As the demand for outpatient care continues to flourish, ASC leaders must pinpoint and capitalize on key growth opportunities to drive their businesses forward.
The 31 leaders featured in this article are speaking at Becker's 30th Annual Meeting: The Business and Operations of ASCs, set for Oct. 30 to Nov. 2 at the Hyatt Regency in Chicago.
If you would like to join the event as a speaker, please contact Rosie Talaga at rtalaga@beckershealthcare.com.
As part of an ongoing series, Becker's is connecting with healthcare leaders who will speak at the event to get their insight on pressing questions facing the industry. The following are answers from event speakers, lightly edited for clarity.
Question: What are your best opportunities to grow your business in the next 12 months?
Adam Bruggeman, MD. CEO and Spine Surgeon at Texas Spine Care Center (San Antonio): Direct-to-employer and direct-to-consumer pathways that remove middlemen are improving revenues and adding value to the healthcare system. I see these as our best growth vehicles over the next year.
Jacob Rodman. CEO of Raleigh (N.C.) Neurosurgical Clinic: The best opportunity for us to grow our business in the next 12 months has two focus areas. First is to get back to basics on delivering an exceptional patient experience from start to finish. Superior customer service will be achieved by navigating through a very difficult process. Second is focusing on maximizing the ASC and outpatient procedures. We should continue to see a site of service shift in spine and that will only benefit patients.
Johnny Russell. Director, Area Operations at Sutter Health (Sacramento, Calif.): One way to ensure we are maximizing the business is to review block time. This review allows for necessary modifications based on specialty demands. With volume and access at the forefront, we have reviewed the business hours of operation. The ASC world is changing fast, and operating Monday through Friday from 0700 to 1500 is a thing of the past. Longer hours have become the new norm to meet the demands.
Amanda Ryan, DO. CEO, Owner and Physician at Advanced ASC of Carlsbad New Mexico: As a new rural cardiovascular ASC with a robust office practice, the growth potential in our space is endless. We are set to "go live" with our streaming option, in which family members can watch our cases and one of our trained staff members can guide them as the procedure progresses. Pulling together various technologies in our ASC by promoting system interoperability will streamline our processes and allow for increased efficiency. Participating in the development criteria for cardiovascular ASCs to define and achieve "Center of Excellence" designations is also a goal. Each of these items will assist us in maintaining quality and efficiency while sustaining rapid growth.
Scott Sigman, MD. Orthopedic Surgeon at Orthopaedic Surgical Associates; Founder and Chief Medical Officer at OrthoLazer Orthopedic Laser Centers (Chelmsford, Mass.): At Orthopaedic Surgical Associates, we have joined the private equity-backed MSO Spire Orthopedics. Our mission at Spire is to scale our orthopedic practice success with other like-minded practices with liquidity to expand. We will identify new practice partners, new physician partners and new opportunities for ancillary revenue while providing outstanding clinical care. At OrthoLazer Orthopedic Laser Centers we have hired our new CEO, Rod Mayer, and have completed our series A capital raise. Our strategy is to perfect our center models with slow expansion to democratize laser therapy to improve patient outcomes and drive success with our physician partners.
Sheila Thompson, RN, BS. Practice Administrator at Twin Cities Pain Clinics & Surgery Centers (Edina, Minn.): As we prepare to open our third surgery center this fall, our focus has been to provide surgery center access within 10 miles of all our clinics. We also have been diligently negotiating our payer contracts to add codes for non-opioid therapies. We are fortunate to be working in the pain specialty that continues to be innovative with new interventions and therapies, which allows patients to reduce and eliminate opioid use.
Joseph D'agostino. Administrator, Advanced Surgery Center Perimeter at Northside Hospital (Atlanta): Continuing strategic growth efforts with the pediatric ENT surgeons as a major competitor has helped open a new hospital campus that will likely disrupt the current surgical market and cause substandard experiences for this surgeon base. Establishing a sustainable partnership with new surgeons entering the local marketplace holds the opportunity to bring additional case volume to our facility. We will optimize surgical case volume by the successful launch and implementation of a new block time policy. It includes block time release requirements, allowing our facility to “back-fill” operating rooms with other cases. Lastly, we will focus efforts on syndication and investor partnership potential with the surgeon client base.
