The following is a guest article by Todd Bellemare, SVP of Professional Services at Definitive Healthcare.
The impact of COVID-19 has penetrated every aspect of daily life. From how we communicate to how we learn, shop and play, we’ve all had to adapt to the seismic shakeup of the pandemic. Nearly two years later, we’re slowly returning to some sense of normalcy.
For healthcare, however, there is no going back to normal. The pandemic has exposed limitations in the U.S. healthcare system, shattering perceptions about how Americans receive the care they need and how they engage with the people providing it.
One thing that is clear moving forward — patients want convenient, low-cost, high-quality healthcare.
While we’ve seen this trend play out most clearly with telehealth and remote patient monitoring, we’re also seeing it in the outpatient surgery space.
Gone are the days of going to the hospital for every procedure. COVID-19 has accelerated the broader shift underway of moving care outside the four walls of the hospital.
We’re seeing this trend most clearly with the growing popularity of ambulatory surgery centers (ASCs.)
ASCs are taking on more patient volume
According to medical claims data from Definitive Healthcare, outpatient surgical procedures in a hospital setting trended downward by more than 15% between 2019 and 2020. Meanwhile, ASCs saw an increase of nearly 25% in surgical procedures.
So what’s causing this trend? Is it because hospitals are taking on and prioritizing COVID-19 patients while halting elective procedures?
While some of the shift in volume may be attributed to ASCs taking on volume after CMS recommended that hospitals across the nation postpone elective procedures to maximize available bed space for COVID-19 patients, that’s not the whole story.
If taking the volume from hospitals during the elective surgery postponement was the sole reason for the shift, then we would expect to see volume shift back to hospital-based procedures once hospitals opened their doors to non-COVID-19 patients again. However, that has not happened.
ASC volume continues to increase year over year
When comparing claims volume for procedures performed in hospitals versus ASCs in 2020 and 2021, we see another year-over-year increase in ASC procedure volume.
2021 is not even over yet, and we’ve seen the monthly average of ASC claims increase 47.1% compared to 2020 (1.5M average claims per month in 2020 compared to 2.2M average claims per month in 2021, according to Definitive Healthcare data).
This year-over-year increase in ASC procedures happened despite the fact many hospitals resumed elective procedures in early 2021 that had been on hold since the start of the pandemic.
COVID-19 accelerated the transition many patients were already making for outpatient surgeries.
ASCs will continue to play a larger role in patient care moving forward
Created in 1970, ASCs are modern healthcare facilities that provide same-day surgical care for procedures that do not require hospital admission. ASCs are highly regulated by states and by CMS to ensure high-quality care. The combination of high-quality care and lower costs makes them an attractive alternative to visiting a hospital for patients.
Due to the pandemic, we’ve noticed a shift in the kinds of surgeries performed in ambulatory surgery centers. In December 2020, for example, we saw the first instances of surgery centers performing more joint replacement procedures than in hospital settings.
We expect more joint replacement surgeries to migrate to the outpatient as CMS evaluates which procedures performed at ASCs are eligible for Medicare reimbursement.
As the costs increase to deliver care in traditional environments and people move out of the cities into suburban and rural settings, hospital systems need to create alternate sources of revenue and new sites of care closer to where their patients live. Not only will this help a hospital’s bottom line, but it will improve the patient experience by meeting the patients where they are.
For hospitals, partnering or acquiring ASCs is an attractive business opportunity. In fact, we’re seeing major health systems acquiring ASCs to capitalize on the growing market and expect to see the trend continue in the years to come.
While COVID-19 did not cause the shift to ASCs, it did help accelerate their popularity. While we don’t know what the future has in store, we anticipate ASCs will continue to be an attractive option for patients as they look for more convenient and affordable care options outside the traditional setting.
About Todd Bellemare
Todd Bellemare is the SVP of Professional Services at Definitive Healthcare. He has spent his executive leadership career building healthcare provider and patient analytics and has helped leading life sciences and technology companies build their commercialization strategies through a deep understanding of the healthcare facilities, physicians, and patient landscape.
