7
ASC
MANAGEMENT
What ASCs can expect more of this year
By Laura Dyrda
A
SCs are in a great position to take ad-
vantage of high-quality, low-cost care
trends this year. But they will face the
same challenges as other companies when it
comes to supply chain and staffing shortages.
Ten projections for ASCs this year:
1. Commercial payers will direct more of
their members to ASCs and increasingly
require the low-cost setting for coverage. In
some areas, payers already are sending letters
to members explaining why they should have
procedures in ASCs, according to Christine
Blackburn, BSN, administrator of South
Kansas City SurgiCenter.
2. e nursing shortage will worsen. Regis-
tered nurses are retiring at a rate of 100,000
per year, according to the American Nurses
Association, and the U.S. Bureau of Labor
Statistics projects there will be a need for 1.1
million new RNs in 2022.
3. ASCs will transform into a more "bou-
tique" healthcare business as patients demand
a more comfortable care experience. Surgery
is stressful for patients and family members,
even for nonemergency procedures, and the
"boutique" feel of a facility is calming for
patients, Ms. Blackburn said.
4. ASCs will dive deeper into data collec-
tion with more sophisticated IT systems and
quality reporting requirements. ey also
will need to collect and analyze data to enter
into bundled payments and other episode-
of-care contracts, including direct employ-
er arrangements.
5. Insurance companies will require more
documentation and question prior authoriza-
tions aer surgery is complete. ASCs in many
areas already are seeing heightened scrutiny
from insurers, and the CMS decision to move
255 procedures off the ASC-payable list in
2022 will spark more time-consuming and
costly requests from commercial insurers.
6. Higher supply costs likely will continue in
2022. PwC projects the medical cost trend
will be up 6.5 percent this year over 2021,
with supply spending as an inflator. Prices
of personal protective equipment, especially,
will increase as facilities stockpile in prepara-
tion for future emergencies.
7. ASCs will be in a strong position to recruit
physicians as more physicians decide to leave
employment contracts. e Biden adminis-
tration's attack on noncompete agreements
may make it easier for physicians to join
independent medical groups. Hospitals also
may shy away from physician hiring because
of the rising costs to attract specialist talent.
8. e biggest ASC companies will keep
getting bigger through organic growth and
a sharp acquisition strategy. United Surgical
Partners International acquired SurgCenter
Development for $1.2 billion at the end of
2021, and the two plan to develop 50 ASCs
in the next five years. ere are several other
midsize ASC companies that are attractive
targets for large chains, such as AmSurg and
Surgical Care Affiliates.
9. ere will be an explosion of ASCs in areas
where populations are rapidly growing, such as
in Texas, Florida and North and South Caro-
lina. e U.S. Census Bureau's world population
review shows all four states were among the top
10 fastest-growing ones last year.
10. ere is plenty of opportunity for
independent ASCs to thrive with the right
relationships to drive referrals, add service
lines and enter into beneficial payer con-
tracts. ASCs with a strong reputation will
also increasingly contract directly with
large employers, bypassing the traditional
insurance model. n
Physicians get temporary reprieve from Medicare pay cuts
By Laura Dyrda
P
hysicians faced a Medicare pay cut this year of about
9 percent before President Joe Biden signed a bill
Dec. 10 temporarily averting the cuts.
The Protecting Medicare and American Farmers from Se-
quester Cuts Act passed Congress with bipartisan support
before the year's end. The bill prevented across-the-board
spending reductions until March 31. It also extended a pay
increase under the physician fee schedule.
Since 2001, Medicare physician pay has dropped 20
percent, while the cost of running a practice increased 11
percent, according to the American Medical Association.
The organization, which represents physicians nationwide,
is in favor of halting the cuts and would like to see Congress
further address flaws in the Medicare payment system.
"There is no need to wait for the last minute to start work-
ing on the systemic problems," AMA President Gerald
Harmon, MD, said Dec. 9 after the bill passed Congress.
"These automatic cuts should remind members of the
needed reforms. Congress can get a head start on doing
the right thing when it reconvenes early next year."
Physicians and surgery centers still are recovering from
pay dips during the pandemic. CMS spending on ASCs
dropped 90 percent in April 2020, when many ASCs lim-
ited procedures or temporarily closed.
CMS spending remained 4 percent to 15 percent lower
than expected in 2020, and CMS spending on physician
services dropped $13.9 billion below expected levels. n
