From industry-wide growth to increased partnerships, six ASC leaders spoke with Becker's ASC Review on how they expect the ASC industry to change in the next five years.
Here are their answers:
1. Industry growth
Shane Ricks, RN. Administrator of Millennium Surgery Center (Meridian, Idaho): The ASC industry will continue to grow by leaps and bounds. The consolidation of the Medicare hospital outpatient departments and ASC fee schedules will play a major part in the movement of surgeries to the ASC space. The ability to perform more complex cases in the ASC space will continue to increase opportunities for growth. COVID-19 revealed a fragile health system. Ambulatory services have the ability to quickly and safely adjust to disruptions to the system. ASCs proved this throughout the pandemic. I can only see exponential growth over the next five years and beyond.
Gabriel Figueroa, CASC. Administrator of Manhattan Reproductive Surgery Center (New York City): The next five years will see aggressive growth and expansion in the ASC space throughout the country. I have believed this for years, and current circumstances validate this projection. Some of the obvious contributing factors include migration of approved procedures to ASCs from HOPDs, quality of care, infection rates, lower cost to the healthcare system overall, physician and patient satisfaction, advances in equipment and technology and the creation of value-based payment methodologies, just to name a few. The recent COVID-19 pandemic, I believe, also gives us an indication of where the ASC platform fits within the overall delivery of care in this country. The ASC can offer continued access to care through times like these, with reduced risk of infection, for a tremendous range of conditions that are essential to the quality of life for the patients we serve.
I believe the hospital systems, insurance companies, private-equity-type investors, physicians and patients all realize that we can work together to continue to create a synergistic relationship that maintains the highest level of patient care while delivering efficient and cost-effective care.
Fred Simmons. CEO of Clearwater (Fla.) Cardiovascular Consultants: I believe the ASC industry will expand at a strong pace over the next five years as managed care will direct, and consumers will demand services in the most cost-effective and convenient locations. In addition, Medicare will continue to expand the services that it will reimburse in an ASC.
2. Obstacles for independent ASCs
Karen Wood. Administrator of Advanced Pain Management Center and Cedar Hills Surgery Center (Portland, Ore.): At heart, I am an optimistic person. That said, with the challenges we continue to face related to reimbursement, panel status and supply shortages, I am concerned about the viability of freestanding centers such as ours. In addition, the increased burden of regulatory administrative paperwork has an increased layer of expense in terms of time and staffing. We had a very difficult 2020. We had to shut down operations for what I consider to be an extended period of time. We were lucky, though, in that our staff stuck with us until we were able to reopen. We are a small pain management facility with a dedicated staff. We very much felt challenges for our facility, staff and patients.
3. Hospital partnerships
Jose Rivera-Gonzalez. Administrator of TriCounty Heart Institute (The Villages, Fla.): If we continue our status quo, I see more hospitals partnering with physicians creating specialized ASCs. The real question should be, what will happen to hospitals in five years? ASC is not the only business unit of a hospital that is branching on its own. We started with imaging centers, and now we have freestanding emergency rooms, resulting in the need for "smaller hospitals." My prediction is that there will be at least three ASCs per standing hospital.
Of course, it is all depending on population density, demographics and government regulation. The ASC will continue to increase as healthcare and technology continues to evolve. Look at the number of procedures cascaded down from hospitals into offices in the past years. I believe the evolution today is exponential due to advances in technology.
4. Insurance partnerships
Curtis Collins. COO of Palmetto Surgery Center (Columbia, S.C.): ACSs, now more than any other time in history, have an opportunity to partner with insurance companies to provide cost-effective solutions for their insured clients by negotiating payments lower than what they are spending in an acute care setting. Transitioning many surgical procedures to the outpatient setting will save insurers from paying four to five times the cost in the hospital setting, which will increase profits for the ASC as well as the insurance industry and may even drive down costs to the insured via premium reduction as well as decreased out of pocket expense.