Economics. Same-day surgical centers should negotiate contracts
before scheduling a procedure with private insurers and establish pro-
cedure-specific facility reimbursement rates. Researchers recently
compared inpatient and outpatient billed charges for single-level
ACDF/CTDR using payers' explanation of benefit (EOB) documenta-
tion. Average outpatient charges ($11,144) were 83% lower than inpa-
tient charges ($68,000) for cervical total disc replacement and 52%
lower for anterior cervical discectomy and fusion (outpatient: $29,313,
inpatient: $61,095).
Post-op complications. Educate patients and caregivers about the
signs and symptoms of respiratory compromise due to post-discharge
hematoma, a rare but potentially devastating complication. Know the
common and rare complications and develop processes, protocols,
and action plans before you perform the first case. If a complication
can happen plan that it will and be vigilant.
OSM
1 0 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J A N U A R Y 2 0 1 7
Dr. Worthington (bradley.worthington@genealign.com) is medical director of
perioperative services and anesthesiology for Surgery and Recovery Partners in
Greenville, S.C.
