Becker's ASC Review

7 ASC MANAGEMENT The state of the ASC industry: 3 earnings call notes from HCA, USPI & SCA Health By Patsy Newitt U nited Surgical Partners International, SCA Health and HCA Healthcare are all indicating different growth strategies in the company's third quarter earnings calls. Here are three major earnings call notes to know that point to the state of the ASC industry: USPI: United Surgical Partners International executives revealed the company is behind on its year-long growth plan in an Oct. 21 third quarter earnings call from Tenet Healthcare, USPI's parent company. Despite this, the company is still optimistic about the revenue- generating power of USPI. "It's a great business, great margins, great cash flow generation. And we believe we have competitive advantages when we engage in [mergers & acquisitions] when there's a competitive process based on the value that we can bring to the table," Tenet's executive vice president and CFO Dan Cancelmi said in the call. "So, we do believe that the pipeline is robust, and so it gives us a lot of optimism as we think about 2023 and beyond." HCA Healthcare: Nashville, Tenn.-based HCA Healthcare's outpatient revenue jumped 36.6 percent in the third quarter, according to financial results released Oct. 21. In the last two years, the company has seen substantial migration of total joint procedures to the outpatient setting, according to an earnings call transcribed by e Motley Fool. "Anecdotally, we've heard from some of our physicians that their clinic practices are starting to recover [from COVID-19] in ways that maybe earlier in the year, they didn't recover. So that's encouraging to us at some level," CEO Samuel Hazen said. "Obviously, during the comparison of 2019 to today, our total joint business migrated fairly significantly to outpatient activity." SCA Health: Optum, parent company of ASC chain SCA Health, is doubling down on value-based care and higher-acuity surgical procedures. Optum's third-quarter revenue is up 17 percent from the same quarter last year, reaching $46.6 billion, according to financial results released Oct. 14 by parent company UnitedHealth Group. OptumHealth's 31 percent revenue-per-customer growth is attributed to the increasing number of patients served under value-based care, according to an Oct. 14 call with investors transcribed by e Motley Fool. OptumHealth is Optum's care delivery platform. "Growth continues to be led by the increasing number of patients served under value-based care relationships and the expanding types of care settings offered by Optum, from meeting behavioral needs to comprehensively serving people in their homes to higher acuity ambulatory surgery," CFO John Rex said in the call. n 'All of society has suffered financially': How ASCs are navigating physician pay changes By Riz Hatton A s inflation and the cost of running a practice rises, CMS's Medicare physician fee schedule proposed rule for 2023 suggests further cuts to physician pay. An orthopedic surgeon and a cardiovascular ASC director connected with Becker's to answer: "How is declining physician pay affecting the ASC industry?" Editor's note: Response has been lightly edited for length and clarity. Henry Goitz, MD. DMC Orthopedics and Sports Medicine (Warren, Mich.): While all aspects of reimbursements have been affected, and while COVID-19 income losses are real, it is my hope that physicians remain ethical in their care and management of our patients and realize that all of society has suffered financially. Needless to say, however, we must effectively negotiate with insurers to obtain a fair price commensurate with the service we, as surgeons, provide. Luis Paz. Director Business Development and Marketing at Cardiovascular Surgical Suites (Coral Springs, Fla.): The feedback from many physicians I run across varies. Some of the comments are: 1. If I had known I would be dealing with so many regulations and constraints that would not allow me to be a doctor, I would have chosen a different career. 2. I don't know how much longer I can continue to be a doctor. It gets more difficult every year. 3. While reimbursements are getting smaller, the cost of running a practice keeps increasing. It's unsustainable. Many of them are feeling anxiety or depression and are considering early retirement. Others are consolidating or selling their practices. The younger ones are more open to changes as they are not sure what to expect but want to feel they made the right decision by going into the medical field. n

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