Becker's ASC Review

6 ASC MANAGEMENT Surgery centers among the small businesses losing hope in the American economy By Patsy Newitt S mall businesses are losing confidence in the U.S. economy amid soaring inflation, supply chain delays and staff shortages, according to a May 22 report from e Wall Street Journal. Fiy-seven percent of small-business own- ers are expecting economic conditions to worsen in the next year, according to a May survey conducted by the Journal, a percent- age equivalent to the all-time low recorded in April 2020. ASCs are among the small businesses hav- ing trouble staying afloat. Surgery centers can't catch a break from the "rising cost of everything," Amy Noble, practice admin- istrator for the Center for Pain Control in Wyomissing, Pa., told Becker's. "From equipment to supplies to staffing, expenses continue to rise while reimburse- ments are stagnant," she said. "With supply shortages, we run into situations where a simple box of 10 surgical dressings can run upward of $1,000 compared to normal pric- ing of $200." According to e Wall Street Journal survey, the portion of small businesses that expect revenue to increase in the next year fell to 61 percent, down from 79 percent in May 2020. Small businesses like ASCs don't have the financial reinforcements found in larger companies, according to the Journal. Many ASCs can't compete with the deep pockets of hospitals for things like supply and payer contracts, staff salaries and technology advancements to attract patients. More than three-quarters of small-business owners who said they had difficulty recruit- ing qualified workers also said they are struggling to compete with larger employ- ers on pay, according to a Goldman Sachs survey cited by the Journal. ASCs are running into similar issues, with Walmart, Target, Amazon and other retailers vying for the same personnel using higher wages. Healthcare providers are having a hard time recruiting for office jobs and other positions because compet- ing industries are able to offer higher pay, Bloomberg reported earlier this year. "In my area, staffing and nursing wages are very competitive," said Lianne McDowell, CEO and administrator of South Portland Surgical Center in Tualatin, Ore. "I've seen a big increase in wages for nurses. ere is a lack of staffing and nursing, there is a lot of competition with the hospital benefits and wages that are really skyrocketing, not just 2 percent or 3 percent, but more like 20 percent to 30 percent increases." Some small businesses are still hopeful — 12 percent said they expect economic conditions to improve, and 28 percent predicted they would stay the same. With other factors, like the increased procedure migration to the ASC setting, surgery centers could still come out on top, despite facing rising costs and a shaky economy. "Particularly through the pandemic, ASCs have proven that they can provide safe and affordable access to care across a variety of specialties," Jennifer Cabrera, director of operations at Snibbe Orthopedics in Los Angeles, told Becker's. "Both patients and providers are more willing and accept- ing of moving their surgeries to the ASC setting. ASCs in our area are increas- ing specialties provided, adopting new technologies and working with payers on bundled payment structures — all pointing to a bright future for ASCs." n 5 statistics making ASC execs nervous By Patsy Newitt W ith rising operation costs, nurse shortages and a push toward industry consolidation, indepen- dent physicians and ASCs are having a hard time staying independent. Here are five stats reflecting challenges ahead for ASC owners and operators: 13 million: Global shortage of nurses predicted by 2030 without sufficient recruitment and retention, according to a January report from the International Centre for Nurse Migration. 79 percent: Percent of medical groups that said that pay- er prior authorization requirements increased in the last year, according to a March poll conducted by the Medical Group Management Association. 108,700: Number of formerly independent physicians who are now employed by hospitals, private equity firms, insurers or other corporate entities, according to a report from Avalere. $2.2 million: Amount surgery centers spent on employee salary and wages, about 21.3 percent of net revenue, ac- cording to the VMG Health "Multi-Specialty ASC Bench- marking Study." 57 percent: Percent of U.S. small-business owners expect- ing economic conditions to worsen in the next year, ac- cording to a May survey conducted by The Wall Street Journal, a number equivalent to the all-time low recorded in April 2020. n

• Cover