Fast forward to present day. Mr. Cera is the administrator of The
Orthopaedic Surgery Center in Boardman, Ohio, a $7 million, 4-OR
orthopedic-centric facility that opened on New Year's Day to accom-
modate the increasing number of joint replacements the surgeons per-
formed: 50 hip, knee and shoulder replacements in 2015, 130 in 2019
and a projected 150 to 170 this year. Those numbers should only
increase moving forward now that, after years of speculation,
Medicare has added total knees to the list of payable ASC procedures.
Total hips have been removed from the inpatient-only list and should
soon join knees on the list of procedures approved for reimbursement
at ASCs.
"Total joints are money-making procedures and insurers would
rather pay our facility thousands of dollars less for the same proce-
dures that cost $20,000 to $40,000 at the local hospital," says Mr. Cera.
"Insurance companies want low-cost, high-quality care, and patients
want to undergo successful surgeries and recover at home. Outpatient
total joints programs meet those needs."
Focused care
Richard Evans, MD, vice president of surgical services at Bon Secours
Charity Health System and member of the Westchester (N.Y.) Medical
Center Health Network, says his health system's Good Samaritan
Hospital built an ortho-only surgical facility to have a dedicated space
where staff could focus on delivering care to total joints patients who,
in turn, would benefit from single-specialty resources and a special-
ized staff's expertise.
"Everyone has the same goal — achieving excellent outcomes," says
Dr. Evans. "Plenty of time to talk joints. Nurses all talk the same lingo
and learn from each other about ways to improve patient care.
Patients see other patients ambulating after undergoing the same pro-
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