Sg2 Releases ‘2021 Impact of Change’ Report

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Sg2 Releases ‘2021 Impact of Change’ Report

The forecast projects a major shift in procedures from hospital inpatient to outpatient facilities

Hospital outpatient departments (HOPD) and ASCs will continue to experience rapid patient growth—19 percent and 25 percent by 2029, respectively—experiencing a patient volume that is 15 million higher in 2029 than in 2019, according to “2021 Impact of Change Forecast Highlights,” a report from Sg2, a healthcare industry analyst, released on June 4. This shift in service settings will help drive down the cost of surgical procedures, according to the report.

“We’re going to see a strong recovery over the next six months in terms of healthcare utilization, with overall outpatient demand surpassing 2019 volumes,” said Madeleine McDowell, MD, principal and medical director of quality and strategy at Sg2, in a January 4 release. “However, not everything will return to pre-pandemic levels. There will be some permanent changes post-pandemic, including sustained shift to virtual, and emergency department (ED) volumes remaining below 2019 levels. In addition, rising acuity and chronic disease burden, trends which were occurring prior to the pandemic, will place increasing demands on the healthcare workforce and across the system of care.”

Key takeaways from the report include:

  • The shift in services away from the hospital inpatient setting will accelerate as the Centers for Medicare & Medicaid Services (CMS) eliminates all of the procedures listed on its inpatient-only (IPO) list—more than 1,700 codes—and expands the number of ASC-covered procedures by 278 by the end of CY 2023.
  • Physician offices and clinics will see 18 percent growth by 2029, much of which will be driven by procedures formerly done in hospitals, such as cataract surgery and endovascular procedures.
  • COVID-19 will leave a lasting impact, creating an enduring demand for specialist care required to support chronic COVID-impacted conditions, such as neurology and pulmonology.

The report predicts a rapid and robust outpatient recovery that is expected to exceed pre-pandemic levels by 2022. The volume of outpatient surgery will be up 22 percent from 2019 to 2029. Overall, the report projects outpatient volumes to reach and surpass 2019 volumes during 2022 and grow slightly above population estimated growth over the decade. Expanded insurance coverage, including exchanges and Medicaid, an aging population and a rise in chronic disease will be the main drivers of this growth.

The rate at which surgeries will shift from hospitals to the outpatient setting will differ based on specialties and procedures. For example, the elimination of the IPO list will have limited impact on major cardio-vascular procedures moving to the outpatient setting because some of those procedures require a longer stay than outpatient surgery settings provide. However, orthopedic and spine cases will go up in 2021, followed by other procedures, such as neuro and general medicine, in 2022.

“Policy changes, virtual and digital innovations and the shift to lower-cost settings will all contribute to a restructuring of the current system of care,” McDowell said in the release. “Understanding clinical demand, and where it is shifting, is essential for providers to properly plan for future resource, workforce, facility and program development demands. Healthcare providers will also need to evolve and pivot to compete with new market disruptors, such as telemedicine providers, Hospital at Home models and AI-enabled services.”

Read the report.