Sg2 2023 Annual Report Forecasts Significant Growth in ASC Volume

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Sg2 2023 Annual Report Forecasts Significant Growth in ASC Volume

GI, ophthalmology and orthopedic procedures will see the highest increases

BY SAHELY MUKERJI | JUNE 2023

ASCs will see 12 percent and 22 percent growth in the next 5 and 10 years, respectively, according to Sg2’s 2023 Impact of Change Forecast Highlights.

“The services expected to see the greatest movement toward ASCs will be those that are clinically appropriate, reimbursed by payers and done by physicians who are incentivized to work in ASCs,” says Tony Guth, senior consulting director of intelligence at Sg2. “While the ASC case mix will continue to be heavy on gastroenterology and ophthalmology, we expect a continued increase in cases shifting from hospitals for services like orthopedics. In select markets, there may be a rise in cardiac cases moving to ASCs, driven in part by private equity firms seizing opportunities to collaborate with independent cardiology groups.”

The growth of ASCs can differ across markets and is mainly driven by a few key factors, Guth adds. “These include state and local regulations (CON laws), how physicians are aligned with a market, pressure from payers to move procedures to cheaper care sites, the size and growth of the market, and the level of competition.”

Vizient Inc. released its annual Impact of Change Forecast from Sg2, part of the Vizient family of companies, on June 21.

The report projects hospital capacity challenges will continue into the next decade, driven by higher patient acuity and staffing shortages. In addition, pharmaceutical and technological advancements will continue to push care delivery, including bariatric surgery, to outpatient status and sites throughout the next decade.

“As the population continues to age and chronic disease incidence rises, we expect increased demand across all sites of care,” said Tori Richie, senior consulting director of intelligence at Sg2, in a release. “The reality is access is a challenge for these patient populations and care redesign will be critical to prevent the acute exacerbation of their medical conditions.”

While hospitals continue to be stressed, ASCs have the capacity to do more now compared to previous years. According to the Centers for Medicare & Medicaid Services, the number of ASCs has grown from 6,109 last year to 6,223 this year.

“As this report highlights, the need for outpatient care will continue to grow—and despite the reimbursement, regulatory and staffing challenges that surgery centers continue to face, they stand ready to build the capacity to safely and efficiently treat the patients who will be coming their way,” says Bill Prentice, chief executive officer of ASCA.

The 2023 Impact of Change Forecast also notes the following on outpatient (OP) and inpatient (IP) surgery.

  • Hospital capacity challenges will continue into the next decade, driven by higher patient acuity and staffing shortages. An increased need for cardiovascular services will challenge IP services even as medications, care shifts and clinical redesign temper growth. By 2033, IP discharges will go up 5 percent, hospital length of stay will be up 1 percent, bed days will be up 6 percent, congestive heart failure up 10 percent and transcatheter valve procedures up 111 percent.
  • OP surgical volume—outpatient major procedures, endoscopies and anything requiring general anesthesia—will grow 18 percent by 2033. Top shifting procedures will include total joint replacement, lumbar/thoracic spinal fusion, revision knee replacement, prostatectomy, cervical spinal fusion, cholecystectomy and bariatric surgery.
  • OP volume—all OP volume including surgical volume—will continue to grow with an aging population requiring more visits, imaging and procedures. By 2033, OP volume will grow 16 percent.
  • Procedural volumes will shuffle to lower-cost sites of care. By 2033, upper GI endoscopy volume in hospital outpatient departments/ASCs will go up 21 percent, hammertoe procedures will be up 21 percent, first ray foot procedures will be up 20 percent and spinal decompression/laminectomy will be up 17 percent.
  • Adult OP demand will be up 10 percent in 5 years and 16 percent in 10 years.
  • Other than GI and orthopedic procedures, cardiovascular procedures that need general anesthesia will see a high growth in OP from 2023 to 2033: 18 percent.

Read the report.