Becker's ASC Review

15 THOUGHT LEADERSHIP The healthcare trends making ASC leaders nervous By Patsy Newitt F rom robotic procedures to government regulations, nine industry leaders recently connected with Becker's to discuss the healthcare trends they are wary of. Editor's note: is response was edited lightly for brevity and clarity. Adeel Faruki, MD. Assistant Professor of Anesthesiology at University of Colorado Anschutz Medical Campus (Aurora): Reimbursements are not matching inflation rates. I believe 2023 will be the year providers will fight harder for better rates in contracts with insurance companies. If negotiations don't go well, these providers may even opt out from certain contracts, resulting in more out-of- network providers for patients. Alejandro Fernandez. CEO of Synergy Orthopedic Specialists (San Diego): In general, I believe that the healthcare business will continue to be strong given the supply and demand in the market. e trends that keep me up at night are Medicare and payers continuing to squeeze physician reimbursements; shortages of physicians and professional staff; increased costs in both wages and cost of goods; and cyber threats to our infrastructure and electronic patient records. Alfonso del Granado. Administrator and CEO of Covenant High Plains Surgery Centers (Lubbock, Texas): I'm wary of the increasing incursion of robotics into procedures that could be done laparoscopically. Although we have robots for our total joints program and our general surgery service line, these were necessary to bring new volume into our centers, especially total joints. But of course the added expenses are not accompanied by concomitant increases in reimbursement rates, so we work with our surgeons to limit the number and types of cases that get scheduled on the robots. I should note that our general surgeons have been excellent partners in communicating the rationale for every robotic case, but it behooves everyone to keep an eye out to protect against robotic mission creep. Christina Holloway, RN. Corporate Clinical Coordinator of Ambulatory Surgery Center of Bala Cynwyd (Pa.): e increase in retail healthcare options is heavily weighted on both ends of the spectrum. More opportunity for service and reduced cost could have a positive impact on surgical scheduling. Medical clearances and preoperative diagnostics for patients without established primary care are cumbersome and oen delay established dates of service. e hesitation in support of this trend is related to the increased responsibility of the patients to manage his or her own medical oversight; random care options that benefit acute issues or needs prevent continuity and oversight, which presents a higher level of instability and potential for error. Curt Collins. COO of Palmetto Surgery Center (Columbia, S.C.): Staffing without a doubt. It seems that more and more healthcare professionals are still traveling, which takes away the opportunity to attract local talent. is makes it difficult to operate safely at full surgical capacity, especially since we have 38 surgeons on our medical staff that want time. Daniel Larose, MD. CEO of Advanced Surgery Center (Omaha, Neb.): is does not apply only to 2023, but the increase in Medicaid coverage forms a significant block of the market that is harder for ASC to treat. For instance, in Iowa, oen the total reimbursement on procedures with implants is a fraction of the cost of the implant alone. As the number of patients on Medicaid increases, mainly because of ObamaCare, the number of patients that ASCs cannot afford to treat increases as well. Oen these patients are treated at the hospital at a greater cost. Joe Peluso. Administrator at Aestique Surgery Center (Greensburg, Pa.): • Recruitment and retention of professional, qualified staff • Capital investments for state-of-the-art technology • Supply chain challenges • Payer contract negotiations • Enhance patient experience Mark Morgan. COO of St. Mary's Huntington (W.Va.) Internal Medicine Group: Financial performance, government regulations, staffing and salaries. Paul Hiltz. CEO of NCH Healthcare System (Naples, Fla.): Trends I'm wary of would include the growth of private equity in the physician space and how that will impact physician practices. n Oregon's ASC loss: Here's what happened By Claire Wallace S ince 2020, the state of Oregon saw a decline in the number of ASCs in the state, according to data from the National ASC Association. Oregon lost more ASCs than any other state in the period, outpacing Wisconsin, which came in second. Becker's spoke with the Oregon Ambulatory Surgery Center Association's executive director, Chris Skagen, on factors contributing to Oregon's decline in ASCs. Editor's note: Response has been lightly edited for clarity and length. Question: Why do you think Oregon lost ASCs between 2021 and 2022? Chris Skagen: Looking at general trends, surgery center density has a direct correlation to population density. Oregon did experience a fall in general population numbers from 2021 and 2022. Additionally, Oregon tends to highly regulate ASCs on the state level as compared to other states, which may have an impact on the opening of new facilities. And industrywide, we have seen a large amount of consolidation in the market. Some of the facilities that closed down may be attributable to consolidation of several facilities that are owned and managed by the same company. OASCA has a continued, assertive presence for the ASC industry throughout Oregon. The ASC model is alive and strong within the state of Oregon generally speaking, and the association has seen stable utilization numbers overall. n

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