Image by Sasin Tipchai from PixabayAcuityMD, a commercial intelligence platform for the med-tech industry, unveiled new data at the American Academy of Orthopaedic Surgeons (AAOS) 2025 Annual Meeting related to the shift of higher-acuity procedures into outpatient settings.
Of note for ambulatory surgery centers (ASCs), the new data revealed how spinal surgeries increased nearly 8% annually from 2021 through 2024.
From 2018 through 2024, nearly 900,000 outpatient spinal procedures were performed in ASCs in the United States, according to AcuityMD.
AcuityMD used U.S. Centers for Medicare & Medicaid Services (CMS) data and over 300 million patient claims to conduct its research, which also found that procedures at ASCs cost 45% to 60% less than comparable hospital procedures.
“There are all sorts of different data sets that are able to describe what’s happening at different settings or different parts of the health care system,” AcuityMD Vice President of Product Ross Feinstein told Ambulatory Surgery Center News. “I think the real task to understand it is putting those into one common data model in a way that covers all sorts of aspects of the system.”
Historically, outpatient centers have only handled minor procedures. But innovations in surgical techniques, improved anesthesia and policy changes from CMS have allowed more complex procedures, including spinal fusions and total disc arthroplasties, to be performed in ASCs.
AcuityMD’s study specifically analyzed six common spinal procedures: endoscopic decompressions; anterior extradural explorations; posterior laminotomies or laminectomies; posterolateral explorations; spinal arthrodesis; and excision by laminectomy of non-disc lesions.
“The key takeaways are, [our customers] are recognizing this trend, and they’re using the fact that procedures are moving to ASCs to get a foot in the door with physicians who also operate at larger facilities,” Feinstein said.
In turn, operators need an easy way to engage doctors who are practicing in both settings, Feinstein said.
“It’s really important to address the ASC market because the total cost of care might be lower, outcomes might be better and patient experience might be better,” he said. “And to the extent that any one of our customers is able to align with better patient experiences, it’s good for that company as well.”
While outpatient spinal procedures have grown in number over recent years, the pace of this trend varies across states and markets.
While Connecticut, Indiana and North Carolina have recorded strong increases in spinal surgeries carried out in ASCs, states such as Massachusetts, Kentucky and South Carolina remain below the national growth average.
Interestingly, states within similar adoption levels don’t share clear commonalities, suggesting multiple factors, like including local health care policies, demographic trends, social determinants of health, provider preferences and reimbursement structures may be at play, Feinstein said.
“It could be a function of what systems are in a given state, what their strategies are and how they value that opportunity, given the geography and the competitive landscape,” he said.
Local regulations and each health system’s strategic priorities can shape this trajectory, too, particularly when physicians decide to move out of hospitals and establish their own surgery centers, he added.
“There’s also a clinical component here,” Feinstein said. “Over time, the ASC is becoming an environment where you can do procedures that you were not able to do before. And I would imagine for some of those states and some of those physician leaders or systems in those states, they’ve kind of decided over time that the calculus now makes sense, where the margins and the cost structure are such that they can attract patients using that patient experience component.”
And as ASCs develop new systems for handling complex spinal surgeries, they can strengthen arguments around lower total cost of care and improved patient experiences, he continued.
These factors expand the addressable market for outpatient surgeries.
“ASCs have been developing protocols for managing patients undergoing more complicated procedures than they had in the past,” he said. “And I think that’s just expanding that market, which all rolls back up to that growth piece we talked about at the very beginning. There’s just an opportunity for every part of the ecosystem to take advantage of that growth.”
