Becker's ASC Review

19 THOUGHT LEADERSHIP The biggest disruptors of the ASC industry By Patsy Newitt F rom high patient deductibles to supply chain issues, five ASC leaders joined Becker's to discuss the biggest disruptors of the industry. Editor's note: Responses were edited lightly for clarity and brevity. Jackie McLaughlin, RN. Administrator of the Northwoods Surgery Center (Woodruff, Wis.): For me, the two biggest disruptors in the ASC industry are the decreased availability of healthcare professionals and the uneven increase in business operation costs vs. reimbursements. Physician and nursing shortages are projected to exponentially get worse in the next coming years while our current physicians and nurses are already being asked to do more to compensate for the shortages. I fear industrywide burnout will create a snowball effect with the looming shortages. Adding to that, with uneven increase in costs versus reimbursements, ASCs will continue to have to operate on slimmer margins than they have in the past. Administrators and business managers will need to have exceptional foresight in strategic planning for success in the future. Eric Anderson, MD. Pain Management Physician in Lewisville, Texas: I think the biggest disruptor is going to be the ever-increasing high patient deductibles. This squeezes the pain management space in the ASC setting for procedures that could be done in an office setting. Patients simply have difficulty affording these large out-of- pocket costs for pain conditions that require more than one procedure, such as medial branch blocks. Brenda Carter. Administrator of Wilmington (N.C.) Surgcare: As we continue to hear about staffing and supply chain, these two aspects of healthcare operations can really be a challenge. There is no way to "cut corners" on qualified staff when candidates are limited, so ASCs must find a way to improve retention and recruitment. Qualified teams are essential for patient safety and efficient care. The cost of staff turnover is incredible. As for the supply chain, where to start? The lists of backordered or unavailable items continues to grow every day. Everything from medications to tubing is more difficult to get, and a new mindset and process is required to have what you need without causing materials staff to lose their minds. It is challenging beyond words, so everyone must adopt the thought of substitution should a preferred item be unavailable — this is easier said than done for complex surgical cases. This task has become more time-consuming and less efficient than ever before. Harry Aslanian, MD. Advanced Endoscopist at Yale School of Medicine (New Haven, Conn.): From the perspective of a gastrointestinal endoscopist, ASC endoscopy volumes appear quite stable. Potential disruptors include a dominant colon cancer screening modality other than colonoscopy and insurance limitations on the use of propofol sedation for endoscopy procedures in patients, neither of which appear likely in the near future. Myrna Loida Chang, RN. Director of Surgical Services at HCA-Good Samaritan Hospital (San Jose, Calif.): Patient safety is paramount. If complications increase in the ASC setting, these cases might go right back to being done inpatient. n team who is solely focused on orthopedic surgeon recruitment. We're investing in that strategy and planning for growth because we're seeing market share increases in almost every market we're in. e demand is certainly there, and we're working diligently to meet those demands. It's no secret in orthopedics that through advancements in surgical technology, anesthesia protocols, medications, etc., more and more cases are moving to ASCs. And that's great because everybody wins — surgery centers provide as good, if not better, outcomes and typically at a lower cost. at said, however, we will always need hospitals. ere are some patients who will need to have procedures done at a hospital, which is why we pursued creating the Orthopedic Institute with Ridgeview. at said, we're developing an ASC in Plymouth and are looking at expanding our existing ASCs. Our physicians operate out of seven ASCs now. We're examining those facilities to see if there are opportunities to add additional OR space. Like many in the orthopedic industry, we are positioning our practice and our ASCs for growth because so many surgeries are moving to the outpatient setting. Michael Boblitz. CEO of Tallahassee (Fla.) Orthopedic Clinic: A key trend for the ASC model is to replicate the environment for spine and joint replacement surgery to realize the benefits of specialization: superior efficiency, less variation, less length of stay and better outcomes. is involves designing a spine and joint replacement surgical center that affords the ability to care for complex patients that require a 23-hour stay, along with the comprehensive range of robotic solutions that span the O-Arm spine imaging system, Mako and Rosa, which orthopedic surgeons require for best practice. e broader benefits reflect the patient being back in the comfort of their home in a matter of hours, along with a 30 to 40 percent lower cost for the payer and employer. At the same time this solution provides a needed relief valve for the hospitals that must prioritize the higher cost complex and emergent patient population. I see orthopedics evolving into two ASC models in the future which operate in parallel to one another. is design yields the benefits on specialization of staff, resources and destination level facilities: 1) Spine and joint surgery centers 2) Outpatient orthopedic surgery center to service the other orthopedic divisions With recent reports now indicating orthopedics ranks second in total cost of care in the commercial payer environment (behind cancer and now ahead of cardiovascular), the time has come for a better model to bend the curve and improve value. n

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