Becker’s Hospital Review
The momentum for the migration of total joint surgeries from the hospital inpatient setting to the hospital outpatient setting and the ASC setting has been favorably impacted by technological advances, surgical techniques, increased effectiveness in postoperative care, and—the single most important factor—the demand for the US to decrease the total cost of healthcare.
Consumers and employer groups are holding commercial payors (CPs) accountable, while employer groups are demanding that CPs sustain and reduce both premiums and the total spend on healthcare. This is increasingly prevalent with large employer groups that are self-funded and, where pricing sensitivity to rising healthcare cost is a top priority for major employers as indicated by the recent announcements of Amazon, JP Morgan and Berkshire Hathaway.
As baby boomers are reaching retirement, and the general population is living longer with more active lifestyles, the projected number of total knee arthroplasty (TKA) and total hip arthroplasty (THA) procedures for the Medicare and commercial patient population is expected to increase. Removing total joint procedures from the inpatient-only list enables cost reduction that results from performing these cases in the outpatient setting.
This article was first published by Becker’s Hospital Review in May, 2018.