Healthcare providers spoke with Becker's about a number of topics this week, including the effects of COVID-19 on ASC growth, staffing challenges, payer strategies and hospital partnerships.
10 insights shared with Becker's this week:
Nurse recruitment, retention is a No. 1 priority for ASCs in 2022
Brock Kreienbrink, MSN, RN. Administrator of the Outpatient Surgery Center of Central Florida (Wildwood): We are a cardiac-only facility, and our staff are highly specialized. COVID-19 has created travel opportunities for these employees at unheard-of prices. The combination of staff leaving our market at significant levels and the increase of ASCs/catheterization labs/hospitals in our market is draining the staffing pool — which is causing major inflation in the staffing cost to compete for these employees.
6 ASC administrators on staffing challenges
Linda Deeming. Center Director of Salud Family Health Centers (Fort Lupton, Colo.): In the next six months, staff retention is at the top of our list. Those who were not furloughed during COVID-19 are feeling exhausted from doing duties other than their regular assigned positions. Those who were furloughed or laid off are not ready to come back to work for a variety of reasons. As we have started operations toward a more normal mode, we are certainly struggling with getting up to normal staffing and keeping the trained staff we currently have. The budget is also a concern; it's certainly a balancing act that is not easy at this point.
'ASCs can help large systems,' administrator says on hospital partnerships
Zachary Welch. Administrator of Wake Orthopaedics (Raleigh, N.C.): We will see a significant increase in partnerships between ASCs and hospital systems. Contract negotiations, supply/implant costs and addressing increasing regulations are all areas these partnerships are likely to mutually benefit from, while also addressing payer requests to move various procedures out of the hospital to the ASC environment. ASCs can help large systems address efficiency opportunities while also serving as a focal point for additional innovation and expansion of various services.
Are COVID-19 surges affecting ASC growth plans?
Andy Wilkinson. Director of ASC Strategy and Business Operations for Shields Health Care Group (Quincy, Mass.): COVID-19 has caused a great deal of disruption across the healthcare system and has delayed a number of our growth plans. While our volumes have returned to pre-pandemic levels, there’s still a feeling among our surgeon partners that the reduction in extracurricular sports, in both the school-aged and adult populations, has impacted potential growth in our sports medicine volume. That said, we strongly feel that ASCs provide a welcoming environment for patients, and because of our commitment to partnering with community providers, our patients have the opportunity to access the care they need close to home and without long commutes to appointments. Because of this, we anticipate that we will see a positive impact on the growth of our ASCs over the next few years.
Payers shifting strategy to keep physicians independent
Matt Kraemer, orthopedic service line administrator at Northern Arizona Healthcare (Flagstaff): With healthcare payers more aggressively entering the care-delivery market to direct patients and case completion, it will be necessary for private groups and healthcare organizations alike to align the efforts of their value-equation model to compete for participation in [accountable care organizations] and receive case authorization.
How 7 ASCs are focusing on growth
David Silvernale. CFO of MNGI Digestive Health (Minneapolis): We continue to see an increase in demand for high-quality endoscopy procedures performed in our ASCs. This has resulted in the development of two new four-procedure room endoscopy centers that will open in 2022. These centers will provide additional capacity to meet the demand for services that continue to increase due to the lowering of the recommended CRC screening age and value-based and shared-savings contracts. This has led to the potential for partnership opportunities with local health systems that continue to look for ways to lower the total cost of care and free up their hospital surgical space for services that are appropriate for the site of service. We are also currently looking for the appropriate space to add an additional endoscopy center in 2023.
CON laws pushing cardiologists to open office-based labs over ASCs, CEO says
Krishna Jain. CEO of National Surgical Ventures and Limb Preservation Centers of America: That's the only way you can open more ASCs and provide better care to the patients at a much more reasonable price. Some of the states where a certificate of need is not required, such as Texas, have more ASCs compared to some of the states where the certificate of need is required, such as New York or Michigan, where growth of these ASCs is much more restricted. However, cardiologists do not need a CON when they're working in the office space level. Because of this, we've seen many more office-based labs opening around the country than ASCs.
Colonoscopy backlog could take 'years to recover from,' CFO says
David Silvernale. CFO of MNGI Digestive Health (Minneapolis): The deferment of elective procedures such as screening colonoscopy that occurred during COVID-19 has created a backlog of procedures that could take years to recover from. This, combined with the lowering of the CRC screening age and attention to site-of-service to lower the total cost of care, has created confidence for the organization to continue to grow through additional physicians and the ASC space for them to work. In addition, as we design new facilities we are paying strong attention to the learnings of infection control, air quality and patient flow that will become part of the new normal post-COVID-19.
Top fears for ASC execs
Matthew Ewasko. Administrator of Physicians Alliance Surgery Center and Surgical Services Business Analyst at St. Francis Healthcare System (Cape Girardeau, Mo.): I'm most nervous about dealing with commercial payers. They're looking at their bottom line as much as we are, so trying to enter into negotiations with them is always a bumpy process. I want to make sure we have all our information to support our side of things as my No. 1 priority. Another issue we've been dealing with in the past several months is staffing shortages. I know that's common across the country, and it's not just for ASCs; hospitals are hurting as well. Staff recruitment and retention is something we are trying to keep an eye on.
'Stewards of public health': Why 1 surgeon supports COVID-19 vaccine mandates
Brian Gantwerker, MD. Craniospinal Center of Los Angeles: It's going to come down to consistent and clear messaging from authority figures. We need to get our politicians in step with us. We have to put faith back in experts. We have to realize that political expediency is no longer an excuse to spread misinformation. And the best bet is to bet on health and the survival of our society in people who are trained and have no ulterior motives to keep people from getting sick and dying.