Dr. Foret, of the Center for Orthopaedics in Lake Charles, La., joined the “Becker’s Spine and Orthopedic Podcast” to share his outlook on outpatient total joint replacements.
Note: This is an edited excerpt. Listen to the full conversation here.
Question: Do you think we’ll see a day where practically all total joint replacements are done in the outpatient center?
Dr. Jonathan Foret: Yes, and we are seeing a large migration currently. The Joint Replacement Center in Louisiana is a specialty center that myself and two partners started to offer our patients a specialized facility for outpatient joint replacement. That’s a trend across the country that we’re seeing is to see these patients in a specialized center that has specialized nurse care, specialized anesthesia care and specialized operative protocols to allow these patients to be outpatients.
When you say “outpatient total joint,” I think there’s really two meanings to that. The No. 1 thing people should understand is that the large majority of total joints, whether they’re done at a hospital or a surgery center, are identified by the payers as an outpatient total joint. The big thing that we’re following now that I think will ultimately drive the total joint volumes at ASCs is that if the payers go to a site neutral payment. If those payments become equal then you’ll see [total joint] patients that were being seen in a hospital driven out into the ambulatory setting.
It’s already been proven to be safe and effective. I do think it takes some additional investments with nurse navigator help, and then obviously enhanced preoperative assessment and enhanced post operative follow up to help the patient successfully go through their total joint replacement.
Q: What kind of investments should ASCs be thinking about if they want to increase their total joint volume?
JF: Specifically on the ASC side, using nurse navigators and physician assistants, you can help both monitor the patients and walk the patient, and especially their family through the process, so that they’re comfortable, and they understand it’s totally safe.
