Issue link: https://beckershealthcare.uberflip.com/i/1528790
10 THOUGHT LEADERSHIP The future of ASCs in 1 word By Patsy Newitt Five ASC leaders joined Becker's to discuss the future of ASCs. Question: What is the future of ASCs in one word and why? Editor's note: These responses were edited lightly for clarity and length. Trina Cole. Administrator of St. Luke's Surgicenter Lee's Summit (Mo.): Challenging. There continues to be movement of cases to the outpatient setting. In relation, we are seeing increased costs of implants, supplies and anesthesia coverage, and a decrease in reimbursements. Although I agree that these cases need to move to this setting, the challenge is to remain profitable and sustainable for both the system and the investors. Deann Davis. Administrator of Surgical Care Center (Painesville, Ohio): Adaptability: The ASC industry is becoming more adaptive due to the expansion of services that are being performed at ASCs. James O'Leary, MD. CEO of Real Doc Speaks: The future of ASCs, in one word, is value. ASCs offer patients tremendous value compared to hospital outpatient departments. The ASCs charge a significantly lower fee than HOPDs, and this is becoming increasingly important for patients. Many patients have a high-deductible plan or have high co-pays or co-insurance costs. Self-funded plans pay the entire claim, and it is always smart to be careful about your employer's money, as high health costs reduce money available for raises. The other value proposition of ASCs includes greater convenience and efficiency compared with an HOPD. Patients spend less time in an ASC and that leads to patient and family satisfaction. Vladimir Sinkov, MD. Founder and CEO of Sinkov Spine Center (Las Vegas): Bright (mostly). As spine surgeries are becoming less invasive, they will migrate more and more into the outpatient arena, including more complex procedures such as fusions. Declining reimbursements (relative to the increasing overhead costs) and consolidations may, however, slow down this growth. Cherilyn Smith. Administrator of St. Johns Surgery Center (Fort Myers, Fla.): Questionable. The future of ambulatory healthcare faces potential uncertainty. While it may be preferred to stay far away from politics, especially in these seemingly volatile times, unfortunately, healthcare and the ASC realm particularly may not escape from its clutch and the effective government policies it may bring. n What market trends are disrupting ASCs? By Patsy Newitt From site-neutral payment reform to consolidation, four ASC leaders joined Becker's to discuss the market trends shaping the ASC industry. Question: What market dynamics are affecting ASCs the most right now and why? Editor's note: ese responses were edited lightly for clarity and length. Deann Davis. Administrator of Surgical Care Center (Painesville, Ohio): Cost effectiveness and the convenience of outpatient care are affecting most ASCs right now. Reduced overhead expenses and the elimination of the need for inpatient care, which contribute to more affordable healthcare without compromising the quality of medical services provided. Patient preference and advancements in surgical techniques also reduce the need for prolonged hospitalization which is cost-effective. James O'Leary, MD. CEO of Real Doc Speaks: e market dynamic that is affecting ASCs now is the lack of site-neutral payments. Hospital outpatient departments are reimbursed significantly more than ASCs for the identical service. is makes no sense, and this kind of nonsense only occurs in healthcare. ere should be one fee paid to both ASCs and HOPDs and that fee would be lower than the current HOPD fee and higher than the ASC fee. e other market issues are medical inflation and difficulty obtaining anesthesia services. Vladimir Sinkov, MD. Founder and CEO of Sinkov Spine Center (Las Vegas): e volume of spine surgeries at ASC is growing. ere is, however, a lot of consolidation going on as well. As independent ASCs are getting purchased by large firms or hospital systems, there will be less competition which will inevitably lead to higher costs and lower quality. is will slow down the growth to a degree as there will be less difference between performing a spine surgery at an ASC versus HOPD. Cherilyn Smith. Administrator of St. Johns Surgery Center (Fort Myers, Fla.): Today's market dynamics scream apprehension as inflation teeters and consumer credit debt continues to rise, and with a change of administration or a continuation of the same, either could have far-reaching impacts. e care provided by ASCs is elective, mostly covered under private or federal insurance plans, and while the way has been paved through a decades' long struggle for a more even playing field of reimbursements, that goal remains far from reach today. Proposals for possibly eliminating private insurers and/ or advocating for a single-payer system for all could prove grossly detrimental to the ambulatory realm. Far too many rural and smaller healthcare facilities have tragically fallen prey to the dynamics of financial impediments while nearly a quarter of healthcare companies backed by private equity filed for bankruptcy last year. Even larger healthcare corporations are not immune from fiscal demise. Ambulatory centers are for-profit operations and to remain solvent, the cash must flow, either from contracted private insurers, increased federal reimbursements or the almighty self-pay. Whoever succeeds in power in the coming months may have a large influence on that potential on an already struggling healthcare battlefield. n