Orthopedic ASC Market Growth Inevitable, Despite CMS TKA Ruling

Orthopedics and spine surgery procedures are starting to migrate to outpatient settings, ambulatory surgery centers in particular. Medtech companies are thinking about how to best to gear up for the change.

At the American Academy of Orthopedic Surgeons (AAOS) annual meeting in March, large device manufacturers highlighted more than in the past their clear interest in the free-standing ambulatory surgery center (ASC) market opportunity, even while noting current numbers are still small and acceleration to wider adoption is several years away. Still, that’s an about-face from previous years, when ASCs were an interesting, threatening blip, at best, on their radars. (“How the Spine Industry Perceives Ambulatory Surgery Centers,” MedTech Strategist, October 16, 2015.)

What’s clear is that orthopedics and spine surgery companies consider the turn to outpatient procedures in general, and ASCs in particular, to be inevitable and they are thinking about how best to gear up for it. (See “Digital Health is Taking Off Among Providers: What Could that Mean for Orthopedics?” MedTech Strategist, January 16, 2019.)

Their attitude is backed by a wide consensus, as highlighted during an insightful roundtable on the impact of ASCs (excluding hospital outpatient surgery centers) at a February investor program in New York City. MedTech Strategist did not attend the meeting, but SVB Leerink subsequently issued a report on March 6, which included some important, albeit high-level takeaways for medical device companies.

Their perspective comes despite widespread confusion following the rollout of the Centers for Medicare and Medicaid Services’ (CMS) revised payment rules removing total knee arthroplasty (TKA) from the inpatient only (IPO) list, which enables for the first time sameday discharge for some patients and which raised safety concerns among many surgeons.

In general, outpatient surgery procedures are still only a small percentage of total surgery procedures in the US—ASCs represent less than 15% of procedures, according to estimates by panelists who projected the trend to move to outpatient surgery accelerating in the next 3-5 years (some other estimates are more conservative, in the mid-single digits for orthopedics (see Figure 1). The panelists were not identified by name but their expertise consisted of “the CEO of a leading surgical cost management solutions company; a partner at a US ASC management firm; a board-certified orthopedic surgeon and medical director at a university hospital and ASC; and the emeritus chief of orthopedic surgery at a teaching hospital in the Northeast.”

By Wendy Diller | MedTech Strategist

Image Credit: Wendy Diller / MedTech Strategist


About Peter Coffaro 489 Articles
A growth-driven and strategic executive, Peter Coffaro commands more than 25 years of progressive management success within the medical device industry. Recognized by the World Journal of Orthopedics, Exponential Healthtech, and MedReps.com as one of the top medical sales influencers in the industry; he has 10 years of combined sales management experience and has held positions as a Director, General Manager, Distributor, and Vice President. Peter has worked for some of the top orthopedic companies in the world - Zimmer, DePuy, and Stryker. He is also the founder of OrthoFeed: a popular blog that covers digital orthopedic news and emerging medical technologies. Peter is a three-time Hall of Fame award winner at Johnson and Johnson and has an extensive background in organizational development, business development, sales management, digital marketing, and professional education. Peter holds a B.S. degree in Biology and Chemistry from Northern Illinois University.

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