What is the biggest change on the horizon for ASCs? How can ASC owners and operators overcome the challenges and prepare for the future?
Physicians Endoscopy CEO Barry Tanner discusses the two changes impacting ASCs today and where they're headed in the future.
Barry Tanner: I believe that there are two significant changes that are slowly gaining momentum. The first is that with the continued growth of high-deductible health plans the biggest single payer for ASCs is rapidly becoming the patient. As a result, ASCs are beginning to face the prospect of also becoming lenders.
Within our specialty of gastroenterology the procedure costs are relatively low and therefore somewhat more manageable but in other specialties, where the procedures are far more costly, this is going to be a mounting problem. We are exploring several options to assist patients in paying for their deductible including third-party financing programs and internally financed payment programs. While we have come up with no perfect solution, it is a growing concern that will consume significant resources.
The second area of change is that ASCs will need to realign their position within the healthcare provider compendium so that ASC are not viewed as competition to hospitals but as part of the overall solution toward delivering the best care in the lowest cost setting. Right now ASCs and hospital HOPDs in most markets compete for the same patients. Physicians have aligned themselves predominantly in one camp or the other. Payers are in many respects caught in the crossfire because they absolutely need the services that hospitals provide for their subscribers and yet they are fully aware that the quality and cost of care in an ever-growing list of common procedures is far better for patients in a freestanding ASC setting.
Speaking from the ASC standpoint, the "we win, you lose" scenario has to change and ASCs, hospitals, physicians and third-party payers need to begin to work collaboratively to deliver the right care in the right setting at the best possible price. That is the goal. The only way to accomplish this is to identify how each of these constituents can fairly participate in the savings that would be generated from accomplishing the goal. We are truthfully just in the thought process of how to begin to try to achieve this.
Our ASCs are increasingly aligning with hospitals but in truth, GI procedures are not terribly high on the radar screen for payers and as a single-specialty provider, in most regions of the country, we are simply not big enough in aggregate dollars to engage payers in meaningful conversation. At Physicians Endoscopy we also are currently limited in both our knowledge and influence to the facility portion of GI procedures which is really only one part of the GI service-line. In order make progress toward the goal we absolutely need to also have physicians, hospitals and payers ready, willing and motivated to engage in meaningful and collaborative discussions. This may still be a way off.