Barry Graf. Senior Vice President Partnerships and Business Development at Virtua Health (Marlton, N.J.): We are always evaluating opportunities for growth to support our physician partners and health system. This includes independent physicians and others who understand the benefits of a strategic alignment. We see physician alignment and involvement in decision-making as core guiding principles. We are currently working on both single- and multi-site ASC partnerships with committed LOIs. Organizationally, we’re also actively engaged in adjacent ways to support our ASC partners.
Gary Haynes, MD, PhD. The Meryl and Sam Israel Chair, Anesthesiology at Tulane University School of Medicine (New Orleans): Anesthesia is essential for surgery, and it has become essential to procedures done outside of the operating room over the past 20 years. Many projections are calling for increases in surgical, diagnostic and therapeutic procedures. Non-OR cases requiring anesthesia are anticipated to be more than 50% of all anesthesia cases performed in the next decade. That is already the case in many hospitals. Growing surgical and procedural case volume requires having programs to retain the anesthesiologists, anesthesia assistants and CRNAs already in place. The demand and cost for anesthesia professionals has skyrocketed since coming out of the pandemic. Recruiting to replace or add staff now is challenging and painfully expensive. It is prudent and far more efficient to develop and reward the anesthesiologists, AAs and CRNAs than to lose them to competitors.
Shar Hashemi, MD. President and CEO of Washington DC Hand & Upper Extremity Ambulatory Surgery Center: Be fearless, connect your budget to your strategy, create a culture of 100% effort and remember that innovation distinguishes between a leader and a follower.
Ashley Hilliard, RN, MSN. Administrator at Deerpath Ambulatory Surgery Center (Morris, Ill.): We have a few opportunities for growth over the next 12 months. Currently, expanding our ENT program is in the works. In addition, I believe we have an opportunity to capture part of the pain management market. As always, we are constantly looking at case costs, vendor contracts and block utilization to ensure we fill as much of the OR time we can and capture best pricing for implants and supplies.
Andrey Ibragimov, RN, MSN. Director, Ingalls Ambulatory Surgery Center at UChicago Medicine: Our best opportunities to grow the business in the next 12 months revolve around deepening our vertical integration within the healthcare system. Vertical integration will help us align more closely with hospitals, physician groups and payers to create a seamless continuum of care for patients. By integrating services, from diagnostics and pre-operative care to surgery and post-operative follow-up, we can offer a more coordinated, efficient and patient-centered experience. This strategy allows us to capture more of the patient journey within our network, reducing fragmentation and improving outcomes. It also enhances our negotiating power with payers by demonstrating the value of a comprehensive, integrated care model that reduces redundancies and lowers costs. Ultimately, vertical integration strengthens our position in the market, increases our competitive edge and enables us to deliver even better care to our patients.
Tedrick Jackson. Director, Physician services at University Medical Center New Orleans: In the upcoming year, the most promising avenues for business growth will revolve around prioritizing patient healthcare, actively engaging with team members to harness their insights for effective solutions and ensuring that self-care practices are implemented to maintain optimal well-being for both staff and patients. My team and I will cultivate organic growth as a sustainable strategy, focusing on long-term success rather than external expansion. We will nurture reliable relationships with current patients, while also ensuring a consistent influx of new ones.
Leslie Jebson. Administrator, The Orthopedics and Sports Medicine Network at Prisma Health (Greenville, S.C.): In our core market, we are blessed to be based in one of the fastest growing states for new population growth. This patient growth, coupled with a robust urgent care and primary care network, creates a natural convergence. As such, we must meet this opportunity with solid surgeon and facility infrastructure, ensuring timely care for patients in need of outpatient musculoskeletal surgical care.
Neal Kaushal, MD. Executive Director, General Gastroenterology at University of Oklahoma Health Sciences (Oklahoma City): Promoting effective colon cancer screening programs is and always will be one of the most sustainable business models in the ASC setting. First and foremost, the public health benefit to promoting effective age-appropriate screening cannot be overstated. Additionally, more effective screening means more effective detection of pathology. In addition to clinical benefit for patients, becoming better diagnosticians can lead to downstream revenue involving ancillary services such as pathology, laboratory services and referrals to other specialties within an ASC network. Colon cancer screening truly has the potential to be a win-win for all moving into the future.
