Improving the value of same-day pediatric orthopaedic surgery by using ambulatory surgery centers: direct cost savings are important, but there is more to the picture

Attempts to improve the value of health care can pursue one of two primary aims: increase the quality of care while keeping costs level, or keep quality level while reducing costs (1). The Medicare Bundled Payment for Joint Replacement (2) is the highest-profile effort by the United States government to incentivize value-improvement efforts in orthopedic surgery. In a recent study, Peter Fabricant and co-authors (3) attempt to calculate the cost savings realized by performing surgery in an ambulatory surgery center (ASC) instead of in a university hospital (UH) setting.