Economic development and opportunities around California are booming, and ASCs are no different. Here, California Ambulatory Surgery Association Executive Director Beth LaBouyer, RN, elaborates on the state of the industry and predicts how ASCs will grow in the future.
Note: Responses were edited for style and content.
Question: Why is California a good place to start a surgery center?
Beth LaBouyer: ASCs are being recognized for the value that they bring to patients, payers and providers. Our state has a large and diverse population, with a huge need for affordable, accessible healthcare. ASCs are helping meet that need with convenient, high-quality and cost-effective care. With about 40 million residents and a rapidly growing senior population, there is sure to be continued growth and opportunity for ASCs within California's healthcare marketplace. CASA and California ASCs have been working for years [to expand] partnerships between ASCs, health systems, medical groups and payers to maximize the role and value of the industry within our state's healthcare delivery system.
Q: What is the average caseload of an ASC in California? How do you expect it to change in 2020?
BL: There is certainly an upward trend in case volume at ASCs. As you look to the future, you will see more procedures and patients being steered to an ASC setting. There are several reasons for this: Some cases will be driven by patient preference, while others will be driven by reimbursement as [CMS] and other payers approve more procedures for ASCs. A good example is the 2019 decision by CMS to add a series of cardiac procedures to the list of procedures approved by Medicare for ASCs. With advances in technology and new pain management techniques, we will continue to see more complex procedures that can be performed safely in the ASC environment.
Q: Are there concerns that the market could become oversaturated? Why or why not?
BL: California is a large state with different healthcare market needs in different areas. As with any business, every ASC will need to be prudent in evaluating their unique market opportunity to determine the appropriate size and scope of their practice. They will need to develop the right partnerships with payers and providers, and sometimes even form joint ventures with hospitals, and ensure there is adequate patient demand for their services.
Q: What is the biggest threat to surgery centers in the region?
BL: The biggest threat to surgery centers is the lack of understanding of ASCs and the risk of harmful legislation or regulation that could undercut their ability to serve patients. It is important that policymakers understand the screening that occurs to ensure only appropriate patients are sent to ASCs for select procedures. Aligning patient care in the most appropriate site of service, whether that is an outpatient setting or hospital setting, will ensure patient safety while reducing overall healthcare costs.
Q: How does CASA advocate for centers?
BL: CASA is working to increase awareness among payers, patients and regulators regarding the value and quality of care that ASCs are providing on a daily basis, and how that is beneficial for healthcare system efficiency and cost reduction. We do this through several routes including direct legislative outreach, providing information to the media, maintaining a dialogue with the different regulatory bodies in California, and providing programming to help support ASCs with new tools, materials and information to strengthen their market position.
Specifically, CASA has established a strong legislative grassroots program that brings policymakers into an ASC setting to see firsthand the quality, value and access to care that ASCs provide for their communities and constituents — through this program, we have conducted over 50 ASC tours for legislators in the last five years. We also strive to be a tremendous resource to our members by providing critical tools and education through webinars, conferences and seminars to help them successfully operate their ASCs. For the last 12 years we have also put on a summit that brings together ASCs and health plans to increase awareness among payers regarding the value of the industry.
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