Session: Outpatient surgery trends—What’s on the horizon?

Editor's Note

Why do robotics matter? Jamie Clow, senior analyst and partner at Cleveland Research Company in Ohio, opened this session with that question, spurring an insightful deep dive into key trends in the orthopedic landscape with a focus on robotics and enabling technology. “There can be some fatigue around this topic in the industry, given both the high cost and the lack of clear-cut clinical evidence around patient outcomes,” he said. But he also cautioned that robotics and enabling technology have dominated vendor strategy going back almost 10 years. “It’s not something that’s going away anytime soon.”

From the industry perspective, robotics and enabling technology drive market share, Clow said. Citing Stryker as an example, he highlighted the upward trend activity of this market. Since Stryker acquired the Mako robot at the end of 2013, it’s been almost nonstop growth. “In the years leading up to COVID-19, Stryker was growing their knee business by 6% to 7% globally, compared to market growth of around 3%,” he said. From the provider perspective, robotics and enabling technology are becoming drivers of volume and efficiency—and that relationship is the root of the dynamics between vendor and provider. “We’re seeing vendors getting flexible” because of the long-term strategy they are deploying, Clow said. That can be complex for the provider side, he added, because “brand matters.” The brand behind the robot a facility purchases is the brand they are stuck with for the next 5 to 7 years. “The [facility] is locked with the market gain—or loss—associated with that brand.”

Given the growing use of robotics in orthopedic cases, coupled with the exponential growth of outpatient surgery services, “there are a ton of emerging technologies” coming up in the market, Clow said. “As these two trends continue to converge—both the shift to the [outpatient] setting and the growth and rise of enabling technologies—we continue to expect this kind of tug of war to play out.” Clow reviewed key data points with attendees, including the surprising number of cases that have migrated from inpatient to outpatient as well as the financial implications of that shift. And the dollars attached to that move paint a more complex than one might think, as the profits might not be immediately available to the facilities when compared to the traditional revenue expectations tied to inpatient services.

What should providers expect to see—and prepare for—out of this shift to outpatient moving forward? What does that shift mean for the value of robotics and enabling technologies, and how the vendor strategy may—or may not—align with providers’ goals? How can providers cope with the uncertainty still surrounding reimbursement rates? Clow touched on all that and more, and attendees walked away with a better understanding of all the factors paving the way for this exciting market growth.