Ken Pettine, MD, a spine surgeon who co-owns the Loveland (Colo.) Surgery Center, a three-OR ASC specializing in orthopedic and spine surgery, offers four predictions on how healthcare reform will affect ASCs.
1. Reform will actually favor ASCs. While many surgeons are skeptical of healthcare reform and talk about repealing it, Dr. Pettine believes the reforms will be a boon for ASCs. "Every time I hear Obama talk on reform, it's about quality care at lower costs," Dr. Pettine says. "ASCs do that the best. They are the right entity at the right time."
2. ACOs are the wrong solution. Accountable care organizations will try to bring together all providers to coordinate care, but Dr. Pettine believes the future lies with small, specialized delivery models, such as his own ASC. "I'm a proponent of small specialized model," he says. "You do one thing and you do it well."
3. More procedures migrate to ASCs. The push for cost-savings will require removing artificial barriers against surgery in outpatient settings, such as Medicare limits on spine surgery. As hospitals lose hundreds of billions of dollars in reimbursements under healthcare reform in the next 10 years, they will be under great pressure to reduce costs by shifting surgery out of the hospital. Changing course, they will begin pushing regulators to allow more outpatient procedures. As the floodgates for outpatient procedures are opened, physician-owned ASCs will benefit as well.
4. Medicaid expansion will favor ASCs. Under healthcare reform, 16 million previously uninsured Americans will be added to the Medicaid rolls in 2014. Dr. Pettine says surgery centers can break even on Medicaid coverage and the added volume can even be welcome. "As an ASC, you don’t make money on Medicaid but you don’t lose money," he says.
Learn more about Loveland Surgery Center.