Becker's ASC Review

15 THOUGHT LEADERSHIP factor have been slashed continuously each year despite the amount of paperwork that the doctors and practice must comply with. In addition, this causes a lot of burden on the practices to be able to deliver quality care with low reimbursement and increasing expenses. I am not aware of any evidence that slashing the reimbursement or conversion factor will improve patients' outcomes. I just have to adapt and try to cut the expenses without interfering with my patients' care. James Tinsley, MD. Family Physician at Lighthouse Direct Primary Care (Newport News, Va.): As a family physician I went under twice with high enrollments of Medicare patients and had to leave the practices with outrageous noncompetes. Once with a 35 percent Medicare empanelment and the other with a 55 percent empanelment. If you have an older car, it costs more to repair because there is more wrong with it and the mechanics have to spend more time repairing the older car. So why aren't MDs paid more to care for the elderly? My children can no longer afford for me to accept Medicare, so I opted out. n Why the future of surgery lies within ASCs — not hospitals By Riz Hatton The ASCs of the future could potentially be the premier site of surgery for most patients. Cathy McCue, MSN, RN, administrator of Uropartners Surgery Center in Des Plaines, Ill., connected with Becker's to discuss the ASCs of the future. Editor's note: This response was lightly edited for length and clarity. Question: What will the ASCs of the future look like in 10 or more years from now? Cathy McCue: I see the ASC of the future as the premier institution a patient chooses for surgery. Hospitals will only be utilized for chronically ill patients with comorbidities. Even today, many ASCs are becoming 23-hour ASCs, allowing more and more complex procedures to be performed there, including robotic procedures. As patients and insurance carriers become more educated on ambulatory surgery centers, they will ask their physicians to send them to an ASC or their insurance carrier will require them to go to an ASC for surgeries. As more surgeries are streamlined or new ones created that fit the ASC requirements, the complex procedures currently done in hospitals will be moved to ASCs. Since ASCs have basically a 0 percent infection rate, are extremely efficient and cost less than hospitals, it becomes a win-win for all involved. n 'ASCs are not new': What people get wrong about surgery centers By Patsy Newitt L es Jebson, regional administrator at Greenville, S.C.-based Prisma Health, joined Becker's to discuss the misconceptions of ASCs and how declining physician pay could affect the industry. Editor's note: ese responses were edited lightly for brevity and clarity. Question: What misconception do people have about the ASC industry? Les Jebson: One of my professional goals remains in informing and educating colleagues and consumers alike about the value proposition that ASCs provide in the care of patient populations. ASCs are not new. However, innovation and advancement in procedural-based care — device materials, anesthetics, techniques — are allowing ASCs to be a valuable component of overall integrated care delivery. When I started my career, joint replacements were four- to seven-day hospital stays. e aforementioned advancements have allowed patients to receive a new joint and return home the same day. If their acuity is such, they can still have joint replacement surgery in a hospital and utilize the infrastructure that the hospital setting affords. us, the systems are designed around providing the best care in the most appropriate care setting. Some additional misconceptions I note are that ASCs do not have to adhere to the same standards as their sister hospitals. Congruently, only simple cases can be performed in ASC settings. I think the advancements in heart procedures, orthopedic procedures and ophthalmology demonstrate that higher complexity care can be provided in an ASC setting. Q: How will declining physician pay affect the ASC industry? LJ: CMS and some commercial payer changes may create some cost pressures, but I do not believe it is immediately impacting physician compensation. Typically, ASCs have very linear services that they provide. By providing high-volume repetitive procedures, the ASC setting may allow for greater efficiencies and throughput, which in turn can negate reductions in some payer rates. Independent physician groups with joint ventures may recognize these declines more than those in larger integrated care delivery systems. n

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