More hospitals are shuttering services and facing financial challenges amid soaring costs and declining reimbursements.
Five leaders joined Becker's to discuss how these market changes affect ASCs and how they're shifting centers' day-to-day workflow.
Editor's note: Responses have been lightly edited for clarity and length.
Question: How will ASCs be affected by the increase in hospitals shuttering services?
Jason Jundt, MD. Vascular specialist in Bend, Ore. This is a regional issue and multifactorial. In areas where hospitals, ASCs and physicians are aligned, this could result in increased efficiency, lower cost of care and greater patient satisfaction. Unfortunately, most of these closures of hospitals and discontinuation of services will happen in rural areas without ASC options and will directly affect the patients and physicians that are trying to serve those communities. It will be up to these communities to reach out to their representatives for assistance to prevent these losses and to physicians to get involved in or contribute to their respective organizations.
Jack Lewin, MD. Administrator for Hawaii's State Health Planning and Development Agency (Honolulu): We are most concerned by the ever-increasing marketplace presence of investor-owned companies in the insurance, hospital, ASC and physician group services markets that could drive up costs, reduce physician autonomy and independent patient advocacy, and increase profit-taking versus reinvestment in community and population health.
Bonnie Greenblatt. Director of Ambulatory Surgical Services at the Michigan Institute of Urology (Utica): [Shuttering services] can impact the ASCs in several ways:
- Increased patient volume. Increased demand for services at the ASC.
- Expanded scope of cases. ASCs may need to expand their scope of services, which could include more specialized and complex cases. This may require additional equipment and staffing.
- [The shuttering of services] could potentially change the landscape in how ASCs are reimbursed for services. Payers would need to fairly reimburse ASCs, in order for these services to remain available.
- As staffing is already a major concern, this may create a staffing challenge.
- Operational costs, without the expansion of reimbursement at levels commensurate to hospitals could put ASCs in a difficult situation.
John Savage, APRN. Owner of MedTrack ASC Consulting (Franklin, Tenn.): ASC volume [could] increase. However, low reimbursement [is] driving hospitals to shutter surgical services. The main relief elements are:
- The continued relentless pursuit for increased ASC reimbursement.
- Adding more Medicare-ASC approved procedures along with reasonable reimbursement.
ASCs save Medicare approximately $7 billion a year. I encourage ASCs managers to use this valuable information to inform local and state political leaders about the tremendous value of ASCs.
Elaina Turner, RN. Administrator of Commonwealth Pain and Spine (New Albany, Ind.): ASCs will have the ability to pick up additional service lines, potentially boosting revenue, as hospitals continue to shutter services. However, not all service lines will be appropriate additions to the ASC. For instance, many hospitals are shuttering their obstetric departments as they report declines in birth numbers. Hospitals will continue to shutter services that are no longer profitable, but ASCs should use caution in implementing new service lines and ensure that staff and providers are trained in those procedures and that the physical space is appropriate for those service lines.