Becker's Spine Review

32 ASC The 'looming' disruptor of the ASC industry By Patsy Newit ASCs nationwide are struggling to recruit and retain amidst the 'Great Resignation' and rising operating costs. "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," Jackie McLaughlin, RN, administrator of the Northwoods Surgery Center in Woodruff, Wis., told Becker's. "I fear industrywide burnout will create a snowball effect with the looming shortages." e competition for staff is fierce, and many ASCs can't afford to compete with hospital salaries, oen because of lower reimbursements. "ASCs' reimbursement rates are notoriously and appallingly lower than hospital reimbursement rates," Ann Cook, RN, director of nursing at Best Surgery and erapies in Cincinnati told Becker's. Staffing is already costing ASCs. On average, ASCs spend $2.2 million on employee salary and wages, or about 21.3 percent of net revenue, according to VMG Health's "Multi-Specialty ASC Benchmarking Study." Battling low reimbursement rates and record-breaking inflation, ASCs are struggling to compete. "[Hospital outpatient departments] offer the same hours as the ASC, with the added hospital benefits and increased wages," Sandra Berreth, RN, director of the Foothill Surgery Center at Sansum Clinic in Santa Barbara, Calif., told Becker's. "How can ASCs compete with that? Simply, we can't, so every day, we work at breakneck speed and efficiency, employing everything we know to maintain the cleanest environment and safest working conditions, and above all, we keep the patient safe, with the highest patient satisfaction rate in the industry. ere's also non-healthcare competitors. Walmart, Target, Amazon and other retailers are competing with ASCs for some of the same personnel, and they're willing to pay higher wages than in previous years. CVS Health and Walgreens Boots Alliance have boosedt their minimum wages to $15 per hour. Target and Amazon also have minimum wages of at least $15 per hour, while the national minimum wage is $7.25. is means office staff candidates and sometimes nurses can receive higher pay for entry-level jobs outside of healthcare. To mitigate these shortages, many ASC leaders are investing in people over service lines or technology. Some ASCs have started offering $5,000 sign-on bonuses for administrators. Other ASCs hope flexible scheduling and workplace culture will draw candidates. "e ability to hire good people and keep them has changed immensely over the last two years," Jeremy Statton, MD, orthopedic surgeon at Arthritis & Total Joint Specialist in Atlanta told Becker's. "We used to take outstanding staff for granted, and now that has changed. We are working on finding new ways to show our staff how much we appreciate them." n Why orthopedics is the golden ticket for ASCs By Riz Hatton Orthopedics may be ASCs' best option for running a profitable and successful center. Orthopedics is the most common specialty for ASCs in 2022, according to March data from the ASC Association, meaning many surgery centers have already begun to unlock the benefits of the specialty. So what are the advantages of incorporating orthopedics at an ASC? One advantage is the amount of revenue the specialty brings in. Orthopedic surgeries bring in more revenue than any other specialty nationwide, according to VMG Health's "Multi-Specialty ASC Benchmarking Study" for 2022. Another benefit is high reimbursements. Orthopedic cases offer the highest reimbursements to ASCs, according to the same study. "Reimbursement for orthopedic cases could always be better, but as reimbursement goes, it is better than several other specialties, making it an attractive specialty to offer at an ASC," John Ryan, CEO of OrthoIndy in Indianapolis, told Becker's July 5. With higher reimbursements comes greater financial stability for the center. "I am likely stating the obvious when I say that ASCs with meaningful orthopedic volume stand a much better chance of financial viability and sustainability than those [without]. While it is absolutely possible for an ASC to be financially successful without orthopedics, those ASCs with orthopedic procedure volume at or above 25 percent have a far clearer path to navigate the other economic pressures on an ASC's financial health," Mr. Ryan said. As orthopedics is shifting away from being performed strictly in hospitals, ASCs have the opportunity to cash in on the specialty, and some have already seen great success. "Spine and joint replacement services have historically been performed predominantly in the hospital setting mingled with the wide range of surgical specialties that span well beyond orthopedics. At Tallahassee Orthopedic Clinic, these services now reflect 75 percent [of cases] plus outpatient case mix," Michael Boblitz, CEO of Tallahassee (Fla.) Orthopedic Clinic, told Becker's July 28.n

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