Analytics firm shares data and insight about shrinkage of inpatient-only list

CMS’ pending elimination of the inpatient-only (IPO) list of surgeries is often framed as a breakthrough for ASCs, which will gain volume; payors, who will pay less; and patients, who will enjoy greater access to care. But there’s a correspondingly negative impact that isn’t discussed as much: inpatient hospitals, many already struggling, are being positioned to lose significant surgical volume and profit margin.

Caroline Catherman of Healthcare Brew recently delved into that side of the story. As she notes, CMS removed 285 mostly musculoskeletal procedures from the inpatient-only list this year. And over the next three years, CMS plans to remove the thousand-plus remaining inpatient-only procedures.

Ms. Catherman spoke with Allison Oakes, chief research officer of analytics company Trilliant Health, which recently found that inpatient total knee replacements declined 17.9% after the procedure was removed from the IPO list eight years ago. Trilliant also told Ms. Catherman that, among the 285 procedures removed from the IPO this year, “hospitals could receive an average of $16,334 less per case when performed outpatient compared to inpatient.”

“Strategically, what’s really important is that every single hospital is understanding how much of their volume and revenue is imperiled by this migration and making sure that they have an outpatient strategy in play,” Ms. Oakes told Ms. Catherman.

Read the full story here.