Becker's ASC Review

10 ASC MANAGEMENT Where ASCs can find wins by 2030 By Rosie Talaga ASCs have grown and evolved exponentially in a short span, placing them at the forefront of change in healthcare. Harel Deutsch, MD, co-director of the Rush Spine Center in Chicago, and Greg DeConciliis, PA-C, administrator of Boston Out- Patient Surgical Suites, connected with Becker's to discuss predicted opportunities for ASCs and the headwinds they will face by 2030. Dr. Deutsch and Mr. DeConciliis agreed that spine procedures will be the leading focus for ASCs in the upcoming years. Although surgery centers initially concentrated on lumbar discectomies and cervical fusions, there has been a shi toward more involved surgeries, such as SI joint fusion and multiple level fusions. Dr. Deutsch attributed this growth to technologies that have broadened the range of minimally invasive surgeries, specifically highlighting SI joint fusion as a breakthrough. "Many years ago, that surgery was considered a very big surgery that was open and could never be done in a surgery center," Dr. Deutsch said. "But through technology, a minimally invasive version of it was developed, and that version is very amenable to surgery centers." While many surgery centers are equipped to perform more complex surgeries, the payer and regulatory environments pose obstacles. Dr. Deutsch noted that the lower level of oversight at ASCs compared to large hospitals oen prevents payer approval due to unclear credentials. Additionally, surgeries that could be executed can hit snags related to payments from Medicare and private insurance. "I see the future focus being on making the case to CMS that complex spine procedures can be performed safely in the outpatient setting," Mr. DeConciliis said. "e top growth opportunity is volume, and capturing additional traditionally complex inpatient procedures, or your ability to perform these types of procedures, will certainly increase your volume." In considering the evolution of surgery centers within the healthcare ecosystem, both leaders discussed the trend of developing relationships with hospitals. An increasing number of hospitals are buying or partnering with surgery centers, which can benefit ASCs by becoming part of their referral networks and enhancing patient information interoperability. "I think it's savvy for both hospitals and ASCs to find a way to coexist because there's certainly enough surgical volume to go around," Mr. DeConciliis said. "If there's a way, through a joint venture or an affiliation agreement, it's probably a wise tactic." While surgical volume remains prevalent, the ongoing staffing crisis has pitted hospitals and ASCs against each as they compete for providers. Dr. Deutsch highlighted the lack of anesthesiologists as a primary concern that is limiting the number of procedures in surgery centers. He predicted the shortage will ebb by 2030 but is doubtful it will improve in the near future. Mr. DeConciliis said successful staff recruitment and retention in the competitive market starts with examining an organization's culture. Examining benefits and salaries, conducting employee satisfaction surveys and holding more team meetings are strategies to foster a positive work environment. Increasing volume and lowering costs can incentivize employees to work more, benefiting both the organization and staff. "Overall, I think as an industry, we've gone through periods of stagnation and upticks," Mr. DeConciliis said. "Now we're in this hockey stick uptick in terms of the ability to do more procedures traditionally done inpatient in the outpatient setting. at means more growth for us, and that's been the most exciting part of it." Dr. Deutsch and Mr. DeConciliis will speak at Becker's 30th Annual Meeting: e Business & Operations of ASCs on a keynote panel titled "ASCs in 2030: Top Opportunities, Headwinds and Issues." Join more than 1,000 executive level attendees and 225 speakers to experience their panel and other thought-provoking sessions. n Optum sets sights on Surgery Partners acquisition By Patsy Newitt U nitedHealth Group, parent company of Optum, is one of the potential buyers of Brentwood, Tenn.- based ASC operator Surgery Partners, Bloomberg reported Aug. 23. Sources told Bloomberg that private equity firm TPG is also an interested buyer. Surgery Partners is also drawing interest from other PE firms and strategic bidders. The deal is in its early stages and is not confirmed, according to the report. Representatives for UnitedHealth and Surgery Partners did not respond to Bloomberg's requests for comment. Surgery Partners, which went public in 2015, is the third- largest ASC operator in the U.S., with more than 160 centers and 4,600 affiliated physicians. In 2017, it merged with National Surgical Healthcare, and Bain acquired HIG Capital's stake in Surgery Partners. Optum is the parent company of Deerfield, Ill.-based ASC chain SCA Health, which has a portfolio of more than 320 ASCs and 9,200 physicians. The company quietly purchased at least two cardiovascular providers in 2023, National Cardiovascular Partners and Pivotal Healthcare. Surgery Partners' revenues jumped 14.2% to $762.1 million for the second quarter of 2024. Additionally, its full year guidance was raised to more than $3 billion in revenue and more than $508 million in adjusted EBITDA. "Our year-to-date acquisitions and robust de novo pipeline, coupled with execution on all of our key growth levers gives us confidence in our continued growth including an updated outlook for the remainder of 2024," CEO Eric Evans said in the Q2 earnings call. Becker's has reached out to Surgery Partners and will update this story if more information becomes available. n

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