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Capturing medtech opportunities in the growing ASC market

Oct 2nd, 2024

By Nicole Witowski 5 min read
Capturing medtech opportunities in the growing ASC market

It’s well-known ambulatory surgical centers (ASCs) are a growing force in American healthcare, and their influence is only set to increase. With more than 9,900 ASCs in the U.S., they represent an attractive market opportunity for medical device companies. By monitoring trends in ASCs—such as shifts in procedural volumes and changes in ownership structures—you can pinpoint opportunities and refine your sales strategies to target high-growth areas. Now, let’s delve into the data to explore these trends in greater detail.

Surgical procedures rise in ASCs as hospital procedures fall

The landscape of sites of service for surgical procedures is changing dramatically. From 2016 to 2023, the share of surgical procedures performed in hospitals dropped by 16%, according to Definitive Healthcare data. During the same period, ASCs saw their share of procedures rise by 24%. Factors driving the shift include advancements in surgical techniques and technologies, along with evolving healthcare policies and reimbursement structures that allow more procedures to be performed in these settings. The chart below highlights these changes in procedural distribution between hospitals and ASCs.

Share of surgical procedures in hospitals and ASCs, 2016 – 2023

Fig. 1 Data is from the Definitive Healthcare Atlas All-Payor Claims Dataset. Claims data is sourced from multiple medical claims clearinghouses in the United States and updated monthly. Data accessed September 2024.

Understand shifts in procedure volumes

With an increasing range of procedures being performed in ASCs, the demand for medical devices that cater to their specific needs is on the rise. However, not all medical specialties offer the same opportunities, as ASC procedure volumes vary widely across service lines. Claims data can reveal which specialties are growing in ASC settings and the speed of these shifts.

For example, when looking at specialties with the highest volume of procedures performed in ASCs, gastroenterology stands out, with 28% of its procedures performed in ASCs, according to Definitive Healthcare data. Ophthalmology follows closely with 16% of its procedures in ASC settings, while orthopedic surgery also has a notable ASC presence, with 13% of its procedures performed in these environments.

Service lines with the most ASC procedure volumes, 2022

Service line% of procedures performed in ASCs
Gastroenterology28%
Ophthalmology16%
Orthopedic surgery13%
Otolaryngology5%
Urology3%

Fig. 2 Data is from the Definitive Healthcare Atlas All-Payor Claims Dataset. Claims data is sourced from multiple medical claims clearinghouses in the United States and updated monthly. Data accessed June 2023.

Tracking growth in specific procedures using claims data

Claims data can also offer insights into the growth or decline of specific surgical procedures performed in ASCs. Among the most common ASC procedures, goniotomy saw a remarkable increase of 2,105% from 2016 to 2023. This surge may be linked to the emergence of new devices, which have influenced the number and kinds of procedures performed in ASCs. The introduction of micro-invasive glaucoma surgeries (MIGS), for instance, has been a game-changer in glaucoma management, offering safer and less invasive options for patients.

Similarly, total knee arthroplasty and total hip arthroplasty saw significant growth during this period, with increases of 2,004% and 1,586%, respectively. This surge reflects, in part, the Centers for Medicare and Medicaid Services (CMS) expanding the ASC Covered Procedures List (CPL) to include these complex orthopedic surgeries. Looking ahead, the addition of total shoulder arthroplasty to the ASC payable list in 2024 is expected to drive similar increases in procedure volumes for total shoulder arthroplasty.

ASC procedures with the highest growth in volumes, 2016- 2023

Fig. 3 Data is from the Definitive Healthcare Atlas All-Payor Claims Dataset. Claims data is sourced from multiple medical claims clearinghouses in the United States and updated monthly. Data accessed September 2024.

While many procedures in ASCs are trending up, it’s equally important to understand declines in certain volumes. For instance, colonoscopy with lesion removal by hot biopsy forceps saw a 40% drop from 2016 to 2023. This likely reflects broader shifts in clinical practice that favor other techniques and technologies, such as snare polypectomy.

These trends underscore the need for medtech companies to adjust strategies and offerings in response to shifting procedural volumes, changes in regulations and reimbursement, and evolving care practices in ASCs. This could involve optimizing sales forces, concentrating on key accounts, or reallocating resources to focus on high-growth areas. Parsing claims data at the affiliation or physician level can give even deeper insight into which facilities and regions are seeing the most growth (or declines) in surgical procedures and surface the most promising opportunities.

The impact of ownership changes on ASC purchasing

Another significant factor influencing how medical device companies navigate the ASC landscape is ownership. Ownership models in ASCs vary based on the control exercised by physicians, management companies, and hospital systems—the key industry players.

The ongoing shift from physician-owned to non-physician-owned ASCs introduces new challenges and opportunities for device companies. In physician-owned ASCs, surgeons are often the primary decision-makers, influencing purchasing directly. In contrast, hospitals rely on purchasing agents and value analysis committees to manage procurement.

Today, about half of all active ASCs are part of larger networks like health systems, which adds a layer of complexity to their purchasing dynamics. The five largest ASC operators—Tenet Healthcare, HCA Healthcare, OptumCare, Envision Healthcare, and AMSURG—manage nearly a quarter of ASC operating rooms in the U.S., according to data from SurgeryCenterView.

Physician-owned ASCs might focus on surgeon-centric tools and cost-effectiveness, while integrated delivery networks (IDNs) like HCA or Tenet, along with corporate entities, might prioritize scalable solutions and broader network integration. Additionally, many ASCs are affiliated with group purchasing organizations (GPOs), which influence purchasing decisions and encourage standardization across facilities.

Medical device companies must consider the unique needs of each ownership model and how these dynamics impact operations. Leveraging opportunities for network effects and aligning with the priorities of physicians or corporate entities is crucial. Furthermore, understanding which ASCs are linked to specific GPOs and navigating the influence of these GPOs on procurement strategies can help boost market penetration. Healthcare reference and affiliation data can offer valuable insights in this process.

The power of quality measures in targeting facilities

As ownership models evolve, so do the priorities of ASCs when it comes to purchasing decisions. Today’s sales teams are shifting their focus from merely cost to the impact on safety and outcomes. Devices that enhance quality metrics, like PSI-90, are becoming more attractive. Although upfront costs might be higher, facilities can save millions in CMS penalties through improved quality metrics.

Critical quality measures to focus on include:

Facilities struggling with these metrics and facing reimbursement penalties by CMS are prime targets. By aligning their products with the quality metrics that matter most to these facilities, medtech companies can address major pain points, improve patient safety, and make a compelling case for their devices. This strategic approach enhances the value proposition when targeting or marketing to ASCs.

Discover opportunities in the growing ASC market

The ASC market is transforming quickly with shifts in procedure volumes, ownership, and operational and strategic priorities. By understanding these dynamics, medtech companies can stay nimble and responsive in a competitive landscape. Data is essential in this process, offering crucial insights that empower organizations to navigate the market strategically.

Want to learn more about trends in the ASC space? Start a free trial with Definitive Healthcare today to see how we can help you reach ambulatory surgery centers and grow your business faster.

Nicole Witowski

About the Author

Nicole Witowski

Nicole Witowski is a Senior Content Writer at Definitive Healthcare. She brings more than 10 years of experience writing about the healthcare industry. Her work has been…

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