Scott Becker, JD, CPA, is a partner at McGuireWoods in Chicago.
Q: During the Aug. 2 webinar on "ASCs: the State of the Industry; Consolidation vs. Independent; How to Work With Service Providers; ACOs and Healthcare Reform," you stated ASCs would not fair well under the accountable care organization model. It had been my assumption that the efficiencies required in the ACO model would be well supported by the efficiencies in an ASC environment (versus hospital setting). I am not certain if you were referring to privately owned, joint-venture or hospital-owned facilities. Would you be so kind as to provide clarification?
Scott Becker: In discussing how ASCs fare with ACOs, this question is just one aspect of the overall prognosis for ASCs. It is important not overemphasize the negative implications of my answer as to ASCs as a whole.
With that said, while ASCs are a low-cost, high-safety setting, the big challenge is that hospitals have a high incentive to keep cases in places they profit from and out of where they don't profit, such as cases done in an independent ASC. With that being the case, and hospitals controlling more of the flow of cases, we have a hard time seeing how ASCs — particularly independent ones — win in a game where more of the healthcare is controlled by vertically integrated systems.
Contact Scott Becker at sbecker@mcguirewoods.com.
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