joint program?

Thinking of adding a total joint replacement program? You're not alone. These programs are becoming increasingly common as advanced anesthesia techniques and muscle-sparing procedures have become the norm.

"It's taken more than a decade to get people interested," says Richard Berger, MD, a hip and knee reconstruction and replacement orthopedic surgeon at Midwest Orthopaedics at Rush in Chicago, Ill., who was one of the first to perform a same-day joint replacement, about 14 years ago. "But over the past 2 to 3 years, the idea of outpatient total joints has really started to take off."

The benefits of outpatient total joints are easy to see. "People would rather be at home," says Robert Kohen, MD, an orthopedic surgeon performing total joints at UnaSource Surgery Center in Troy, Mich. He says patients requiring these procedures are also becoming ideal for outpatient surgery. "There are more young people needing the surgery," says Dr. Kohen, who has performed outpatient total joints for about a year. "Most of these people are healthier than the traditional population."

Additionally, ambulatory surgery centers can offer freedom and accommodations surgeons can't always get at a hospital, driving demand for these programs, says Dr. Berger. "On the inpatient side, it's becoming more and more cumbersome, and more and more restrictive on what you can and cannot do," he says. "This is a way to get control back into the surgeon's hands."

While Medicare hasn't yet authorized payments for total joint replacements performed in an ASC, that doesn't mean private insurers aren't taking note of same-day joints' big financial benefit. With costs about one-third of hospital inpatient care, more insurers are working with centers to offer the procedure to their members. Dr. Kohen notes that while his center can currently only offer total knees, due to insurance constraints, he sees the tide turning. "I think it will change over time," says Dr. Kohen. "We do it at such a lower cost than inpatient procedures at a hospital."

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