Issue link: https://beckershealthcare.uberflip.com/i/274954
8 12th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference + The Business of Spine - call (800) 417-2035 ASC Ownership Trends: Are Physicians Making the Investment? (continued from cover) A key driver in evaluating the ASC market and investment potential is to look at the underlying foundation, meaning the role of ASCs in the fu- ture of healthcare. We all know the challenges fac- ing healthcare in our country, specifically the ris- ing cost of healthcare. Care provided in traditional acute care big box hospitals is expensive when compared to the same procedures performed in an ASC. As payers (government and private) look more and more to quality outcomes, patient sat- isfaction, as well as price to determine the most appropriate site of service, you have to believe that ASCs are well positioned to be part of the solution. ASCs provide the right care at the right price with great outcomes. Couple these factors with the ev- er-increasing list of ASC-approved procedures and we believe more and more cases can, and should, be performed in an ASC and that makes ASCs part of the solution. We believe that we will get to the point where cases are required to be performed in the lowest cost, most appropriate setting with the best outcomes. Q: is it a good time for physicians to buy or sell ownership in ASCs? EG: This would depend on the specific situation but, in general, we think it is a good time for physi- cians to be part of an ASC, and if they are not cur- rently involved in one, to either join one, start one or affiliate and start doing cases at one. Q: What advice do you have for current phy- sician owners to improve their investment? EG: For an existing ASC, look to become part of a bigger network, and that does not necessar- ily mean a health system's network. Look to be a part of a wider network of like-minded providers and facilities to connect to other providers and the consumers. Those networks are out there, and we are building them. Have a succession plan for when partners leave or retire before someone announces they are leaving or retiring. Be nimble and not rigid. Healthcare is changing, reimbursement is changing, technology is changing rapidly; be ready to adapt, but also plan for the future. Look forward and think about what you can do or what might be possible, not just what you did in the past. Work with a great healthcare lawyer who can guide you safely though the regulatory environment and transactions. For a new ASC: Pick your partners carefully, whether "partners" means other surgeons, corpo- rate partners/management companies or hospi- tals/systems. Look for a long term philosophical fit, not just the biggest short term payday. Look for other physicians that want to support your ASC and are not in multiple other ASCs. Look for those physicians who are genuinely and passionately concerned about outstanding patient care and outcomes. Look for physicians who are not difficult to work with, even if they are busy. If they cannot or will not work well with the other physicians or the staff, they will likely become problematic at some point. Look for a corporate partner or management company that has a vision for more than just your ASC, but also for your practice and your patients. Will they help your ASC grow and will they help your practice grow? Will they help you to secure your referral base and connect your practice and your ASC to consumers, be they patients, employers or others? Ask them how they will do that. If it is a hospital/system, try to understand their real motivation for wanting to partner with you. Do they really want to be your partner or just eliminate you as a competitor? How have they treated you in the past? Think hard if the relation- ship will work long term. Hire a great progressive thinking healthcare transaction lawyer. Q: What do you think will be the predomi- nant ownership arrangement for surgery centers this year and in the next few years? EG: A number of variables will determine the best fit for a particular ASC. Each group will deter- mine which variables are most important to them but some to be considered include: 1. The level of independence desired by the physicians. Some physicians wish to remain independent and free of the local hospitals/ systems, while some want the perceived secu- rity of partnering with a hospital/system. 2. Current local politics or relationship dy- namic with their local hospitals or systems. If the local hospital is, or is perceived by the doctors to be progressive thinking and phy- sician-friendly, they may find a way to work together. Many times the relationship with the local hospital can be chilled or even ad- versarial, in which case partnering with one another is not likely to produce a good long term result. Q: Are there any other trends you are see- ing in terms of physician relationships with surgery centers? EG: In the last few years with the debate over healthcare reform and the passage of the Patient Protection and Affordable Care Act many physi- cians were rightly wary of the unknown, and we saw some degree of flocking to the hospitals and systems looking for a safe haven to mitigate their uncertainty, with the perceived stability of a hos- pital or system. While that uncertainty is not completely gone, physicians are a little less nervous and are looking again at more options than just hospitals/systems as their safety net. There remain a large number of entrepreneurial and independent minded physi- cians that are open to forward thinking proactive solutions and who do not necessarily see hospital/ systems as the only solution. In summary we are still bullish on ASCs and be- lieve they are part of the solution to the country's healthcare challenges. n 12th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference + The Future of Spine June 12-14, 2014 • Chicago To learn more or register, visit www.beckersasc.com/beckers or call (800) 417-2035 132 Sessions • 168 Speakers • 63 Physician Leaders • 28 CEOs Keynote Debate: Former U.N. Ambassador & Republican Diplomat John Bolton Former Six-Term Democratic Governor of Vermont Howard Dean "In general, we think it is a good time for physicians to be part of an ASC and if they are not currently involved in one, to either join one, start one or affiliate and start doing cases at one." — Eric Gleichman, Nuterra Healthcare's U.S. operations.