Practical Implications of Value-Based Care in the Setting of Ambulatory Surgery Centers.

BACKGROUND

Ambulatory surgery centers (ASCs) are increasingly replacing traditional hospital settings for orthopaedic procedures, driven by advancements in surgical techniques, anesthesia, and enhanced recovery protocols. These innovations enable complex procedures to be performed safely in outpatient settings. ASCs align with value-based care (VBC) principles by offering cost-effective, high-quality, and patient-centered care. This article explores strategies to integrate VBC into ASCs, focusing on operational, financial, and clinical enhancements.

METHODS

This analysis evaluates strategies for preparing ASCs for alternative payment models (APMs) like bundled payments and Accountable Care Organizations. It highlights the importance of standardizing practices, such as lean methodologies and Six Sigma approaches, to improve efficiency and outcomes. Data collection is targeted at actionable metrics, and cost management includes strategies like standardized implant selection and vendor negotiations. Financial alignment through performance-based compensation structures was also assessed.

RESULTS

ASCs have demonstrated cost savings of up to 45% compared to hospital outpatient departments, driven by streamlined operations and patient-centric approaches. Adopting APMs fosters improved care coordination and efficiency while aligning financial incentives with clinical outcomes. Standardizing practices, such as implant selection and clinical protocols, has reduced variability, enhanced surgical outcomes, and controlled costs. Performance monitoring using metrics like patient-reported outcome measures and surgical complication rates has facilitated continuous improvement.

CONCLUSIONS

ASCs represent a significant opportunity to implement VBC principles in orthopaedic surgery. By preparing for APMs, standardizing practices, and leveraging performance data, ASCs can achieve cost savings and improve patient outcomes. Continuous improvement and alignment between financial and clinical goals are essential for ASCs to remain leaders in orthopaedic care delivery. These strategies position ASCs to meet the evolving demands of health care while maintaining high-quality, patient-centered care.