November 12, 2021

Outpatient surgery tops ten-year growth forecast

Over the last year and a half, the pandemic has driven significant short-term shakeups in volume—but we’re watching to understand whether care patterns will shift permanently. In the graphic below, our colleagues at healthcare strategic intelligence firm Sg2 share their 10-year hospital volume forecastOutpatient surgical volume is expected to see the sharpest increase, driven in large part by surgical site-of-care shifts. Orthopedics and neurosciences account for five of the six highest-growth procedures across the next 10 years, with knee replacements alone expected to increase three-fold. Ambulatory surgical centers (ASCs) will see the majority of this new volume; Sg2 predicts that over a third of total knee replacements may be performed in ASCs by 2029. We anticipate the Centers for Medicare & Medicaid Services will continue to implement policy changes to incentivize this shift. Movement to site-neutral payment has been broadly supported by both the Trump and Biden administrations. And despite the Biden team’s reversal of the Trump administration’s removal of the inpatient-only procedure list, we anticipate fewer and fewer procedures will fall under this designation over time. Developing a path to safely move surgeries to the outpatient setting will be critical for health systems, lest they lose volume entirely to ambulatory-only competitors.


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Looking at inpatient care, hospitals will be left with sicker patients, needing higher-acuity, specialized care as consumers shift to new, lower-cost care sites for lower-acuity needs. With an aging population carrying a higher incidence of chronic disease, patients coming to the hospital will have more complex challenges, driving up demand for tertiary-level inpatient care, with demand for general inpatient care remaining relatively flat. Emergency department volumes are not expected to fully bounce back as we exit the pandemic, as consumers shift to new access channels and lower-cost sites of care for minor acute needs. If the future forecasted here comes to fruition, health systems will likely need to shift bed allocation and clinical workforce staffing plans toward greater critical care capacity.

2029 volume forecast