CMS approval for total knee replacements for ASCs is a billion-dollar risk to hospitals — are you prepared?

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Surgical procedures that represent the largest opportunities for migration to ASCs also present the greatest cannibalization risk to hospitals.

Procedures like total joint replacement, spinal fusion and hysterectomy can safely be performed in the ambulatory surgical center on appropriately selected patients. In some cases, Medicare, commercial payers and employer groups are driving the shift because ASCs are the lower-cost setting; this trend is growing.

For 2020, CMS proposed rule to add total knee replacements (TKA) to the ASC payable list, presents meaningful risk to hospitals. Consider the potential impact: a shift of 10 percent to 30 percent of hospital Medicare TKA volume to ASCs represents a $600 million to $1.8 billion loss in revenue. However, there are opportunities for hospitals to capture new volume from ASCs by joint venturing with physicians, developing strategies to optimize opportunity with alternative payment methods and implementing an ASC strategic plan that complements and augments opportunity.

Learn more about mitigating the risk and potential losses attributed to surgery migration, and optimizing opportunities with an ASC strategy at the Becker's Hospital Review CEO + CFO Roundtable on Nov. 11-13 in Chicago, during the session "Surgery Migration and Mitigating Risk for Hospitals without an ASC Plan," presented by ECG Management Consultant leaders, Naya Kehayes, Principal and Ambulatory Surgery Practice Leader and Sean Hartzell, Associate Principal, Strategy and Business Advisory.

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