That outpatient trend is not new, but it has accelerated at a time when hospital finances are already under pressure from the coronavirus pandemic and rising labor costs.
When a Rothman Orthopaedic Institute surgeon replaced Kathryn Patterson’s left hip in May 2021, the North Cape May resident was part of a massive shift in the way joint replacements are done.
The 78-year-old arrived at the AtlantiCare surgery center in Egg Harbor Township at 7 a.m. the day of her surgery and was back home in the middle of the afternoon. Her only rehab, which she completed with the help of her son, consisted of walking for 10 minutes every hour.
“It was a great experience,” Patterson said recently. “I went in with pain, and I came out with no pain. It’s been like that ever since.”
At the Philadelphia-based Rothman Orthopaedic Institute, which is among the largest orthopedic groups in the United States, speedy outpatient joint replacements like Patterson’s are rapidly becoming the norm — replacing the traditional inpatient stays after surgery and adding to the extraordinary financial strain hospitals are under.
In the first half of this year, 73% of Rothman’s hip and knee replacements were outpatient, compared with just 14% outpatient in the first half of 2019. That change comes with significant savings. Between 2019 and last year, the average cost to a private insurer of a total joint replacement at Rothman fell to $25,001 from $36,433, according to Rothman data.
Driving the move to outpatient surgeries, which typically cost 30% to 40% less than the same surgery done on an inpatient basis, have been changes in Medicare rules, the general shift away from hospital-based care — in overdrive during the coronavirus pandemic — and long-developing improvements in medical care.
Image Credit: Vernon Ogrodnek