Sandy Berreth, RN, a surveyor for the Accreditation Association for Ambulatory Health Care, joined Becker's to share key factors in the success or failures of ASCs this year.
Q: What will make or break ASCs in 2023?
Editor's note: Responses have been lightly edited for length and clarity. If you would like to contribute to our next question, please email Paige Haeffele at phaeffele@beckershealthcare.com.
Sandy Berreth: This year will be a telling one for ASCs. We have heard that hospitals want to joint venture and we have heard that payers want to move cases to the ASC arena. However, those situations are happening at corporate management levels. While those moves are perceived as helpful to ASCs, it hardly affects the hometown ASCs that are not involved with corporate leadership. There are still small organizations all over the country that have substantially difficult relationships with their local hospitals. Often these same organizations find it difficult to deal with payers. There are some organizations where payers won't even talk with them, and to negotiate for better payments is not an option. How discouraging is that?
Here's the thing: Without better partnerships between physicians and hospitals and better payments from Medicare and commercial payers, the hometown ASC arena will not be able to financially compete with their hospital counterparts, at least for the ASCs that do not have management corporate leadership.
Major concern: Staffing should be under 30 percent of your total expenses. With staffing expenses increasing, including benefits, these benchmarks are difficult to maintain. The staff currently working at ASCs may have a wonderful environment with great leadership, but money becomes an overriding consideration and as hospitals are starting to recognize these attributes, they are starting to recruit to the hospitals. For example, 12-hour shifts mean three days a week, often staff can work four to six days in a row and have four to five days off in a row. Other aspects of hospital staffing are changing as well. Some hospitals are offering weekends only; just think, a staff person can work the weekend and have the entire week off to be with children or pursue another career option. The options, if the hospital desires, are endless and with a better compensation package. No longer days, no weekends and no holidays attract staff.
So ultimately, the answer to your question, what will make or break ASCs is simple. People — it is all about people.
During the last year I have been to many ASCs and many of them are struggling. Their biggest challenge is staffing; without staff, you can't provide quality care.