Becker's ASC Review

8 13th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference + The Future of Spine – Call (800) 417-2035 2. Hospitals will continue to acquire phy- sician practices for the next five years. For the past few years, hospitals have been acquiring physician practices at a high rate as healthcare reform went into effect. "In anticipation of what healthcare reform will look like, more than what reality may or may not occur, hospitals have acquired physician practic- es," says Jeffrey Simmons, CDO of Regent Surgi- cal Health. "There are physicians who heretofore were not interested in relationships with hospi- tals, but now they are partnering because they're afraid they'll be left out otherwise." But many of the original contracts will come due, and some employed physicians won't renew their contracts. "There will be some who come back into the independent market, but that will be difficult because they don't have their former Medicare numbers or payer contracts," says Mr. Mallon. 3. The Supreme Court and/or a new presi- dent could make significant changes to the current healthcare legislation. A decision is expected late spring in the King vs. Burwell case challenging federal subsidies for the health insurance exchanges, which could dismantle a huge portion of the ACA and have a negative ripple effect across the industry. A Republican — or even a new Democrat — as president could also make changes to healthcare reform's current trajectory. "The good news is, ASCs still represent a strong value for Medicare and Medicaid systems," says Mr. Mallon. "We are less at risk than the high cost academic medical centers or high cost regional health systems." 4. Physicians in specialties that can be in- dependent likely will remain so. Five years ago, many cardiologists were independent, but the independent practice became unsustainable today because professional fee reimbursements were cut so significantly. Could other specialists suffer the same fate? "A mistake was made in a cost study for Medi- care reimbursement for physician-owned cath labs and various tests cardiologists owned that enabled them to stay independent despite their professional fees being fairly low," says Mr. Mal- lon. "That's what pushed the cardiologists into a hospital-employed mode. Unless the cost-con- tainment panel does something similar to ortho- pedic surgeons or ENT physicians, the groups that want to be employed have already done their deals and the rest want to remain independent as long as they can." 5. ASCs could be part of accountable care organizations in the future. ACOs are still in their infancy in most markets, but the focus on improving quality and lowering costs could make them, or similar initiatives, more pervasive. ASCs could align with hospitals or large medical practice groups that have risk contracts under the new health plans. "If more ACOs come to fruition, I see ASCs hav- ing exclusive relationships with large medical groups that would have ownership or exclusive contracts," says Mr. Simmons. Currently, however, Regent centers haven't been hugely impacted by narrow networks or ACOs. n Healthcare Reform Marches On — 5 Key Observations for ASCs in 2015 & Beyond (continued from cover) Jeffrey Simmons Thomas Mallon HCA Defeats Opponents: 5 Key Notes on TriStar Southern Hills Medical Center's $17M Project By Carrie Pallardy D espite several dissenters and a denial from the Tennessee Health Services and Development Agency, Hospital Corporation of America's TriStar Southern Hills Medical Center will be moving forward with a surgery center project, according to a Nashville Business Journal report. Here are five things to know about the project. 1. HCA purchased a $65 million site for the medical center's free- standing and surgery center project last year. 2. The Tennessee Health Services and Development Agency denied the medical center's certificate of need application for a freestanding ED. 3. But now, the state department has approved a CON for the South- ern Hills Surgery Center to be relocated to the former AIG campus near Brentwood, Tenn., according to the report. 4. Opponents of the project include Vanderbilt University Medical Center in Nashville, Tenn., Williamson Medical Center in Franklin, Tenn., and a number of surgery groups. 5. The surgery center relocation project is expected to cost $17 mil- lion. n

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