Becker's ASC Review

27 Thought Leadership The struggle for ASC independence: Gastroenterologist Dr. Michael DiMarino weighs in By Rachel Popa M ichael DiMarino, MD, is a gastro- enterologist practicing at Jefferson University Hospitals in Philadel- phia. Here, he shared his thoughts on ASC growth, potential headwinds and more. Note: Responses were lightly edited for style and clarity. Question: What's the No. 1 opportu- nity you see for ASC growth this year? Dr. Michael DiMarino: Outpatient proce- dures in surgery centers have been on the rise as insurers recognize that hospital outpatient departments are costly, and as a result they want to push more procedures to ASCs. ASCs are able to give good care, be more efficient and less costly, which is appealing to payers. Low-acuity orthopedic and gastroenterology cases have migrated into ASCs, and there will continue to be procedure growth across the board. Q: What do you think will be the greatest roadblock the ASC industry will face in the future? MD: In New Jersey, there is a law that says you cannot open an ASC without it being a joint venture with a hospital. Now that hospitals are opening their own ASCs, there's going to be competition for patients for private ACSs. Hospitals want to keep patients in their own net- works, so it's getting harder for ASCs to maintain their independence. ere's a reimbursement threshold that ASCs have to stay in business. However, it's more important for ASCs to maintain and show their quality. at's where EHRs have been very important to our practice. We use Modernizing Medicine's gastroenterology EHR to collect data and prove our quality outcomes to insurance companies so they can adjust reimbursement accordingly. Everybody is getting squeezed with low reimbursements, but now is the time that insurers are pushing for more care to take place in outpatient facilities so reimbursements may increase, but only if the quality is there. Q: How has the ASC industry changed since you began practicing? MD: e acquisitions of ASCs by hospitals has been a big change, as well as the New Jersey joint venture ASC law. EHRs have been impor- tant, as they help us show our quality and document procedures better. If we spend a lot of time writing reports, it can be tough to keep the throughput going. EHRs have sped up the reporting process. ASCs have to supply the same care at a lower cost to stay independent and keep their value. I think ASCs are better for patients because they enjoy being in that independent, less stressful environment. Addition- ally, patient satisfaction is driving reimbursements and allowing physi- cians to stand out. EHRs have helped coordinate these efforts. n 'It's like building a moon colony': 2 surgeons on starting an outpatient total joint program By Rachel Popa T he Oregon Surgical Institute in Beaverton, Ore., an ASC dedi- cated solely to outpatient joint replacements, opened last year. Two of the institutes partner surgeons, Drs. Jim Ballard and Chris Nanson, shared their thoughts on their experience opening the center with Regent Surgical Health. Three things to know: 1. Dr. Nanson compared the experience of opening an ASC focused on total joints to building a moon colony, filled with ups and downs that surgeons should be prepared for. Dr. Nanson said total joints are the "next frontier," driving the paradigm shift of procedures to the outpatient setting. 2. Dr. Ballard said the ASC environment is key to patient success after a total joint replacement. Patients recover better at ASCs because they're less stressful than hospitals, he said. 3. Dr. Nanson said the most important thing about establishing an outpatient total joint program is creating the patient care pathway, which is the process of getting all ASC staff on board with the various steps of a procedure, including anesthesiologists and operating room nurses, among others. n US ASC market to hit $84.1B by 2027 — 4 market insights By Eric Oliver T he U.S. ASC market could grow at a com- pound annual growth rate of 5.6 percent through 2027, reaching a value of $84.1 billion, according to a report by Coherent Market Insights. What you should know: 1. Analysts estimate the market was valued at $54.2 billion in 2019. 2. The migration of surgeries from the inpa- tient to the outpatient setting, paired with an increased number of ASCs and heightened in- vestment rate, will drive market growth through 2027. 3. Analysts also identified a growing number of single-specialty surgery centers as a growth factor. In 2017, there were 2,890 single-specialty ASCs in the U.S, according to a report from CMS. 4. Physician owners will continue to control the majority of ASCs in the U.S. n

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