ASCs stand to benefit from several trends as the healthcare landscape rapidly evolves, according to ECG Management Consultants Principal Naya Kehayes and Associate Principal Sean Hartzell.
At Becker's ASC 25th Annual Meeting: The Business and Operations of ASCs, Oct. 18-20 in Chicago, the pair discussed the changing healthcare environment and what it means for ASCs.
Here are five trends to watch:
1. Procedure migration. In response to pressure from employers and payers, higher acuity cases are moving from the hospital inpatient setting to hospital outpatient departments and ASCs. These procedures traditionally migrated to ASCs last, but Medicare is beginning to skip HOPDs, Ms. Kehayes and Mr. Hartzell agreed.
2. New payment models. Payers are creating narrow networks to offer deeper discounts in return for creating smaller networks. Payers say the increased volume will offset the discounts. Payers have also developed benefit designs that could drive hospitals to partner with ASCs, Ms. Kehayes said.
3. Payer consolidation. With widespread payer consolidation, there's an increase in hospital-physician alignment, and more equity partners are buying groups with ASCs. The resulting "mega-groups" have more negotiating power. In this environment, Ms. Kehayes said, "Understanding your cost is critical to negotiating reasonable and adequate reimbursement."
4. Hospital investment in ASCs. Hospitals are proactively approaching ASCs and physicians after seeing outpatient surgical volume steadily grow over the past 20 years, Mr. Hartzell said. ASCs offer hospital systems several benefits: access to new volume, lower costs, mitigation of future losses, increased efficiency and better physician alignment and satisfaction.
5. Disruptive economic models. The many blockbuster deals announced over the past few years, including the Amazon venture, all focus on better experience, lower costs and increased access, according to Mr. Hartzell. Amazon's Whole Foods acquisition shows it's focused on eliminating waste rather than generating profits, and it's bringing that revolutionary economic model to healthcare.
"This is another thing that makes hospital CEOs quake," he said. "ASCs are already focusing on the experience, the cost, the access … Hospitals need to start to partner with those folks already down that road."
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