As the ASC market grows, surgical technologies are evolving to meet their needs

The ASC landscape has changed dramatically over the last several years, and the most significant shifts and growth have emerged since 2019. In decades past, patients and insurance providers remained reluctant to pursue surgical procedures in an outpatient setting. Now, however, ASCs handle 41% of surgeries performed in the United States each year1, with continued growth projected through 2027.2

This shift is part of a long-standing trend that has only been accelerated by the pandemic’s effect on patient behavior.3 Armed with more information and access than ever before, today’s patients have become increasingly discerning when facing elective surgery, as they have more options amid the growing ASC market and are more aware of the risks of hospital-based care due to COVID-19.

Patients are looking for providers that offer convenience, consistent communication, and value-added technology that improves their health outcomes while also reducing the cost of care. And often, they find that surgical practices operating out of the ASC are better able to meet these expectations.

Patients facing major procedures are avoiding in-hospital operations

Surgical procedures offered in the ASC have many advantages for healthcare providers, insurers, and patients. One of the strongest selling points–particularly for patients and insurance payers–is that ASCs can deliver better patient outcomes at a significantly lower cost compared to inpatient surgery or care in hospital outpatient departments (HOPDs).4

But despite these benefits, ASCs were long considered a less preferable option for more invasive procedures like knee and hip replacements when compared to hospitals. Whether due to risk aversion or to fulfill insurance requirements, many patients have avoided undergoing procedures performed in the ASC.

Now, many of those same patient populations are actively avoiding the hospital and the risks that they currently associate with inpatient care. And with more insurance payers, including the Centers for Medicare & Medicaid Services (CMS) approving payments for orthopedic procedures in the ASC,5 patients have more incentives and fewer barriers to pursuing these cost-effective alternatives for high-quality care.

Physicians, hospitals, and payers are guiding patients to outpatient surgery

In light of the pandemic, not only have patients become more aware of the risks associated with inpatient treatment, but outpatient facilities have also had to handle the overflow of elective surgeries due to overwhelmed hospitals.6 As a result, these additional barriers have fallen as well, leading to the consistent growth seen in the ASC market despite surgical volume dramatically decreasing during 2020.7

More clinical practices and insurance companies have had to consider and recommend ASCs for patients requiring elective surgery during this period, which increases awareness of the positive health outcomes, convenience, and value-added services these facilities can offer.

The shift to orthopedic care in the ASC requires new orthopaedic tools and technology

The growing relevance and profitability of ASCs have not gone unnoticed by large healthcare groups and insurers. A survey from Avanza Healthcare Strategies found that 76% are increasing investments into ASCs and the number of hospitals with affiliations with two or more ASCs has increased by 17% in a two-year period.8 Leaders in the industry attribute this shift to payer incentives that make the reimbursement process easier for surgical centers.

As an orthopedic device company that creates handheld surgical navigation tools, OrthAlign has consulted with surgeons and other experts to understand what surgical teams need in the ASC operating room. The shift from a hospital environment to operating in an ASC requires a different approach for both center administrators and surgical staff.

To succeed in the ASC, surgical teams need orthopaedic instruments that support efficient workflows and value-adding services while ensuring positive patient outcomes. Recently, OrthAlign launched Lantern®, an intuitive, handheld navigation tool that provides accurate component positioning for partial and total knee replacements. In contrast to other navigation and robotic systems, Lantern requires no upfront cost or pre-operative imaging and keeps case costs to a minimum through a reduction in trays and a single, disposable unit.

How ASCs can position themselves to provide cost-effective, quality care

The ASC market is poised for rapid growth–particularly within orthopedics. While this specialty only saw 10% of procedures in the ASC in 2018, that share is expected to grow to 68% by the mid-2020s. According to recent research by the Ambulatory Surgery Center Association (ASCA), total knee replacements and knee mosaicplasty procedures alone are projected to save Medicare $73.4 billion by 2028.9

Additionally, the ASCA estimates that ASCs currently reduce private healthcare costs by $38 billion each year.10 As patients and insurers increasingly seek to take advantage of the cost savings and other benefits of ASC-based care, orthopedic surgical practices need to be prepared to handle rapid growth by adopting simple, scalable, value-adding technology to their practice.

Learn how OrthAlign’s surgical navigation tools such as Lantern can provide easy integration with existing workflows and individualized, accurate implant positioning, helping your practice provide value-added care that meets shifting demands in a competitive outpatient market.


  1. Stewart, Angie. “ASCs projected to take 68% of orthopedic surgeries by mid-decade — 5 insights.” Becker’s ASC Review. October 22nd, 2020.
  2. Wood, Laura. “$81.3 Billion Ambulatory Surgery Centers (ASC) Industry to 2027 – Impact Analysis of COVID-19.”—impact-analysis-of-covid-19–301305244.html. June 04, 2021.
  3. Pooja Kumar, Pooja. Parthasarathy, Ramya. “Walking out of the hospital: The continued rise of ambulatory care and how to take advantage of it.” January 13, 2022.
  4. Carey, Kathleen, et al. Patient Outcomes Following Total Joint Replacement Surgery: A Comparison of Hospitals and Ambulatory Surgery Centers. J Arthroplasty. 2020 Jan; 35(1): 7–11.
  5. Zipp, Ricky. “CMS adds hip replacements, other surgeries to ASC list in final rule.” Dec. 3, 2020.
  6. “Statement from the Ambulatory Surgery Center Association regarding Elective Surgery and COVID-19.” March 16, 2020.
  7. Leggett, Hadley. “Surgery rates in the U.S. rebounded quickly after initial COVID-19 shutdown.” December 8, 2021.
  8. Perna, Gabriel. “As investments into ASCs soar, health care leaders must navigate a new landscape.” February 17, 2021.
  9. “Reducing Medicare Costs by Migrating Volume from Hospital Outpatient Departments to Ambulatory Surgery Centers.” January 13, 2022.

“Study: Commercial Insurance Cost Savings in Ambulatory Surgery Centers.” ASCA.