Becker's ASC Review

11 THOUGHT LEADERSHIP Why aren't there more cardiovascular ASCs? By Riz Hatton C ardiology has been recognized as a prime growth specialty for ASCs, so why aren't there more cardiovascular-focused surgery centers? Cardiology is the fastest-growing ASC specialty, according to Avanza's "2022 Key ASC Benchmarks and Industry Figures" report. Though the speciality has gained popularity in the surgery center space, it has yet to become commonplace. Prashanth Bala, vice president of ASC operations at Shields Health in Quincy, Mass., spoke with Becker's to discuss why this is the case. Editor's note: Responses have been lightly edited for length and clarity. Question: Though outpatient cardiology is becoming more common, why aren't cardiovascular-focused ASCs an industry standard at this point in time? Prashanth Bala: I think we're gonna see that happen over time. But I think one of the number one reasons, at least what we're seeing here in the Massachusetts and New England market, is that most of those cardiologists or cardiovascular surgeons are employed by hospitals. So it makes it harder for them to break free and do something separately. If they're employed by the hospitals, and or since they're employed by hospitals, unless the hospital or the health system wants to do freestanding facilities such as an ASC focusing on cardiovascular, it typically isn't done or isn't seen. So though it is sort of becoming a national trend, you're seeing that happen more amongst the private groups. They're doing remarkably well and they're showing that the quality of care that can be performed in the outpatient setting is as good as, if not better than, some of the hospitals. It's the same providers doing great high-quality care, just in a different location. Q: What is pushing cardiovascular procedures to ASCs? PB: I think it starts with the payers. Medicare, for example, has included those CPT codes now on the outpatient ASC fee schedule, allowing for those procedures to be reimbursed. If they're being reimbursed, you're finding providers now taking advantage of that, and moving those cases into a location that they can better control or to gain efficiencies from. First and foremost is that Medicare now reimburses several cardiology related CPT codes. But secondly, something that you have to keep an eye on is our state regulations. State regulations either allow you to move [cardiovascular procedures] into an outpatient setting or restrict the types of procedures that can be performed in the outpatient setting. That may be another reason why you're not seeing too many of those cardiovascular ACS popping up just yet. I think there's still room for growth and opportunity, but I think it's going to be a state-by-state determination of whether these are prevalent or are really great opportunities. You are seeing a small subset of providers in the vascular space, taking advantage of the office based labs, and I think you'll see that continue to be prominent in the workplace as long as reimbursement is there. So to your question about what's pushing it, it's really the opportunity to be reimbursed. n What ASCs need most right now, per 6 leaders By Paige Haeffele S ix healthcare professionals joined Becker's to share what the ASC industry needs most, from training and retaining staff to technological upgrades and other necessities. Q: What do ASCs need most right now? Editor's note: Responses have been lightly edited for length and clarity. Kimberly Cantees, MD. Vice Chair of Equity, Diversity and Inclusion, and Clinical Director, University of Pittsburgh Medical Center Presbyterian Hospital: ese are unprecedented times in healthcare. Hospital profit margins for 2022 were historically low, and 2023 is not forecasted to improve. However, as we move to a more value-based/patient centered experience in healthcare in general, it makes sense to move high revenue generating cases from the hospital to ambulatory surgery centers for the "patient experience." is could include traditional inpatient procedures such as joint replacement, minor spine surgery, urologic procedures, and gynecologic and general surgery procedures, to name a few. In order for an ambulatory surgery center to be successful in this next phase, two things will be necessary. First, a review of all local, state and national requirements for care has to be reviewed and in some cases challenged in order to care for these patients outside of the hospital. Secondly, as more complex cases are performed in ambulatory surgical centers, the individual patient's stay might exceed the traditional work hours of care in an ambulatory surgical center. is will be a shi in the labor paradigm for those individuals working in this environment. Garth Dahdah. Senior Director of Facilities and Planning, the Ohio State University Wexner Medical Center (Columbus): Ambulatory surgery centers need several things at the moment to continue providing high-quality healthcare services: Adequate staffing: ASCs need enough staff, including nurses, anesthesiologists and surgeons, to handle surgical procedures and provide patient care. Staffing challenges put a strain on ASCs. Financial support: ASCs are facing economic challenges due to

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