Becker's Spine Review

19 ASC Hospitals target ASCs with new proposals By Laura Dyrda O utpatient revenue for hospitals and health systems jumped 10.6% year over year in January, as hospitals continue to see more complex procedures become safe in the outpatient setting, according to Syntellis. Some health systems are developing ASCs while others are partnering with national chains. It requires a financial investment to build a new surgery center, which won't achieve the same reimbursement rates as hospitals or hospital outpatient departments. e costs associated with employing physicians is also on the rise, and hospitals with tight margins are contacting local physicians and surgery centers with creative ideas for partnerships. "Hospital systems continue to face significant headwinds from payers and employers to aggressively shi elective patients into lower cost settings, such as spine and joint replacement cases into ASCs," said Michael Boblitz, CEO of Tallahassee (Fla.) Orthopedic Clinic. "ese pressures are causing hospital systems to quickly reevaluate employed physician practices that have not directly covered costs for many years." Mr. Boblitz told Becker's he is seeing more systems seek partnership models with large private practices with the scale to deliver value while also removing the traditional financial losses associated with those services. "I am receiving these calls and excited to support our hospital partners," said Mr. Boblitz. Ali Ghalayini, administrator of Munster (Ind.) Surgery Center, which focuses on pain management, sees the outpatient shi as well. "ere's an accelerating trend of procedures shiing away from hospital settings to outpatient facilities like ASCs. is shi is driven by advancements in minimally invasive surgical technologies, allowing safer procedures with faster recovery times," he said, noting another motivating factor is the cost savings for both providers and patients. "is trend is particularly relevant for our center as it underscores the demand for ambulatory surgery services, presenting opportunities for expansion and specialization in pain management procedures," Mr. Ghalayini said. Joseph O'Brien, MD, medical director for minimally invasive orthopedic spine surgery at Virginia Hospital Center in Arlington and a spine surgeon with OrthoBethesda in Bethesda, Md., is seeing more energy around partnerships between hospitals and physicians as care moves outpatient. "Co-ownership aligns physicians with the economic realities of healthcare. ASCs allow doctors to share in the profitability of the center and have a synergy that may not be present in the hospital setting," he said. Health systems focused on value-based care and aiming to send patients to high quality, low cost sites of care are looking for ASCs and physician groups aligned with their mission for partnerships. "As we enter 2024 and are preparing to face the second half of the decade, I am energized to see so much focus in healthcare on areas that I really think will bring value to patients and communities around the country," Kevin Flemming, vice president of Orthopedic Institute at AdventHealth in Orlando, told Becker's. He said the system is focused on investing in developing a sustainable workforce and finding the right partners to align with for growth. "Finding the right partner, be it another health system, an industry vendor or a physician organization that shares an aligned mission and similar values can create synergies that become a strategic advantage in the dynamic healthcare ecosystem. e most creative solutions in this space will be exciting and fun to watch." n ASC leaders remain wary of reimbursement trends By Riz Hatton Reimbursement challenges are among the biggest trends ASC leaders are watching. Note: These responses have been lightly edited for length and clarity. Pete Bekas. Administrator of Fort Apache Surgery Center (Las Vegas): I am watching labor shortages, particularly in nursing and technicians. Organizations are focusing on flexible work arrangements and wellness initiatives to attract and retain skilled professionals. Meanwhile, reimbursement strategies are shifting toward value- based care models, incentivizing quality outcomes over volume. Yet most payers are still fee-for-service and continue to lower reimbursement rates. Bruce Feldman. Administrator of Bronx Ambulatory Surgery Center (New York City): The top trends we are seeing in healthcare right now is an increase in the types of surgical cases that are moving from the hospital setting to the ASC setting. This is most notable in the areas of spine and cardiovascular procedures. My concern, however, is that reimbursement for these procedures is not comparable. The other major trend is the continued shortage of anesthesiologists, which has led to many surgery procedures having to be canceled and/or postponed both in the hospital as well as ASC setting. Tricia Wollam. Clinical Administrator of Alliance Surgery Center (Traverse City, Mich.): For 2024, the trends I am following are the continued rise of anesthesia provider cost as well as the decrease in reimbursement rates for anesthesia services. The shortage of surgical technicians and the impact it has on surgical services. A positive trend I continue to follow is the existing growth of ASCs. Patients are continuing to become engaged consumers on their healthcare options and the advantages ASCs offer. n

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