Becker's ASC Review

28 Thought Leadership Did the pandemic change ASC-hospital relationships? By Laura Dyrda D uring COVID-19 surges last year, ASCs and hospitals worked together in new ways to care for patients across the U.S. ey shared resources and collaborated on protocols for performing safe surgical procedures to ensure the continuity of care for patients who didn't have COVID-19. But will the harmony last? Becker's heard from seven ASC owners and operators about whether the pandemic changed their relationship with local hospitals and what they anticipate for the future. "In my perspective, our relations with the hospital grew better during the pandemic," said Trina Cole, administrator of Saint Luke's Surgicenter Lee's Summit (Mo.). "We needed to rely on each other during different times. They needed us for the possibility of treating non-COVID patients, and they have assisted us with COVID-19 testing." Steven Jascewsky, administrator of Wellspring Pain Solutions in Co- lumbus, Ind., said his center's relationship with the local health system strengthened during the pandemic as well. "My physicians and clinical director started having conversations very early on about resource management, personal protective equipment allotments and the possible need for our facility to safely handle patient overflow from the hospital," he said. Taylor Cera, COO of Orthopaedic Surgery Center in Youngstown, Ohio, told Becker's his leadership team spoke with the hospital's leader- ship a few times during the pandemic and offered the center's space for outpatient surgeries. e independent center's administrative team also worked with the hospital's medical experts to develop the ASC's COVID-19 policies and procedures. "It was nice to be able to connect with these experts in certain areas, such as infectious disease, to see how the large health systems were monitoring COVID-19," said Mr. Cera. "ey have many more re- sources and tools that assist in making safe decisions." Tracy Hoe-Hoffman, administrator of Heartland Surgery Center in Kearney, Neb., and Roger Franck, administrator for the Endoscopy Center and Gastroenterology Associates of North Mississippi in Ox- ford, both said their relationships with local hospitals didn't change, but they were able to work with the hospitals to access vaccines for their staff. Trudy Wiig, RN, FACHE, administrator of Kerlan-Jobe Surgery Center in Los Angeles, said her center was affiliated with Los Angeles-based Cedars Sinai prior to the pandemic and was able to support the hospital by closing the center last March to conserve supplies. In December, the ASC welcomed surgeons from the hos- pital to perform necessary cases because the hospital temporarily closed its outpatient services. "Assisting our hospital partners solidified our relationship with them and they with us," said Ms. Wiig. "We both discovered many new ways we may be of service to each other, our patients and our community during these unprecedented times in our recent history." e pandemic drove the outpatient migration of many elective procedures from hospitals to ASCs, since surgery centers didn't treat COVID-19 patients. Many of those procedures, including total joint re- placements and spine surgery, are high-reimbursing specialties for the hospitals. Vip Nanavati, MD, of Humphrey Shoulder Clinic in Eagle, Idaho, sees the potential for strained relations between independent ASCs and hospitals in the future. "As the number of independent and hospital-based ASCs grow, I suspect you will see increasing lobbying pressure on Capitol Hill and at a state legislature level for increased regulations and barriers to entry for new ASCs into the market," he said. "To me, we will see regulatory changes and the development of barriers to new entry that will be driv- en by the loss of revenues that hospital systems have experienced, and continue to experience, from this pandemic and from the irreversible trend of lucrative income-generating high-volume surgical procedures leaving the hospital setting." n ASCs should 'look beyond the financial' when considering private equity: Q&A with Liliana Lehmann By Patsy Newitt A SCs can partner with private equity-backed platforms as a way to capitalize on future value and mitigate risks, but some ASC leaders warn that partnering with private equity firms requires consideration of costs outside the financial. Liliana Lehmann is the founder and president of Axis HealthCare Partners, a company that specializes in partner- ships with physicians and health systems. She spoke with Becker's ASC Review to provide insight for ASCs consider- ing a partnership with private equity. Question: Is private equity investment good or bad for ASCs? Why? Liliana Lehmann: When considering private equity, ASCs must look beyond the financial. Questions and discussions surrounding strategic goals, synergies and alignments must be addressed. There must be very specific questions in regard to the steps that will need to be taken in order to achieve the goals proposed. If any of the answers don't provide a strong growth alignment, then private equity is not the right answer. n

• Cover