Here are five factors making ASC leaders nervous about the future:
1. Physicians are increasingly moving to employed models, and privately owned practices are being incorporated into healthcare systems. The number of physicians working in private practice between 2012 and 2022 declined by 13 percent, according to a report from the American Medical Association. Many leaders worry that this will stifle the amount of ASCs opened by larger players in the industry.
"For those hospital systems that encourage a partnership with freestanding ASCs, I’m hopeful, but there are plenty of healthcare systems that knowingly remove affordable options in their community in order to sustain their bottom line," Marie Yarborough, administrative director of Walnut Creek, Calif.-based Sequoia Surgical Pavilion, told Becker's.
2. Recruiting and retaining staff is still burdening ASCs nationwide. In many markets, ASCs have to compete with the deep pockets of hospitals and health systems for staff. Additionally, some ASCs have to spend a quarter or more of their net operating revenue on employees to stay ahead of shortages, according to a report from VMG Health.
"I think the biggest threat towards ASCs in 2023 is staffing, especially qualified, experienced staffing in all areas of an ASC, including business office, pre-op, OR (both nursing and surgical technicians), post-anesthesia care unit and recovery nurses," Michael Powers, administrator of Knoxville, Tenn.-based Children's West Surgery Center, told Becker's. "There is increased competition, and in fact it is hard to compete with large health systems/hospitals. I am also finding that ASCs are competing in the same region against one another for the available staffing pool."
ASCs are using creative recruiting tools, along with flexible hours and a positive work environment, to retain staff.
3. Private equity is increasingly looking to ASC and ASC specialties to invest. While some leaders view the cash influx as a way to maintain independence from healthcare consolidation, other leaders are worried about the effects on patient care.
Additionally, many leaders are concerned about the ways it affects physician workflow.
"I finally removed myself from private equity and corporatized medicine and changed jobs," Andrew Gerstner, MD, an independent anesthesiologist and consultant, told Becker's. "I stopped working at giant hospital systems and moved to a smaller, physician-owned hospital and have a much more manageable schedule and am simply just paid fairly for my time … and no longer have to put up with being forced to take on more uncompensated or under-compensated work just because the hospital or staffing company has understaffed everything and expect physicians to pick up the slack for their own business mistakes for free."
4. CMS is floating a 3.34 percent conversion factor decrease in its proposed Medicare physician fee schedule for 2024 released July 13. Many physicians are fed up with these continued cuts.
"These cuts are even more discouraging after physicians and healthcare professionals have spent more than two years continuing to provide patient care during a global pandemic," Taif Mukhdomi, MD, interventional pain physician at Columbus, Ohio-based Pain Zero, told Becker's. "It seems as though physicians are routinely facing compensation cuts, as if to say physician reimbursements are the reason why healthcare costs continue to rise."
5. Anesthesia costs are skyrocketing, and many ASC leaders are concerned that they won't be able to sustain the rising costs as margins sink. ASCs rely on great anesthesiologists and anesthesia group partnerships to perform their procedures, but in some markets, independent anesthesiologists are hard to find.
"Today's shortage of anesthesia providers has been compounding for years and has turned into an incredible challenge for all,"' Andrew Lovewell, CEO of Columbia (Mo.) Orthopaedic Group, told Becker's. "Not only is it difficult to find anesthesia coverage, finding coverage that understands and embraces the priorities and workflow of an ASC is seemingly impossible."