AAOS Registry Program Blog

Guest Blog: ASCA, AJRR, and the Orthopaedic Surgery Market

Aug 30, 2018 11:45:44 AM

Guest Blogger Alex Taira from the ASCA

August is National Ambulatory Surgery Center (ASC) Month and the American Joint Replacement Registry (AJRR) has invited Alex Taira, Policy Analyst, Ambulatory Surgery Center Association (ASCA), to contribute a guest blog on the evolution and diversity of today’s orthopaedic surgery sites. It has always been the American Academy of Orthopaedic Surgeons’ (AAOS) belief that choosing the appropriate orthopaedic surgery setting is a decision that the patient and the surgeon make together based on a series of factors that lead to the best patient experience and outcome. Today’s patient options include hospitals, hospital-sponsored ASCs, and independent ASCs.

Over 1,000 U.S. hospitals and 68 ASCs participate in AJRR. Based on the number of procedures submitted monthly, AJRR is the largest orthopaedic registry in the world. The AJRR database holds 1.3 million hip and knee arthroplasty procedures from over 8,000 surgeons practicing in one or more types of clinical settings. As more total joint arthroplasties (TJAs) are performed in ASCs, reducing variation and demonstrating quality of care delivered can be accomplished through Registry participation.


Guest Blogger: Alex Taira Talks About ASCA, AJRR, and the Orthopaedic Surgery Market  

In 2017, AJRR and ASCA announced a collaborative relationship, aimed at encouraging ASCA-member ambulatory surgery centers to register in the AJRR. William Prentice, ASCA CEO, announced the new venture with enthusiasm saying, “The data collected by the AJRR will be used by ASCA and our members to support efforts to educate government and commercial payors of the safety, efficiency, and good outcomes that result when ASCs perform these procedures.” As the discussion around value-based reimbursement for total joint procedures in ASCs increases in intensity, AJRR will undoubtedly play a vital role in validating ASCs as a high quality site of service.

The size of the entire orthopaedic surgery market continues to grow, challenging providers to service larger volumes of patients. By 2060, primary total hip replacement (THR) is expected to reach 1.23 million (330 percent increase), primary total knee replacement (TKR) is expected to reach 2.60 million (382 percent increase), revision THR is expected to reach 110,000 (219 percent increase), and revision TKR is expected to reach 253,000 (400 percent increase)*.

Orthopaedics represents a significant portion of procedures done in ASCs and the procedural volume of ASCA members continues to grow along with the market. For example, of 126 discrete surgical procedures that appeared in the Top 100 Medicare codes by volume in ASCs (2010-2016), 22 codes were orthopaedic related. As technology has progressed, it enabled these procedures to move to outpatient settings. It is likely that orthopaedic treatment will only grow in importance to ASCs as total joint procedures become eligible for Medicare reimbursement in the future.

As more TJAs continue to migrate from the inpatient setting, either to hospital sponsored or independent ASCs, it is important that AJRR continue to capture these procedures. Further, as the AAOS Registry Program expands to include other anatomical areas including shoulder, elbow, and especially rotator cuff surgical procedures; increasing partnerships with ASCs will be necessary to provide a true picture of the marketplace.

Nathan Glusenkamp, MA, Director of Registries, AAOS, recently said, “If more ASCs participate in AJRR, we can first, begin to run ASC-specific analyses from presentation and second, begin to provide like-institutional comparisons.” ASCA agrees that registry participation benefits institutional subscribers and patients alike. ASCA and AAOS will continue their collaboration to help measure and ensure demonstrably safe, high quality outpatient orthopaedic procedures in the ASC space.


*Matthew Sloan, MD, lead author of research paper submitted to the March 2018 AAOS Annual Meeting (3/6/2018).



For information about the AJRR RegistryInsights™ platform, speak with a Registry Engagement Associate at (847) 292-0530 or Request A Demo today!


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Topics: Registry Participation

A Message for Our Readers

This blog was created by the American Joint Replacement Registry (AJRR), part of the American Academy of Orthopaedic Surgeons (AAOS) Registry Program. The blog is part of our commitment to improve orthopaedic care through the collection, analysis, and reporting of actionable hip and knee arthroplasty data. Our purpose is to communicate with others in the orthopaedic field who share the same commitment. Watch for weekly news alerts, quick tips, actionable checklists, best practices, and research findings posted to this blog. It will be information you can use each week!

The more interactive you are, the greater the value shared. Visit us at www.aaos.org/ajrr, speak with a Registry Engagement Associate at 847-292-0530, or follow us on Twitter.

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This Week's Blog

  • Thursday, August 30, 2018 - Guest Blog: ASCA, AJRR, and the Orthopaedic Surgery Market

This Week’s References

Alex Taira, Guest Blogger

Alex Taira is a Policy Analyst at the Ambulatory Surgery Center Association (ASCA) focusing primarily on regulatory issues. He is the ASCA lead for physician payment issues, and is leading an electronic health record (EHR) stakeholder group towards development of an ASC-specific EHR certification. He also manages ASCA's research agenda.

Ambulatory Surgery Center Association (ASCA) 

ASCA was founded in 2008 after the merger of two premier ambulatory surgery center (ASC) associations, the Federated Ambulatory Surgery Association (FASA) and the American Association of Ambulatory Surgery Centers (AAASC). Since then, ASCA has grown to include roughly 3,000 member facilities, acting as the premier advocate for member facilities and the surgery center industry as a whole. ASCA's member offerings include:

  • Experienced national and state regulatory and legislative advocacy
  • Diverse education and networking options, culminating in an annual convention and exhibition
  • A centralized resource center with publications, benchmark surveys, and career center

ASCA and National ASC Month

During August, ASCA celebrates National ASC Month and the ASC industry by promoting awareness through open houses and facility tours with all stakeholders. If you have questions, please contact:



AJRR RegistryInsights™

As a health care provider of orthopaedic services, you can access information about joining AJRR and RegistryInsights by visiting www.aaos.org/ajrr or speaking with a Registry Engagement Associate at (847) 292-0530.  New Call-to-action

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AJRR Staff Writers

AJRR Blog posts are researched and created by AJRR staff writers: Karen Metropulos, Erik Michalesko, and Lori Boukas. If you would like to contact the writing staff, email us at AJRRinfo@aaos.org


This blog shares health care information from a variety of independent expert sources. Some sources offer opinions that may be of interest to other professionals facing similar challenges. Our approach helps ensure diverse, well-rounded presentation of important, often complex health care content. Shared content does not necessarily represent AJRR or AAOS findings and practices.