While ASCs have been an established industry for decades, recent regulatory changes have reginited growth conversations and placed outpatient centers in the middle of the healthcare picture moving forward.
Matthew Searles, partner at Merritt Healthcare Advisors; Marni Jameson Carey, executive director at Association of Independent Doctors; David Young, CEO and president of Physicians Endoscopy in Jamison, Pa.; Amber Walsh, JD, Partner at McGuireWoods; and Nader Samii CEO at National Medical Billing Services discussed growth opportunities in the ASC industry during an Oct. 24 keynote at the Becker's ASC Review 26th Annual Meeting in Chicago.
ASCs are in the middle of a boom period after experiencing a plateau over the past decade. While Mr. Searles acknowledged that centers were growing at an increased rate, he explained that the current environment for surgery center growth is untraditional at best.
"We have continued growth in joints and cardiology," Mr. Searles said. "[But], it's a more difficult business to be in now and you have to be very proactive about how you can grow in an environment where your costs grow faster than your revenues do. I wouldn't say we're bearish on [ASC growth but] we're getting more creative with finding ways for clients to grow that haven't traditionally attracted the surgery center business."
This environment particularly has been troubling for independent physicians. Ms. Jameson Carey stressed while the number of independent physicians may be dropping, ASCs should turn to the remaining independent physicians to augment their center and drive success for both entities.
"Since we began in 2013 … I have witnessed a leveling. While there are reports of more doctors going to work in the hospital, there are also more reports of doctors leaving the hospital," Ms. Jameson Carey reports. "While independent physician numbers were trending up. We are not at a place where only one of every three physicians is independent. I definitely think having an ASC where an independent specialist can go and perform procedures is an avenue of autonomy and success."
Change, too, is coming to specialties that are commercially viable in the ASC setting. Effective Jan. 1, CMS could soon move cardiology procedures to the ASC space. While these procedures represent a large opportunity, Mr. Sami doesn't feel that ASCs are ready to capitalize on them.
"We're definitely seeing movement, but it's still in the early stage," Mr. Sami said. "It's behind orthopedics, and it feels like it's coming as opposed to it's actively here in large volumes."
Ms. Walsh agreed with Mr. Sami and elaborated on how changing regulatory perspectives are fueling growth for the continued migration of inpatient cardiology procedures to the outpatient space.
"We're seeing the states be more and more willing to embrace [outpatient cardiology] which allows us to move it out of the hospital so the regulatory bodies and other stakeholders are coming on board," Ms. Walsh said.
Yet, as new specialties arrive, established areas like gastroenterology and orthopedics continue to remain commercially viable with growth opportunities in plentiful abundance. Mr. Young defined what constitutes growth and elaborated on the future of the specialty.
"We're seeing growth on the GI side organically and good growth from the right demographics, from the right parent companies, and from the right screening [populations]," Mr. Young said. "But we're also seeing more growth coming through on the M&A side, mostly more in de novo, than buying in. The new de novo growth is coming from the payers and hospitals that are opening joint ventures and partnering with physicians."