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Knee Surgeon and Specialist Stefan D. Tarlow, M.D.

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Why Choose an Ambulatory Surgery Center: Safety and Cost

March 3, 2017 By Stefan D. Tarlow MD 1 Comment

Safety

Ambulatory Surgery Centers May Be Safer Than Hospitals for Surgical Care

Ambulatory Surgery Center

A recent article in HealthLeaders Magazine explored the volume, pricing and quality of surgical care delivered in an ASC (ambulatory surgery center).

The conclusions are that the numbers of ASC’s are growing in the U.S. (and this is a good thing).  The good news is that the cost of procedures performed at ASC’s are 55% of the  cost of the same service performed at a hospital outpatient department.  Even better, the number of adverse events (complications) are “significantly below the rates reported for inpatient hospital setting”.

The explanation, says Michael Cruz, MD, OSF Saint Francis’s vice president of quality and safety, is simple. The ambulatory environment “is more expeditious and efficient. Some of our patients are much better served—their patient experience is much improved—than if they were brought to a complicated medical center for a routine procedure.

At SurgCenter of Greater Phoenix, in Scottsdale, we render same day services for Makoplasty Partial knee resurfacing, Makoplasty Direct Anterior hip replacement, and total knee replacement. Our emphasis is on advancing surgical patient care to the most sophisticated levels found in the U.S..  By offering traditional services using new principles and innovative ideas, our patients experience high quality care,  benefit from going directly home after their procedure and may even save a little money in the process.

Low Complication Rate Reported from New Outpatient TJA Facility

Bottom Line
  • The study examined results for 432 patients undergoing TJA at a newly opened outpatient surgery facility over approximately 13 months.
  • The overall rate of hospital readmission was 1.2 percent.
  • The rate of unplanned access of the healthcare system was 10.9 percent.
  • A statistically significant lower rate of unplanned access to care was seen in the concluding 4.5-month period of the survey versus that in the first 9 months.
This study appeared in the July AAOS Now.
Our results at SurgCenter of Greater are similar, with no hospital admissions of our series of Outpatient Joint replacements and high patient satisfaction from being able to sleep in their own beds with reasonable pain management.
Lead author Daniel P. Hoeffel, MD, a surgeon at Summit Orthopaedics in Woodbury, Minn., which opened the ambulatory surgery center in 2014, said that the study represented one of the largest series to date on outpatient total TJA. He said the rates of hospital readmission reported in the study are “lower than those historically reported” for inpatient TJA
The study, presented in a scientific poster at the AAOS Annual Meeting, reported results for 432 patients who underwent either total hip arthroplasty (THA; n = 177) or total knee arthroplasty (TKA; n = 255) in the outpatient surgery center over 13 months. A total of 12 adverse events occurred, with five patients (1.2 percent) requiring hospital readmission. Two of these were due to swelling with pain or hematoma, and three were for dislocation, pneumonia, or infection.

Cost

What Should Knee Replacement Surgery Cost?

Total Knee Replacement is one of the most expensive surgical procedures performed in the United States. Comparing costs for services is confusing to say the least.  Trying to get pricing information using your health insurance is impossible until after the Explanation of Benefits arrives from the insurance carrier.  The best way to compare apples to apples is to compare all-inclusive cash pricing (the price one would pay assuming payment at time of services from the patient to the facility – includes surgeon fee, assistant surgeon fee, anesthesia fee, facility fee and implant cost)

This is also true:  Total Knee Replacement performed in our ambulatory surgery center, SurgCenterGreaterPHX as an outpatient is significantly less expensive than the exact same procedure performed in a Hospital.
Here are the fees from Stefan D. Tarlow, M.D. of Advanced Knee Care, P.C :
Ambulatory Surgical Center: Total Knee Replacement @ SurgCenter GreaterPHX -(implant included)  — $22,300
Hospital: Total Knee Replacement  @Scottsdale Healthcare Thompson Peak- (implant included) — $30,700
There are several helpful sites for patients to view
HealthCare Blue Book — For Scottsdale “total fair price” said to be $22,899.
https://www.healthgrades.com/procedures/how-much-does-knee-replacement-cost –The United States is known for wide variation in healthcare costs. The average national price for a knee replacement in 2012 was about $20,000 plus the cost of the implant. Implants can cost up to $10,000.
https://health.costhelper.com/knee-replacement.html – Estimate cash cost to be $35,000 or more for people with insurance but note cash price for uninsured $20,000-$34,000 depending on geographic location.
https://www.kneereplacementcost.com/ — The United States has among the highest costs in the world for knee replacement surgery. An American with no health insurance can expect to pay $45,000 – $70,000 at a typical hospital. Those with insurance will, barring a few exceptions, be covered by their provider. However, out-of-pocket expenses can still be costly for those who have health insurance. Patients with medicare are eligible for knee replacement surgery.
Surgery Center of Oklahoma – Price is $19,400 plus the cost of the implant (typically $4,500 – $10,000).

Consumer Patients Choose Ambulatory Surgery Centers When Costs Revealed

Freestanding ASC (ambulatory surgery centers) saved the consumer patient 17 % compared to the hospital outpatient department.

A California price study found hospital cost $6640 and ASC cost $4795 for knee arthroscopy.

Consumer patients became sensitive to price differences when transparent pricing was revealed.  Patients respond strongly to pricing incentives.

Dr. Tarlow supports and practices transparent pricing on his website.

Consumers need to be accorded a greater decision making role when accessing the health care system.  They should be provided information on price and quality.

Stefan D. Tarlow MD

Dr. Tarlow is the only Orthopedic Surgeon to limit his practice to encompass Adult Reconstruction and Sports Medicine for the diagnosis and treatment of knees. Dr. Tarlow’s practice focuses on excelling in the art of Knee Diagnosis and Surgery. He performs the full spectrum of Knee Surgery from Knee Arthroscopy, ACL Reconstruction, Patellar Stabilization and Cartilage Restoration to Makoplasty Partial Knee Replacement to Total Knee Replacement to Revision Total Knee Replacement. His focus is exceptional customer service and he endeavors to exceed the diverse expectations of his patients.

Filed Under: Ambulatory Surgery Center Tagged With: AAOS, HealthCare Blue Book, Outpatient TJA Facility, Surgery Cost

Comments

  1. jresquival says

    March 27, 2017 at 3:47 pm

    Wow, that’s impressive that the overall rate of hospital readmission was 1.2 percent. I guess outpatient surgery is very safe. I’ve been worrying about how much time I’ll have to take from work for my surgery, so I might consider outpatient care.

    Reply

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PRP Knee Injections: A Natural Approach to Relieve Joint Pain and Promote Healing

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  • SURGICAL TREATMENTS
    ▼
    • Robotic Mako Total Knee Replacement
    • Makoplasty Robotic Partial Knee Surgery
    • Robotic Cementless (Press Fit) Total Knee Replacement
    • ACL Reconstruction
    • Knee Arthroscopy
    • Knee Cartilage Repair Restoration Surgery
    • Subchondroplasty
    • Knee Arthritis Treatment Options
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    • My Knee Cap Hurts
    • Hyalofast Cartilage Restoration Surgery
  • SPORTS INJURIES
    ▼
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