search.noResults

search.searching

dataCollection.invalidEmail
note.createNoteMessage

search.noResults

search.searching

orderForm.title

orderForm.productCode
orderForm.description
orderForm.quantity
orderForm.itemPrice
orderForm.price
orderForm.totalPrice
orderForm.deliveryDetails.billingAddress
orderForm.deliveryDetails.deliveryAddress
orderForm.noItems
DOING BUSINESS


Indeed, the demand for primary total hip arthroplasty and total knee arthroplasty is projected to grow 73 percent from 1.1 million in 2016 to 1.9 million in 2026. Further, in 2016, only 15 percent of these procedures, or 165,000, were performed in an outpa- tient setting. By 2026, 51 percent, or 969,000, will be performed in an out- patient setting. This is an increase of approximately 487 percent, according to Sg2 Research. The trend shows a clear increase in TJRs, with a signifi- cant movement of these complex pro- cedures going from the inpatient to the outpatient setting. While many commercial insurers already pay for total joint surgeries in the ASC setting, it also seems as if the Centers for Medicare & Medicaid Ser-


ASCs need to be ready to make the clinical and business changes that will help them fully embrace total joint surgeries.”


—Nader Samii National Medical Billing Services


vices (CMS) is warming up to the idea as well. CMS removed total knee and shoulder procedures from the inpatient only list in 2018. While the CPT codes were not added to the ASC approved list, it is expected that they could be


added in the future as demand for these procedures continues to grow. Since the majority of TJRs are for Medicare patients, Medicare approval would dramatically increase the number of total joints performed in ASCs. In the final analysis, ASCs need to be ready to make the clinical and business changes that will help them fully embrace total joint surgeries. Given the significant revenue and profitability associated with total joint surgeries, ASCs that are built to capitalize on this opportunity will significantly increase their top line, bottom line and equity value.


Nader Samii is the chief executive officer of National Medical Billing Services in St. Louis, Missouri. Write him at Nader.Samii@nationalascbilling.com.


22 ASC FOCUS MAY 2019 | ascfocus.org


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38