After the flight · three questions for your Monday

The joint moved. Did your strategy?

Where is your market on the map?

ASC share of Medicare joints runs from under 1% to 27% by state, and the fastest markets are adding three to six points a year. The interactive data edition holds every state's market file.

What does your bundle book look like without the ASC joints?

TEAM and proposed CJR-X only capture episodes that start in hospitals. Every joint that migrates to a freestanding center leaves your episode volume and changes the case-mix of what remains.

Can you hear your patients between visits?

Pre- and post-operative patient-reported outcomes turn mandatory for HOPDs and ASCs in CY2027, and the Information Transfer measure already scores TEAM in years 3–5. Navigation and asynchronous touchpoints are becoming the scoreboard.

Model your TEAM exposure → Open the interactive data edition → Follow the series
Evidence · every number above
  1. Medicare Inpatient Hospitals — by Geography and Service, 2013–2024 — CMS. 542,513 discharges (2017) → 127,759 (2024); $16,328 avg payment (2024).
  2. Medicare Outpatient Hospitals — by Geography and Service, 2015–2024 — CMS. 317,419 HOPD joints, $10,784 avg payment (2024).
  3. Medicare Physician & Other Practitioners — by Provider and Service, 2013–2024 — CMS. 70,218 ASC joints, $6,909 avg payment (2024); ~13.6% national ASC share; state shares MS 26.6% to KS 0.7%.
  4. CY2018, CY2020 and CY2021 OPPS/ASC final rules — CMS. TKA off the inpatient-only list (2018); THA off IPO + TKA to the ASC list (2020); THA to the ASC list (2021).
  5. TEAM and CJR-X — CMS Innovation Center. TEAM live Jan 2026 (721 hospitals, 30-day episodes, inpatient + HOPD initiated); CJR-X proposed Apr 2026 (nationwide 90-day episodes from Oct 2027).
  6. Carey K, et al. J Arthroplasty 2020 — propensity-matched: outpatient readmissions, complications and payments lower than inpatient.
  7. Kimball CC, et al. Orthopedics 2020 — matched cohorts: minor complications 2.8% vs 5.8%, equivalent major complications and readmissions.
  8. Schloemann DT, et al. JAMA Netw Open 2023 — no outcome deterioration after IPO removal; access skew by age, race, sex and safety-net status.
  9. Singh V, et al. J Arthroplasty 2022 — equivalent 90-day outcomes and patient-reported outcome scores for same-day discharge.
  10. Rajasingh CM, et al. JAMA Netw Open 2023 — freestanding ASCs treated healthier, better-insured patients as volume grew.
  11. THA/TKA PRO-PM in outpatient and ASC settings — J Arthroplasty 2025 — HOOS JR./KOOS JR. mandatory CY2027 for HOPDs and ASCs; 2% payment penalty for non-reporting.
  12. ASC regulatory landscape review — Holland & Knight 2025 — Tennessee CON elimination for ASCs by Dec 2027; Georgia and North Carolina reforms.
  13. ASCA coinsurance advocacy — Becker's ASC Review 2026 — HOPD copay capped at the inpatient deductible; ASC 20% coinsurance uncapped.
Policy analysis and public-data journalism, not medical or investment advice. Medicare fee-for-service claims only; full methodology, equations and falsification tests live in the interactive data edition. A Techy Surgeon × RevelAi Health production.