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