Value-based care, robotic technology and constant improvement for ASCs: Key thoughts from Regent Surgical Health CEO Chris Bishop

Chris Bishop, CEO of Regent Surgical Health, discusses the biggest trends for the ASC industry today.

Regent has 23 ASCs, including 17 joint ventures with hospitals, in the U.S. and Europe. The company manages nine centers with outpatient total joint replacements.

Mr. Bishop will share his expertise as a speaker at the Becker's ASC 26th Annual Meeting: The Business and Operations of ASCs, Oct. 24-26, 2019 in Chicago. To learn more and register, click here. For more information about exhibitor and sponsor opportunities, contact Maura Jodoin at mjodoin@beckershealthcare.com. 

Question: What healthcare trends are game-changers for ASCs today?

Chris Bishop: High quality at lower costs has been an industry buzzword for years but with the transition to value-based care for health systems, we are seeing material movement of care from the more expensive inpatient setting to the more cost-effective outpatient setting.

The triple aim of lower cost, higher quality and higher patient satisfaction has been the mantra of the ASC industry for years, but employers, payers and health systems alike have truly begun embracing this philosophy the past few years. Additionally, consumers are increasingly researching their site of care and surgeon and finding these triple aim characteristics to hold true in the ASC setting.

Q: Where do you see the biggest opportunity for ASCs to thrive in the next five years?

CB: Continued transition of higher acuity care to the ASC setting is becoming increasingly adopted by surgeons. For example, Regent experienced over 100 percent growth in our joint replacement volumes for the past three years due to better postop pain control and improved surgeon comfort with minimally invasive techniques. Higher acuity spine such as lumbar fusions are moving to the ASC setting, as are cardiac procedures.

A year ago, I would have told you that robotics were still five years away from making sense in ASCs and yet, I predict Regent will place at least three robots in 2019 in our facilities, possibly more. As the price of this technology comes down and allows us to shift cases that were previously unavailable to our industry, robotics will continue to transition into our space.

Q: How can ASC owners ensure the viability of their business in a competitive market?

CB: Healthcare is in a transitional phase today that can best be classified as 'bigger is better' and I believe the same consolidation that we are experiencing with health systems and/or the dialysis industry, we will see in the ASC space. With increased regulatory requirements, clinical reporting and sophisticated value-based care reimbursement methodologies, the independent center will find it increasingly difficult to maintain independence.

At Regent, we may have as many as 17 different experts from our team assisting our centers to achieve their maximum operational potential and it is simply impossible for an independent center to access that degree of people resources. Whether there are independent centers forming a loose alliance in a specific geography to share resources or aligning with a fully resourced platform like Regent, consolidation is a must to thrive in this rapidly evolving environment.

Q: What payer trends should ASC owners and operators pay attention to today?

CB: Value-based care. If your center is not capable of organizing a 90-day prospective bundle shared savings contracting model with a payer, then you must either seek out consultants that can assist you with this or align with a company that brings these types of resources. We made the decision over a decade ago to joint venture with the local health systems, as they had the leverage to assist in securing fair market value contracts with major payers. Although I do believe payers are recognizing the value of competitive ASCs to a community, they still respond far better to a large health system contracting department than an independently managed ASC.

Q: What are ASCs doing today that won't lead to success in the future?

CB: Staying at the status quo … there is no remaining stagnant with your operating model. You are either moving forward or backwards. Regent case in point: one of our longest standing, best performing centers averages 12.4-minute turnover time and targeted 11 minutes this year. The clinical team is actively accessing Regent's resources to assist them in removing unnecessary steps to aid in reducing turnover times. The irony is that this center is one of our highest MD physician scoring centers and yet, they are not remaining idle. Constant lean process improvement identifies continued opportunities for improvement and the concept that you have never 'arrived' drives our centers to improve.

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