Consolidation, cost cutting, and efforts to improve efficiency and quality will transform the ASC space within the next 10 years, according to Kerri J. Gantt, administrative director of Gastroenterology Associates of S.W. Florida, a practice based in Fort Myers and Cape Coral.
Ms. Gantt shared her observations and predictions about the industry with Becker's ASC Review.
Note: Responses have been lightly edited for style and clarity.
Question: How has the ASC space evolved since you started your career in the industry?
Kerri J. Gantt: Barkley Surgicenter [in Fort Myers] opened up in 1993. Since that time, there has been an increase in the number of covered procedures. Initially, there were approximately 1,500 procedures that were deemed as covered procedures; now, that list has grown to well over 3,000. There has also been a large increase in the number of Medicare-certified ASCs. Insurance companies realize the cost savings associated with ASCs vs. HOPDs and are beginning to drive patients to the ASC arena through lower copayments, less precertification requirements, etc.
ASCs have become progressively more regulated to ensure patient safety and high-quality care. Infection control regulations have increased significantly, and surveys are much more stringent now than in the past. More and more centers are accredited by either the Joint Commission on Accreditation of Healthcare Organizations or [the] Accreditation Association for Ambulatory Health Care.
Patients have considerably more trust in ASCs now than they did in the "early days." Patients were often hesitant and would want their procedures done at the hospital because they felt that ASCs would not be capable of handling emergency situations. Now, patients would rather come to an ASC because of the efficient processes that ASCs offer — they are at the facility a shorter amount of time. Value-based care is driving more procedures to the ASC space due to cost savings, efficiencies, safety and good outcomes.
Q: How do you think the ASC space will evolve in the next five to 10 years?
KG: Consolidation. I believe there will be a marked increase in the number of joint ventures between hospitals and ASCs due to patient care shifts to outpatient markets — hospital systems will be forced to look at outpatient options to capture lost inpatient volumes. More private equity firms will invest in centers providing capital to expand centers. Insurance companies may look to purchase ASCs as they begin to open more of their own physician clinics. I believe that insurance companies will continue to develop incentives for patients to use ASCs versus hospitals.
Q: What are the biggest opportunities for ASCs in 2019?
KG: Expansion and market share; contracting with insurers and incorporating quality metrics; orthopedic center expansion moving higher-acuity cases to the ASC setting; and working with vendors and suppliers to control costs to ensure that ASCs retain an acceptable profit margin.
Q: How are major industry trends affecting day-to-day operations at your surgery center?
KG: ASCs are positioned to do well in value-based care by the sheer nature of the cost savings and efficiencies inherent to an ASC. For example, gastroenterology physicians can participate in GIQuIC [GI Quality Improvement Consortium], a registry that provides benchmarking information specific to colonoscopies and upper endoscopies. While GI physicians have a lot of good data, the insurance companies are not yet positioned to determine how the provided metrics will save the insurance company money. ASCs must be able to demonstrate quality through accreditation and quality measures.
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