Where outpatient joint replacements are headed: Key thoughts from Dr. Keith Berend of Joint Implant Surgeons

Practice Management

ASCs performing outpatient joint replacements constantly incorporate new techniques and technologies to spur growth and potential success in the future. Keith R. Berend, MD, of New Albany, Ohio-based Joint Implant Surgeons spoke about the current state of outpatient joint replacement at ASCs.

Dr. Berend is speaking on a panel titled "Outpatient Joint Replacement at the ASC" at the Becker's 15th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference + The Future of Spine, June 22 to 24, 2017 in Chicago. Click here to learn more and register.


Q: Where is joint replacement at the ASC headed in the future?


Dr. Keith Berend: Realistically for many of us and for most of our patients, the future is now. At Joint Implant Surgeons we eclipsed the 5,000 outpatient arthroplasty mark this year at our ASC, White Fence Surgical Suites. Our readmission/transfer rate is less than 1 percent and the actual value we provide to all stakeholders is higher than any hospital system can possibly compete with today. But the future will entail CMS allowing for an outpatient hip and knee replacement "code" such that healthy patients on Medicare can enjoy the benefits and safety of outpatient arthroplasty.


Q: Do you foresee more ASCs incorporating total joints over the next five years?


KB: Absolutely. If they don't, they will not survive. In fact, all of the ASCs we have been involved with starting for the past four years with SurgCenter Development, LLC, have primarily focused on outpatient total joints, along with spine and the other more routine ambulatory procedures. But primarily focused on joints and the special needs surrounding efficiency.


Q: How do you incorporate new joint replacement techniques and technologies?


KB: The answer is: slowly. Most new technology carries an increased cost. By virtue of being new, the technology is largely unproven, and thus any increased cost is completely unjustified. We never discourage the use of whatever technology a surgeon believes will benefit his or her patient, but we try to always ask if the increased cost is truly bringing improved results or value. I always try to look for the technology that provides the highest value for all stakeholders.  That value is not simply price or cost, but multifactorial and has to include all stakeholders but primarily the good of our patients.


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