Issue link: https://beckershealthcare.uberflip.com/i/1230114
25 Thought Leadership Q: Do you foresee cardiovascular procedures becoming more common in ASCs? CZ: It requires hard work and is not a slam dunk, but we do see cardio- vascular as a huge opportunity in the surgery center world. Medicare recently added more codes for payment at the ASC, and based on our conversations with physicians and cardiovascular interventionalists, we think there is interest in moving out of hospital employment where most of them have been. e service line is challenging and expensive, and there are regulations in many states that should be considered before launching the line. Q: What types of partnerships, with surgery centers or other organizations, do you anticipate over the next few years? CZ: Partnerships are incredibly important for the future. I'm focused on deepening our partnerships with Optum, which also includes primary care. Some of their contracts are full risk and some are fee for service, but they are all looking for meaningful solutions to reduce the total cost of care and improve quality for patients. We are thinking through how to align and become a high-value ecosystem. SCA is a huge part of that. We are also actively looking and seeking to partner with health systems and payers across the U.S. where it makes sense to align because we have the same mission and values for healthcare delivery. We recently partnered with Minneapolis-based Allina to develop ASCs, and I expect to see future partnership like this in diverse geographies. We are also still very focused on acquisition as a high-growth organization. We go through our portfolio to exit centers where it makes sense while still acquiring. We did a large amount of acquisitions last year and expect more this year. But the acquisition has to make sense for the specialists at the center and allow us to provide value to patients. ere is a large opportunity to find specialists that want to partner with us, and we are making sure that's the right partnership. n Florida's ASC market is booming — Administrator elaborates By Eric Oliver A t least nine ASCs opened in Florida last year, cement- ing its place among the states that experienced the most ASC growth in 2019. Here, Ashlie Cramer, MSN, RN, nurse administra- tor at Delray Beach (Fla.) Surgical Suites, explores why new ASC de- velopment was booming in Florida and shared insights into the future of the market. Note: Responses have been edited for style and content. Ms. Cramer's responses are her own opinion and are not neces- sarily reflective of the opinions of any entity affiliated with Delray Beach Surgical Suites. Question: Why is Florida a good place to start a surgery center? Ashlie Cramer: The weather is great in Florida, which also means that the population is high and increasing as North- erners get tired of the cold and want to live in paradise. Therefore, the increased population inevitably means more people needing surgery. The population age also indicates the need for orthopedic in- terventions as people tend to be older, yet still more physically active. There are also many patients that are willing to travel to a better climate to recover, so "concierge" surgery seems to be popular. I wouldn't say that reimbursement is better, as I know in certain areas Florida isn't as high as other states, and I wouldn't say regulatory-wise there is an advantage. Personally, I feel if [physicians] are able to provide a high level of quality care, they are going to stand out in Florida. [If] a center can ensure that they have top-notch doctors and employ top-notch staff, they are going to be success- ful. [Word-of-mouth] recommendations in this area mean more to the population than any amount of advertising can do. I have had so many patients come to my center multiple times. Some of them have had a procedure completed and then asked for the name of another surgeon that operates here, just so they can come back for their next procedure. I honestly do not feel as if we offer anything out of the ordi- nary, but I have had multiple patient satisfaction surveys re- turned telling me that my center is leaps and bounds better than any other facility, ranging from other surgery centers to the hospitals in the area. Q: What is the average caseload of your center? How do you expect it to change in 2020? AC: My center opened in August 2017 and we saw 1,642 cases in 2019. We average 135 cases per month and grow- ing. We perform total joint procedures and with Medicare's inclusion of total knee replacement, anticipate a major growth in our total knee procedure volume. Q: Are there concerns the market could become over- saturated? Why or why not? AC: I am not concerned with oversaturation of the market. My center is physician-owned, and those physicians have a financial interest in this center. As long as we continue to provide a high level of quality care, our surgeons are not going to have interest in another center, therefore, there could be 10 centers opened within the block, but we shouldn't lose any cases. Q: What do you view as the biggest threat to surgery centers in the region? AC: The largest external threat is the weather and natural disasters, like hurricanes. Economically speaking, the largest threat [is] payer reimbursement. [The president's proposed budget is threatening to cut CMS'] budget drastically, mainly through physician and hospital reimbursement. Medicare reimbursement isn't always the most profitable currently; cuts to this reimbursement will increase the urgency to contain medical supply and overhead costs, but also [lead to our] physician owners performing their cases in the hospital set- ting, where there is no personal financial interest. n