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3 opportunities for stakeholders to respond to the surgical care impacts on site-of-care shifts

By Jinia SarkarSophie TanKaci Brooks

November 9, 2021

    During our recent Site-of-Care Summit, we asked our members which category of shift they expected would have the biggest impact in their market over the next five years. Of the categories of shift identified by Advisory Board as having the greatest effect, participants rated surgical care as the most impactful – and this isn't unfounded. According to our research on what surgery may look like across the next decade, there are three main opportunities for stakeholders to take on as surgical care trends impact site-of-care shift.

    See our key takeaways from the other polled questions here: Recap of Poll Results from Our 2021 Summit: The Site-of-Care Shift

    Opportunity #1: Organizations can steer patients to the most appropriate site-of-care more strategically as patient selection criteria becomes imperative to surgical care.

    In the coming years, numerous pharmaceutical advancements, alternative therapies, and technological improvements to complement surgery will arrive on the market and expand patient eligibility for non-hospital sites of care. Clear patient selection criteria, like risk-stratification protocols, will be necessary to navigate through the greater number and quality of treatment options to determine the most appropriate care pathways.

    This also presents a chance to re-evaluate current patient selection criteria and direct patients to care locations outside of the traditional health system campus (e.g., office-based labs, ambulatory surgery centers (ASCs)) to access new clinical innovations, which may cut costs or alleviate inpatient bed capacity strain.

    Action items for…


    • Invest in capabilities to collect and analyze data to inform risk-stratification and identification of appropriate sites of care for patients.
    • Use interoperable devices to maintain care quality and convenience at all sites of care.

    Health plans

    • Incentivize providers to create clear patient selection criteria with site-of-care considerations to eliminate unnecessary surgeries and support value-based contacts.

    Industry leaders

    • Gather and analyze patient reported outcomes to direct provider's risk-based stratification and site-of-care identification.
    • Design technologies to be interoperable with multiple devices at different sites of care.

    Opportunity #2: Organizations with a top of site care strategy may have a first mover advantage as technologies mature to the point of transcending hospital walls.

    We expect to see less expensive and more mobile surgical robots hit the market in the coming years, as current developments from device manufacturers exist in this area. These innovations will make it easier for providers to perform robotic surgeries in outpatient settings, thus creating the potential to draw more low-margin, high volume procedures out of conventional hospital operating rooms. In turn, this could open capacity for high-margin, more complex inpatient cases, benefiting stakeholders looking to increase revenues from the inpatient setting.

    Action items for…


    • Develop a centralized robotics management structure to accommodate the growing use cases of robotic surgery across different specialties and sites of care, as surgeons' facility preferences evolve.
    • Devise an ambulatory robotic surgery strategy, alongside risk-stratification protocols, to identify appropriate patients and procedures for the outpatient setting.

    Health plans

    • Reconsider reimbursement rates for robotic surgery to secure greater member access to the technology and its clinical benefits and cost saving potential.

    Industry leaders

    • Collect data to demonstrate how surgical robots may help ASCs meet financial, quality, and volume-based goals.
    • Enter flexible financing arrangements with providers to improve adoption of robotic surgery technologies.

    Opportunity #3: Organizations can leverage site-of-care shifts to ensure future success in the face of redefined market and competition boundaries.

    New technologies will change provider competition by enticing out-of-market patients to travel to early adopters of innovations. Additionally, telehealth, including teleproctoring and telesurgery, will allow treatment to occur even when a patient and their care team are not physically in the same place. Given these factors, it is no question that site-of-care shift can play a part in attracting surgical patients via lowered costs and/or use of advanced technology.

    Action items for…


    • Analyze how far the geographic reach of the service area can expand when incorporating virtual visits into services offered.

    Health plans

    • Restructure plan policies to facilitate partnerships between physicians and facilities in different locations around the world.
    • Include telemedicine and technology clauses within agreements to secure cost savings while guaranteeing worthwhile reimbursement rates for providers.

    Industry leaders

    • Create technologies that support and adopt to consumer demand that is more geographically dispersed.
    • Serve as network builders, in response to the growing need to connect consumers and their care teams.

    Health care stakeholders will need to keep an eye on how surgery is impacting site-of-care shifts in their markets and plan their next steps accordingly. For now, providers, health plans, and industry leaders can start evolving their strategies to take advantage of some of the opportunities surgical and site-of-care trends may offer them across the next decade.

    5 key takeaways from Advisory Board's site-of-care shift summit

    site of care

    During Advisory Board's recent Site-of-Care Shift summit, we convened over 400 health care leaders across health systems, health plans, and industry suppliers and polled them to understand their perceptions on the shifts with the biggest impact to them. Here are our five key takeaways.

    Read more

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