Becker's ASC Review

7 ASC MANAGEMENT hospital setting compared to a single-specialty or multispecialty group, according to Physicians rive's "2023 Physician Compensation Report." Hospital-employed orthopedic surgeons earned $675,000 while single-specialty group surgeons earned $650,000. Multispecialty physicians earned $663,000. • Despite this reported gap in pay, many orthopedic surgeons still value the autonomy of independent practice over employment by hospitals or large health systems. • "As a leader of one of the largest independent practices in Colorado, I hope we will continue to show growth in physicians," Brian Larkin, MD, chief medical officer at Denver-based Orthopedic Centers of Colorado, told Becker's. "I have regular conversations about all the options that exist and am oen told the same things. Hospital employment sounds great early, but ultimately is challenged over the long term by many factors the surgeon cannot control (allocation of resources, PCP referrals, potential for reimbursement to reduce). Private-equity backed groups continue to struggle with how to recruit into a group aer the initial private equity investment, when future partners cannot realize the initial benefit. ASC growth will continue, but I do not believe that they will be large employers of orthopedic surgeons. Alignment with health insurance entities through MSO relationships has an opportunity to grow as well." n The hurdles, opportunities defining ASCs today By Patsy Newitt ASCs are balancing both promise and pressure as they expand their role in the healthcare landscape. Two leaders joined Becker's to discuss where the industry must focus next to overcome challenges and unlock untapped potential. Editor's note: These answers were edited lightly for clarity and flow. Question: What are the most pressing challenges and the biggest untapped opportunities shaping outpatient and ASC care today? Tracy Helmer, BSN, RN. Administrator of Tri City Cardiology Surgical Center (Mesa, Ariz.): We have seen movement this year, but the continued study and advancement of proper cases into the outpatient setting is the challenge and the goal. When we can migrate the correct procedures into the space, giving patients a true choice of where to get their care, then we will have accomplished something great. Patients deserve this. It is encouraging to see it moving this direction but much more needs to be done. Safety and efficacy needs to continue to be the primary goal for every ASC and that will help us tap into the cases that belong in our environments. Allyn Wilcock, CRNA. Owner of Advanced Anesthesia Services and Northwest Healing and Wellness (Snoqualmie, Wash.): As I talk with administrators at various ASCs, regardless of the specialties they serve, staffing remains one of the biggest challenges they mention. The ability to secure reliable, affordable anesthesia services and consistent, but flexible nursing and operating room staff is a key differentiator between ASCs that will thrive and grow in the coming years and those that will struggle to survive. While the anesthesia labor market is expected to stabilize in the coming years, in the short term, obtaining reliable anesthesia coverage will remain a top priority. ASCs that are now paying significant stipends for anesthesia coverage rightfully expect more from their anesthesia group. Excellent communication, simple but thorough patient screening processes and data-based quality assurance and improvement initiatives should now be expected from an ASC-based anesthesia group. Partnering with an anesthesia group that can provide value above the anesthesia care they provide is an untapped opportunity for ASCs. n How ASCs can expand without sacrificing autonomy By Francesca Mathewes I ndependent ASC owners looking to expand their practice face a difficult set of circumstances in 2025 as hospitals, health systems and corporate entities grow their influence over the market and the cost of operations continues to climb. Joe White, CEO and founder of Send-It Healthcare, a physician staffing marketplace, recently joined Becker's to discuss the ways that ASCs can expand their operations while maintaining their independence. Editor's note: is response has been lightly edited for clarity and length: Joe White. CEO and Founder of Send-It Healthcare: It really comes down to the fundamentals: improving revenue and managing costs. A strong balance sheet gives owners the capital needed to expand operations and reduces pressure to seek strategic partners who may compromise your autonomy. On the revenue side, leverage the emerging analytics companies that benchmark your reimbursement against other centers—use this data to negotiate competitive rates across all contracts. It's also critical to understand and cultivate your revenue stream partnerships. For expenses, you must be vigilant with every line item, especially labor. Create a culture of accountability among employees and vendors. Stay focused on your long-term vision; don't be swayed by market fluctuations or competitor actions. Continuously refine your processes, then refine them again. e best offense is a good defense. e operational habits and systems you build determine your center's defensibility and long-term independence. n

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