If you’re expecting to require joint replacement surgery in the coming year, your options for care just multiplied. With the start of 2018, Medicare now covers joint replacement surgeries completed in outpatient facilities, the most common of these being ambulatory surgery centers (ASC). This decision came after the Centers for Medicare & Medicaid Services (CMS) found that outpatient facilities do not have higher rates of complications or readmission.
This change may save both patients and Medicare money, with Medicare paying over $7 billion in 2014 from hospitalization from joint replacement surgery alone. With additional options, patients can now choose the surgical option that fits their needs best.
What Are Ambulatory Surgery Centers?
The simplest definition of an ambulatory surgery center is a location where you can get a surgery without being admitted to a hospital. They aren’t health clinics or care centers, though. ASCs aren’t set up to provide diagnostic or health care services outside of surgery. You’ll still need your primary care physician to sign off on any procedure you’d get.
The primary advantages of ASCs are twofold. First, since there is no hospitalization, you’re free to go home after your procedure. For surgeries with limited recovery or patients who wish to recover at home, this is a great option. Second, since you don’t spend time in a hospital after your surgery, you don’t have to pay for an inpatient stay or the care that goes with it. This is how ASCs can save both you and CMS money.
Which Option is Best for Me?
So, if you have the option and need a joint replacement surgery, which should you choose? Well, as with most choices, that depends on your circumstances. Both inpatient and outpatient facilities can give you high-quality care. Outpatient facilities offer patients a convenience, since patients leave that day. The lower costs are also an advantage of ASCs. Since there isn’t an inpatient option, it’s rarer that patients are sick. This lowers infection rates at outpatient facilities.
Alternatively, traditional, inpatient facilities offer more comprehensive care for patients. Many facilities provide some level of rehabilitation services to help you recover from your surgery. This includes access to nurses and doctors who will follow up with you after the procedure. This monitoring may help set you on the right recovery path for when you return home. It also helps protect you against any complications that may crop up after the surgery. Inpatient facilities are especially encouraged for high-risk patients, like those with heart conditions or those that aren’t in top physical fitness.
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Ultimately, before you decide, your best option is to talk to your doctor. They’ll be able to tell you which facility is best for you.
With this new coverage option for the millions of Americans with Medicare, seniors have more options than ever when it comes to joint replacement surgery. Now, it’s up to you (and your doctor) to find which option is best for you.