Becker's connected with the CEOs of three ASC to see what healthcare trends have outstayed their welcome and the trends they believe are gaining favor in the industry.
Note: These responses have been edited lightly for length and clarity.
Question: What trends are losing steam in the ASC industry? What trends are picking up?
Brian Bizub. CEO of Raleigh (N.C.) Orthopaedic Clinic. Overnight total joint patients have lost steam. Care pathways have been optimized to increase consistency, including less invasive techniques and faster-acting and more effective anesthetics, allowing patients to be safely discharged the same day rather than observing patients for 23 hours. Patients are demanding recovery in their homes rather than an overnight stay, which allows each patient to recover in the comfort of their home, return to activities quicker and research has proven to reduce complications of overnight stays continuing to reduce healthcare spend. Most patients prefer to complete their rehabilitation and physical therapy on an outpatient basis.
Higher-acuity procedures are moving from the hospital outpatient department to ASC settings. Total shoulder replacements and minimally invasive spine procedures were moved from the inpatient-only list and have increased volumes in ASCs.
ASCs continue to strategize on how to handle the substantial increase in procedural volume in the future as CMS continues to release procedures from the inpatient-only list to the ASC setting. ASCs have shown to be a patient’s preference for their surgical procedure. ASCs focus on being patient-centric providing greater personal attention, convenience and navigation throughout the surgical process, substantially less expensive than HOPDs or hospitals, while ensuring high quality of care and patient safety. Surgery centers are highly regulated to ensure quality and safety, which has been the hallmark of the ASC model.
John Brady. CEO of Fox Valley Orthopedics (Geneva, Ill.). The lack of surgical techs and the decreased enrollment in tech training programs. Many centers are now cross-training RNs to scrub into those roles as result of the surgical tech shortage. This places additional cost pressures on the operations side of the business as now we are using higher priced assets to perform these duties. Seeing this trend reverse would be very helpful to the industry.
Kristopher Kitz. CEO of Wyatt Surgery Center, Tucson Ambulatory Anesthesia and Eye Associates of Tucson (Tucson, Ariz.): The trend of more aggressively moving cases from hospital ORs seems to be picking up. Payors have been pushing this through educating consumers on the differences in their out-of-pocket costs should they have a procedure in a hospital OR rather than a surgery center. This has been happening for some time, but during 2020-21 there was a break related to the pandemic and seems to be picking up. Likely a related trend is hospitals and health systems becoming more active in the ASC joint venture and management services space, likely to preserve revenue streams leaving inpatient ORs. I also see more hospitals and health systems allowing their employed physicians to invest in ASCs, which previously was uncommon.
Previously, hospitals and health systems focused on HOPD surgery centers rather than joint ventures or revenue enhancement opportunities. While somewhat market-dependent, many organizations are shifting away from hospital outpatient department-focused strategies and to the joint venture model that engages surgeons and attracts consumers with price-sensitive health insurance.