on January 24, 2012 |
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Topics: Service Lines, Neurosciences, Sleep, Spine, Planning, Strategy, Volume Growth, Service Line Growth
Emilia Thurber
Although neuroscience volumes have been one of the best areas of recent growth for hospitals, high growth for some procedures may not be sustained in future years. In fact, volumes for some neuroscience procedures are even predicted to decline in the hospital setting.
Across some services, the drop will result from a shift in site of service, migrating out of hospital settings. For example, the advent of portable sleep monitoring is pushing many hospital-based sleep services to the patient home. Even though total sleep study volumes are projected to increase 66% by 2020, hospital outpatient department (HOPD) volumes will decline by an estimated 12%.
Similarly, many pain procedures, including pain injections and blocks, are increasingly being performed in physician offices as physicians try to retain greater procedural volume. While the overall volume for pain injections and blocks is estimated to increase by 36%, HOPD volumes are projected to decrease by 31%.
For other services, dampened growth will result from questions about efficacy and appropriateness. One such procedure is vertebroplasty. The clinical efficacy of the procedure—a widely used procedure for vertebral compression fractures—has recently come under scrutiny. Multiple studies have suggested that vetebroplasty is not more effective than a sham procedure or conservative treatment, causing the American Academy of Orthopaedic Surgeons to recommend against this procedure in 2010.
Looking at other spine procedures, hospitals should be wary of increasing competition and growing concerns over utilization appropriateness. Many insurers are increasing efforts to review spine procedure appropriateness, and the spine market has seen a sharp increase in the number of providers across the last decade due to favorable per-case economics for several procedures.
Hospitals must consider the potential impacts of these changes when developing service line strategy and investment plans, given the downward pressure on volumes. For more information on growth projections for inpatient and outpatient neurosciences, visit our Service Line Forecast Compendium. To learn more about top-of-mind considerations for neuroscience service line leaders, please read “Scoping the Service Line Ambition” in Neurosciences: Service Line Strategic Outlook.
