ASCs have grown and evolved exponentially in a short span, placing them at the forefront of change in healthcare.
Harel Deutsch, MD, co-director of the Rush Spine Center in Chicago, and Greg DeConciliis, PA-C, administrator of Boston OutPatient Surgical Suites, connected with Becker's to discuss predicted opportunities for ASCs and the headwinds they will face by 2030.
Dr. Deutsch and Mr. DeConciliis agreed that spine procedures will be the leading focus for ASCs in the upcoming years. Although surgery centers initially concentrated on lumbar discectomies and cervical fusions, there has been a shift toward more involved surgeries, such as SI joint fusion and multiple level fusions.
Dr. Deutsch attributed this growth to technologies that have broadened the range of minimally invasive surgeries, specifically highlighting SI joint fusion as a breakthrough.
"Many years ago, that surgery was considered a very big surgery that was open and could never be done in a surgery center," Dr. Deutsch said. "But through technology, a minimally invasive version of it was developed, and that version is very amenable to surgery centers."
While many surgery centers are equipped to perform more complex surgeries, the payer and regulatory environments pose obstacles. Dr. Deutsch noted that the lower level of oversight at ASCs compared to large hospitals often prevents payer approval due to unclear credentials. Additionally, surgeries that could be executed can hit snags related to payments from Medicare and private insurance.
"I see the future focus being on making the case to CMS that complex spine procedures can be performed safely in the outpatient setting," Mr. DeConciliis said. "The top growth opportunity is volume, and capturing additional traditionally complex inpatient procedures, or your ability to perform these types of procedures, will certainly increase your volume."
In considering the evolution of surgery centers within the healthcare ecosystem, both leaders discussed the trend of developing relationships with hospitals. An increasing number of hospitals are buying or partnering with surgery centers, which can benefit ASCs by becoming part of their referral networks and enhancing patient information interoperability.
"I think it's savvy for both hospitals and ASCs to find a way to coexist because there's certainly enough surgical volume to go around," Mr. DeConciliis said. "If there's a way, through a joint venture or an affiliation agreement, it's probably a wise tactic."
While surgical volume remains prevalent, the ongoing staffing crisis has pitted hospitals and ASCs against each as they compete for providers. Dr. Deutsch highlighted the lack of anesthesiologists as a primary concern that is limiting the number of procedures in surgery centers. He predicted the shortage will ebb by 2030 but is doubtful it will improve in the near future.
Mr. DeConciliis said successful staff recruitment and retention in the competitive market starts with examining an organization's culture. Examining benefits and salaries, conducting employee satisfaction surveys and holding more team meetings are strategies to foster a positive work environment. Increasing volume and lowering costs can incentivize employees to work more, benefiting both the organization and staff.
"Overall, I think as an industry, we've gone through periods of stagnation and upticks," Mr. DeConciliis said. "Now we're in this hockey stick uptick in terms of the ability to do more procedures traditionally done inpatient in the outpatient setting. That means more growth for us, and that's been the most exciting part of it."
Dr. Deutsch and Mr. DeConciliis will speak at Becker’s 30th Annual Meeting: The Business & Operations of ASCs on a keynote panel titled "ASCs in 2030: Top Opportunities, Headwinds and Issues." Join more than 1,000 executive level attendees and 225 speakers to experience their panel and other thought-provoking sessions.