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10 ASC MANAGEMENT 3 Biggest Opportunities for ASCs Today and 4 Healthcare Reforms That Will Affect ASCs Most in the Future By Laura Dyrda S cott Kulstad, executive director of musculoskeletal services at Minneapolis-based Fairview Health Services and a member of the board of directors for Minneap- olis-based Ridges Surgery Center and Fairview Maple Grove (Minn.) Surgery Center, discussed how to approach strategic planning in today's volatile healthcare environment and what to expect in the future. Question: What future healthcare reforms do you expect to affect ASCs and physicians the most? Scott Kulstad: e next several months, I believe we will see the following reforms: • Reimbursement will continue to decline, and payment parity will accelerate the migration of cases to the outpa- tient/ASC settings; • Medicare will remove "inpatient only designation" on certain procedures (i.e., TKA), which will accelerate the migration of cases to the OP setting; • Employers and payers will direct cases to lower cost set- tings more than they have historically. • Technology will (continue to) transform how, when and where patients access care, information and engage with providers, including those in the ASC. Q: Where is the biggest opportunity for ASCs to suc- ceed in healthcare today? SK: No. 1: collaboration with hospitals. e systems will work best when there is equilibrium, collaboration and clinical integration. No. 2: appropriate titration of cases. e ASCs will succeed when they appropriately titrate the cases that can — and should — move from the HOPD to the ASC with those that should remain in the hospital outpatient department. ere is plenty of volume that will move out of the hospitals, but ASCs that move clinically inappropriate cases to the ASCs will risk losing more than they gain if/when there are complications. No. 3: Maintain focus on high-reliability systems to ensure cost effectiveness, high quality outcomes and patient safety. n 39% of ASCs are 15+ Years Old, 92% Have Physician Ownership: 14 Statistics on ASCs By Laura Dyrda M ost ASCs have at least partial physician ownership and are 10 or more years old, according to new data from ASCA. Based on ASCA's 2017 Salary and Benefits Survey and ASCA's Clinical and Operational Benchmarking Survey, here are 14 quick statistics on ASCs today: ASC ownership 1. ASCs with partial or full physician ownership: 92 percent 2. ASCs with hospital owners: 24 percent 3. ASCs part of a corporate chain: 16 percent Location 4. Suburban or small city: 59 percent 5. Urban area: 27 percent 6. Rural area: 15 percent Years in operation 7. Longer than 15 years: 39 percent 8. 11 to 15 years: 23 percent 9. Seven to 10 years: 19 percent 10. Three years or less: 10.9 percent Size 11. 3,501 to 7,500 square feet: 24 percent 12. 10,001 to 15,000 square feet: 20 percent 13. 15,001 to 25,000 square feet: 18 percent 14. Larger than 40,000 square feet: 2 percent n 5 Statistics on Ophthalmology Net Revenue per Case at Multispecialty ASCs By Eric Oliver V MG Health's 2017 Intellimarker Multi-Specialty ASC Study included statistics on ASC revenue per case for ophthalmology. Here are five statistics on ophthalmology revenue per case: • Mean: $1,512 • 25th percentile: $1,235 • Median: $1,434 • 75th percentile: $1,716 • 90th percentile: $2,082 n

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