Greg DeConciliis, administrator of Boston Out-Patient Surgical Suites, spoke with Becker's to weigh in on how hospitals are potentially harming ASCs in the Northeast.
Editor's note: This piece was edited lightly for brevity and clarity.
Question: How does the ASC industry in the Northeast market differ from other markets in the country?
Greg DeConciliis: We are fortunate to be surrounded by some of the best hospitals in the country. From Boston to New York City to Connecticut, there exists such strong and powerful hospitals and hospital systems, it makes survival as an ASC difficult. This causes many potential obstacles for ASC success:
1. They are often the largest employer in the area. This is troublesome for two specific reasons. One, they often have their own insurance plan which would prohibit their insured from care at your ASC. Two, politicians are often hesitant to hear or approve any pro-ASC legislation or policy changes for fear they will upset the hospital and lose all of those valuable votes.
2. They often employ a large number of physicians in the area, from specialists, which means less specialists to operate at your ASC, to primary care physicians, whose referrals can be controlled by the hospital. The primary care will only refer to specialists who operate at hospital-affiliated facilities.
3. Insurers also are hesitant to approve policies that favor ASCs, for fear it will cause issues with the hospitals. Even though insurers can experience substantial savings through the shift of the site of service to the ASC, they rarely approve pro-ASC policies or directives. Instead of embracing competition, they prevent it from occurring. They do not realize the cost savings (aka profits to them), and this fact largely goes unnoticed due to a lack of political power by the ASC associations and a lack of press who want to cover these types of issues.