Heather Lara, RN, BSN. Perioperative Ambulatory Clinical Manager, Fort Sutter Surgery Center of Sutter Health (Sacramento, Calif.): Recognizing and identifying common obstacles to business growth and development in the ambulatory surgery setting is an important first step to developing an action plan. One of the essential functions of a manager is to look for opportunities for growth and identify barriers preventing progress. This is attainable by performing an in-depth analysis of the organization. Factors such as under-utilized block times, staff burnout, long patient wait times and balancing case- and payer-mix all contribute to barriers to growth. Once these issues are identified, a mitigation plan can be created, and a change process can be implemented. Addressing these issues singly and encouraging involvement by establishing councils or steering committees will increase staff and physician buy-in, allowing for a more seamless transition.
Benjamin Levy, MD. Gastroenterologist, Clinical Associate of Medicine at University of Chicago: Over the next 12 months, Gastroenterology practices will increasingly be offered the opportunity to incorporate artificial intelligence dictation software into their clinics. This new HIPAA compliant AI software expedites note writing and will allow gastroenterologists to safely increase the number of patients seen in the clinic each day, while documenting patient conversations and medical advice in real-time. Our goal is to help more patients in the community. In addition, ASCs will likely expand the use of AI-driven platforms such as natural language processing softwares to document what physicians see and say during endoscopy procedures in real-time. Hopefully AI endoscopy softwares will decrease the turnaround time between colonoscopy and EGD procedures, enabling gastroenterologists to help more patients at ASCs and hospitals each day. I also expect that ASCs and hospitals will continue to incorporate AI-driven polyp detection software
Aman Mahajan, MD, PhD. Senior Vice President of Health Innovation and Enterprises for UPMC (Pittsburgh): At UPMC, we emphasize providing patients and care teams with the resources, knowledge and tools needed to optimize the surgical experience. Digital tools can be used to increase patient adherence to perioperative care pathways, which have been shown to shorten lengths of stay, lower readmissions, reduce wound infections and result in better overall surgical outcomes. Empowering clinical teams and patients to partner in best care delivery yields significant benefits and will lead to growth, along with minimizing financial expenses and elevating patient satisfaction levels.
Brett Maxfield, MS, CRNA. Director, Anesthesia and Surgical Services at Teton Valley Hospital (Driggs, Idaho): One of the best opportunities that I’m seeing for business growth in the next 12 months is in the physical surgery center properties themselves. Many of the markets I’m working in are seeing a decline in commercial real estate prices. That, coupled with the potential drop in interest rates that we are anticipating this fall, should lead to an increased opportunity for creation and development of surgery centers.
Manoj Mehta, MD. Medical Director at Endoscopy Center of the North Shore (Wilmette, Ill.): The best opportunity for growth in the medical industry lies in what happens with restrictive covenants. The FTC has made its ruling, but the states can still contest this. There is uncertainty about the influence of this decision for not-for-profit hospitals and physicians who are considered managers. This battle will need to be fought in the courts by someone, but the process has not begun. However, the presence of restrictive covenants is what ties physicians into situations that affect their quality of life, work-life balance, overall happiness and burnout rate. In turn, this affects quality of care, patient interactions and the ever-growing frustration of patients with the healthcare industry. When physicians can work where and how they are happy, the patients will finally get the care they want and deserve.
Travis Messina. CEO of Regent Surgical Health (Franklin, Tenn.): Regent’s greatest opportunities to grow over the next 12 months are focused on two key areas: new partnership origination and value enhancement for existing partners. For new partnerships, we are seeing numerous opportunities with health systems that have employed physician groups, a cohort that has been historically overlooked by ASC management companies. And we are realizing outsized returns with our existing partners by investing in specialty expansions by leveraging our growth team and cost reduction initiatives in areas like anesthesia and agency spend.
Taif Mukhdomi, MD. Pain Physician at Pain Zero (Columbus, Ohio): With the growing consolidation of hospitals and healthcare systems, we are creating arrangements with private employers and insurance companies to create cost effective therapy plans and treatments. These arrangements can prove beneficial to both parties and avoid site of service, cost prohibitive practices. In addition, building out our ASC service line is essential for growth and sustainability in the current healthcare market.
