Let’s hope out­pa­tient cen­ters are fully pre­pared for to­tal joint pro­ce­dures

Modern Healthcare - - COMMENT -

Re­gard­ing the Aug. 4 cover story “Hos­pi­tals wary of CMS plan to cover joint re­place­ments in out­pa­tient cen­ters,” p. 20), I fully sup­port any­thing that low­ers to­tal health­care spend­ing. How­ever, as men­tioned in the ar­ti­cle, it will be crit­i­cal that the CMS re­cal­cu­late sur­gi­cal site in­fec­tion rates and other com­pli­ca­tion rates for in­pa­tient pro­ce­dures, know­ing that only the sick­est pa­tients will be treated at in­pa­tient fa­cil­i­ties.

There cer­tainly are many pa­tients who could have their pro­ce­dures done in an am­bu­la­tory surgery cen­ter or other out­pa­tient set­ting, but I hope no overly ag­gres­sive cen­ters try to take on more than the ap­pro­pri­ate cases based on over­all health and co­mor­bidi­ties.

An­other fac­tor in this is post­op­er­a­tive care. ASCs don’t typ­i­cally staff ex­tended hours, which will likely be re­quired, since not ev­ery to­tal joint pa­tient can be dis­charged af­ter a short re­cov­ery. Ad­di­tion­ally, I’m not sure they all have the re­sources for the case man­age­ment nec­es­sary to achieve the best out­comes. Only time will tell, and I sin­cerely hope pa­tients’ care and out­comes are not com­pro­mised as this change takes place.

Denise Adema Fort My­ers, Fla.

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