ASCs interested in maintaining independence may first want to consider why they desire to maintain autonomy — because partnering may ultimately better serve the community and the surgery center's interests.
"Consider the relationships the ASC's physicians have with the community's hospitals," suggests Rob Carrera, president and CEO of Pinnacle III. "Payers are more inclined to offer sustainable contractual terms to ASCs that offer value that's unique to that market."
A market's dynamics will encourage an ASC's fight for independence or squash the very idea. Mr. Carrera says about three-quarters of the development project inquiries received by Pinnacle III involve joint ventures, with the remaining 20 percent to 25 percent of prospects seeking independent ventures.
Single specialty or multispecialty?
Although Mr. Carrera is seeing a trend toward partnerships, he believes both single specialty and multispecialty ASCs can hold their own in the right market. Multispecialty centers diversify procedures and potential risk, but single specialty centers can also be successful given favorable market conditions.
"If your single specialty ASC can corner the market in a select geographical area, you may have a strong opportunity to remain independent," observes Mr. Carrera.
An orthopedic ASC, for example, may find success by offering the gamut of orthopedic services, from professional services to surgery to rehabilitation. Single specialty centers may be able to offer bundled service options, concentrating its specialty expertise in a single continuum of care.
Alternatively, multispecialty ASCs possess the advantage of offering a range of services in various specialties. "This works particularly well if your ASC has the lion's share of all the specialties," Mr. Carrera notes.
Future outlook
Closed systems or exclusive plans may present obstacles for an ASC's dream of independence, but the benefits of independence can be tempting in this tumultuous healthcare landscape.
"Independent ASCs are not locked in to a particular hospital or system," says Mr. Carrera. "You may be able to exist as a free agent and remain outside of the politics."
With consolidation entangling more sectors of the industry, many physicians aren't keen on letting go of their independence without a "real clear vision of what healthcare is going to be in the future."
Mr. Carrera isn't certain what the future holds for healthcare and the ASC industry. Although health systems continue to grow, he wonders whether the market can sustain it.
"The overhead created by consolidation may weaken them unless they are able to create significant market efficiency," says Mr. Carrera.
For those ASCs entering partnerships for more security in the industry, Mr. Carrera cautions to choose carefully. Consider the outcomes of the partnership, and position the center so "you're still going to be happy with that move."