Becker's ASC Review

22 ASC MANAGEMENT 6 CEO insights from USPI, Surgery Partners, HCA By Patsy Newitt U nited Surgical Partners Interna- tional, including its parent com- pany, Dallas-based Tenet Health- care; Surgery Partners; and Nashville, Tenn.-based HCA Healthcare are three of the largest ASC chains in the U.S. Here are six insights from their CEOs on their strategies for 2022 and beyond, pulled from their fourth-quarter earnings calls: Sam Sutaria, MD. CEO of Tenet Health- care: We've deployed over $2.5 billion in capital investment at USPI since Decem- ber of 2020, scaling USPI to be the lead- ing ambulatory surgery platform. We also welcomed over 3,400 physicians to USPI's medical staff and started approximately 90 new high-acuity service lines. We antici- pate strong returns from the high-caliber investments we've made. Brett Brodnax. President and CEO of USPI: We have continued to experience significant growth in our total joint busi- ness. … Obviously, SurgCenter Develop- ment does a great job, and has historically done a great job in expanding their total joint footprint. [With our new partner- ship], we're going to continue to learn from them and vice versa in terms of how we expand not only in total joints, but also across a wide variety of higher-acuity spe- cialties, including spine, including cardiac. So we'll continue to learn from one anoth- er as we integrate their business into ours. And obviously, with our five-year partner- ship with SurgCenter, we will continue to work together as they build out their port- folio and partner together on a go-forward basis with essentially everything they do from a development perspective over the next five years. Eric Evans. CEO of Surgery Partners: We certainly anticipated some of an increase [in labor cost], but where we projected it and where it showed up were in those re- gions that were affected more significantly by the omicron variant, most notably in our California facilities. Based on our comprehensive review, we believe these pressures are localized, not widespread, and largely temporary responses to supply and demand pressures. We have consid- ered some of the regional labor rate pres- sures in our plans for 2022. Rest assured that we constantly monitor and closely manage these costs. When we saw this trend begin to emerge in early 2021, we developed more robust and detailed intel- ligence reporting that enhanced our opera- tors' and executives' ability to proactively manage labor efficiency, premium labor statistics and other key metrics with the objective of rapidly identifying hot spots, as well as best practices Eric Evans: We continue to see our physi- cian pipeline strengthen. This is not some- thing that's slowing down. Our pipeline is as strong entering this year as it's ever been, actually, I'd say, stronger than it's ever been. So we look at the opportunities that remain on that as a big part of our or- ganic growth. When we go out and acquire a new facility, one of the big value propo- sitions we bring is being really thoughtful around how we market to and gain trac- tion with the most important physicians in that community that can drive value in our facilities. We've executed upon that really well, and I don't expect that to change. Sam Hazen. CEO of HCA Healthcare: Our non-COVID acuity levels for the year have been up compared to 2019. And so we have seen a natural lift in acuity. Part of that is strategic, part of that is some mi- gration into outpatient, and part of that is the environment that we're in. So we antic- ipate that acuity levels will remain strong. I don't know that we've assigned a metric to it at this particular point in time, but if you look at our non-COVID activity for the year as a whole, it is up compared to 2019. Sam Hazen: We have a strong pipeline of projects that will come online in 2022 and 2023 that are connected to both our hospi- tal platform as well as our outpatient plat- form. So we see, again, the model of HCA continuing to produce solid results and de- liver value to our patients and value to our shareholders. n Physician pay freeze should stay, says MedPAC By Laura Dyrda T he Medicare Payment Advisory Commission recommended Medicare continue its physician fee payment freeze despite ongoing financial pressure from the pandemic. MedPAC, which advises Congress on Medicare payments to healthcare pro- viders and health plans, said its analysis showed professional service pay- ments are adequate and relief funds provided by Congress in the last two years should have covered the lost volume during the pandemic. The report also stated case volume and physician revenue are expected to rebound this year, and potentially reach higher rates as physicians address a backlog of cases. So it's recommending that CMS continue physician fee schedule payments for 2023 as planned, which include a pay freeze . The American Medical Association disagrees with this recommendation and sent a letter March 15 to congressional leaders warning against following MedPAC's recommendation. The AMA argued physicians will be more likely to consider leaving medical practice if the Medicare physician fee schedule spending isn't revised. Adjusting for inflation over the last 20 years, the Medicare physician fee sched- ule reduced physician pay by 20 percent. The 2022 inflationary spike is likely to widen that gap, according to the AMA's analysis. CMS takes MedPAC's recommendations into consideration when develop- ing the 2023 physician fee schedule. A proposed draft of the fee schedule is scheduled for release midyear. n

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