Shifting care from hospitals to ambulatory surgery centers - a temporary fad or here to stay?

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Written by Mary Nojeim

Recognizing and understanding shifts in procedure trends is vitally important to building a winning strategy in today’s healthcare market.

If the past eighteen months have shown us anything, it’s that the moment we start to assume something is stable, it turns out to be anything but. Some trends turn out to be a temporary blip, and other trends quickly morph into permanent change.

According to our claims data, one temporary transition that doesn’t appear to be that temporary is the shifting center of care for surgical procedures.

Shifting from hospitals to ambulatory surgery centers

Between 2019 and 2020, outpatient surgical procedures performed in a hospital setting trended downward by more than 15%.

So what’s causing this trend? Is it because hospitals are taking on and prioritizing COVID-19 patients while halting elective procedures?

When we look at where the remainder of the nation’s surgical procedures are being performed, we see that COVID-19 isn’t the main factor behind the shift. In the same timeframe that we saw a decrease in hospital volume for outpatient surgery, we saw an increase of 23.6% in total patients receiving surgical intervention at ambulatory surgery centers (ASCs).

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 tends to make them an attractive alternative for both patients and hospital systems.

What is driving the shift from hospitals to ambulatory surgery centers?

So what’s driving the increase in ASCs volume? One piece of the puzzle is that these facilities are taking on the volume of patients from the hospitals unable to see them during the pandemic.

However, this only accounts for a portion of those patients seeking care elsewhere. If it were 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.

When we compare 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).

This year-over-year increase in ASC procedure volume happened despite the fact many hospitals began to resume 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 offer patients high-quality care at lower costs, which makes them an attractive alternative to visiting a hospital for outpatient surgeries.

What’s even more interesting is that many of these ASCs are actually owned by hospital systems.

As the costs increase to deliver care in traditional environments, and people are moving 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. In fact, our hospital and ASC databases show that more than 3,400 ASCs are owned by hospitals systems and the average hospital system owns an average of 4 ASCs.

How the shifting care setting is reshaping the medical device industry

Understanding this market shift is incredibly important for anyone selling into the traditional hospital surgical setting, particularly those in the medical device field.

As ASCs grow in popularity and continue to take on more procedures, medical device companies may need to adjust their sales and marketing strategy to target the ASC market. ASCs present a new and potentially major market for medical device companies.

Companies looking to target the ASC market need healthcare commercial intelligence to gain context on the trends shaping the healthcare market, which will enable them to develop better sales strategies, marketing campaigns, and ultimately sell more devices.

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Want to learn more about how Definitive Healthcare can provide the healthcare commercial intelligence medical device companies need to navigate a shifting landscape? Request a free trial.

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