Rick Ngo, MD. Founder and General Surgeon at Texas Hernia & Surgical Specialists (Houston): As a general surgeon who focuses on outpatient surgery in a competitive market like Houston, it is imperative for me to be flexible and nimble geographically. Thus, an opportunity for me to grow my practice would be to sublease office space from a physician or practice that could also serve as a potential referral source.
Tina Piotrowski. CEO of Copper Ridge Surgery Center (Traverse City, Mich.): Continuously working with physicians on cases they are performing in the hospital setting that can be safely moved to the ASC is a growth opportunity. It is also beneficial to identify the barriers preventing the migration and develop a plan to address them, whether it be investing in additional technology, staff training or negotiating for appropriate reimbursement with payers. In addition, maintaining an ongoing focus on case costing across all our service lines explores opportunities to lower costs and improve profitability.
Adamina Podraza, MD. Anesthesiologist at Anesthesia Consultants of Morris; Medical Director at Deerpath Ambulatory Surgical Center (Morris, Ill.): The best way to grow your ASC business is to secure top-quality anesthesia coverage. An experienced anesthesiologist is invaluable for ensuring efficiency of OR turnover and excellent patient care. For optimal patient satisfaction, it's crucial that patients can comfortably ambulate from the surgery center with minimal pain or discomfort following their anesthetic and operation.
Adriana Puram, BSN, RN. Director of Nursing at Surgcenter of Greenbelt (Md.): Our best opportunity for growth is surgeon recruitment.
Kathleen Regan, RN, BSN. Administrator at Buffalo Surgery Center (Amherst, N.Y.): An opportunity for our recently expanded, multispecialty ASC is to embrace data metrics and key performance indicators around efficiency. For example, transparency around first case on-time starts, average case times and surgeon block utilization will help us plan our surgical block time to a higher degree of accuracy. In turn, we can capitalize on adding cases for higher daily volumes while also minimizing unnecessary staffing and anesthesia expenses when necessary.
Randy Robbins, MD. Managing Partner at Valiant Anesthesia Associates, PLLC (Southlake, Texas): From a clinical anesthesia and practice standpoint, the biggest hurdle I face is a massive shortage in the numbers of providers, as well as the quality, work ethic and cost of those providers. The second biggest hurdle, and the more concerning long term hurdle, is America’s aging population alongside the payment shortcomings in the CMS anesthesia conversion system. There’s plenty of business to be had, but there are not enough workers to get it done in a profitable manner.
Corey Welchlin, DO. Owner of Center for Specialty Care (Fairmont, Minn.): For my rural setting, it is a growing pain program. Epidurals, kyphoplasty RFA and Intracept present growth opportunities, as well as networking with general surgeons to provide procedures locally.
Caleb Ashmore. Orthopedic Rehab Services Supervisor at Harris Health System; Gina Taylor, MSN, RN. Quality and Accreditation Program Manager, Harris Health System (Bellaire, Texas): At Harris Health, we have identified that the best opportunities for growth within our ASC involve expanding our services to include more complex surgical procedures. Additionally, integrating robotics into the ASC presents several benefits including: decreased surgical times, reduced risk of infection, improved surgical outcomes and increased patient satisfaction. We firmly believe that both of these opportunities will significantly benefit the under-served patient population that we serve in Harris County and dramatically enhance their overall experience when they visit our facility.
Sarah Fuentes Molina. Chief Growth Officer of TriasMD (NewPort Beach, Calif.): Recognizing the importance of maintaining a competitive edge in the industry, TriasMD is developing comprehensive services to enhance physician brands. We are leveraging the expertise of our clinically integrated network to achieve cost efficiencies in areas such as online reputation management, local search engine optimization and programmatic digital advertising. Additionally, we are increasing our team of patient care advocates to better screen and guide new prospective patients to appropriate physician practices. Our approach is completely data-driven, focusing on tracking key performance indicators such as search impressions and costs per new customer. This enables us to evaluate the impact on both conservative care and the surgical pipeline for each physician. This strategy is especially effective when targeting specific service lines, procedures or segments of consumer audiences.