Becker's ASC Review

12 THOUGHT LEADERSHIP resources and expertise, leading to more robust and efficient operations. Not only does consolidation enhance operational efficiency, but it also allows ASCs to negotiate better reimbursement rates with payers, invest in technology and attract top talent, ultimately benefiting both patients and healthcare providers. To sustain growth and continued success, ASCs will need to navigate the complexities of the healthcare system and adapt to regulatory changes and market dynamics. While challenges may arise along the way, I believe the demand for safe, high-quality care will drive the continued growth of ASCs. Marie Todd. Administrator of Robotic Orthopaedic Institute (St. George, Utah): • Posted pricing for bundled case surgery across all specialties in the ASC with a cash-pay discount program that requires full payment in advance. I just worked on the document set for an ASC this morning. • Direct with employer/union/TPA contracts, with patient redirection (possibly involving medical travel) and full payment in advance of the surgery (I just worked on contract templates for this at 0430 this morning). • Robotic-assisted joint replacement surgery service lines addition or expansion. I've been doing these deals in my ASCs since the 1990s, but now they are taking flight. ese cases add millions to the bottom line outside of Medicare and managed care contracts if one pursues these business development opportunities. ey almost eliminate the need to accept Medicaid and push business to the not for profit hospitals in the area and their employed surgeons. Unless the ASC has a huge compelling pediatric service line, straight medicaid and Medi-Medi cases can go to the community not-for-profit hospital. Geogy Vennikandam, MD. Chief Operating Officer of GI Partners of Illinois (Chicago): I believe the greatest growth opportunity in the ASC industry over the next five years lies in expanding high-acuity surgical capabilities and fully embracing value-based care models. Advances in medical technology and anesthesia have enabled more complex procedures to be safely performed in outpatient settings, meeting patient demand while significantly reducing costs. At the same time, collaborating with payers to implement bundled payment models and other value-based care initiatives will position ASCs as leaders in delivering cost- efficient, high-quality outcomes. Additionally, strategic investments in technology – such as AI, data analytics and patient engagement platforms, similar to what we've done at GI Partners of Illinois – will further enhance ASCs' ability to provide patient-centered, high-quality care, making them the preferred setting for complex surgical procedures. Alan Wagner, MD. Founder of Independent Health Alliance (Norfolk, Va): Direct- contracting and fee transparency. Hospital- based/legacy origin bricks and mortar are not likely to be able to compete in price, quality, flexibility and speed of evolution to meet the open competitive market needs and support the providers appropriately. n ASC leaders 'divided' on noncompetes By Francesca Mathewes T he fate of noncompete agreements has been in flux recently as changes to the FTC remain possible under a new presidential administration and the clauses remain the subject of lawsuits in healthcare. Here is where three ASC leaders told Becker's they stand on noncompete agreements: Editor's note: Responses have been lightly edited for length and clarity. Brian Bizub. CEO of Raleigh (N.C.) Orthopaedic Clinic. As we move into 2025, ASC leaders should consider revisiting their approach to noncompete agreements. Rather than relying on traditional, restrictive noncompetes, adopting more flexible alternatives — such as limited noncompetes, non-solicitation clauses, and performance-based incentive — can protect business interests and financial stability, while promoting physician autonomy, improving workforce satisfaction, and complying with evolving legal standards and regulations. Adopting other alternatives to restrictive noncompetes can assist ASCs to stay competitive. Andrew Lovewell. CEO of Columbia (Mo.) Orthopedic Group. This is an area where ASC leaders are divided. From my perspective, in some markets, noncompetes are essential and should be enforced. However, attracting and retaining top talent may mean that the noncompetes have to be limited in some geographic areas. Some people see noncompetes as essential to protect business interests and ensure that the investments in staff, equipment, and technology are recognized. However, others find them to be intrusive and limit career growth. With everything in the complex healthcare space, there will always be a division on some topics — this is one that I see remaining as a divisive topic for years to come. In my opinion, the most important thing ASC leaders can do is focus on creating a balance between business protection and creating an environment of growth and collaboration. Bruce Feldman. Administrator of Eastern Orange Ambulatory Surgery Center in Cornwall, N.Y. I feel noncompetes prevent competition amongst ASCs, especially within the same geographic area. Competition helps ASCs to help distinguish themselves when it comes to clinical outcomes. None should be eliminated. Physicians should be able to bring their patients to those facilities which they deem to provide the best level of care and have the best outcomes for the specific type of procedures they perform. To me, having a noncompete is a form of restraint of trade. n

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