Here are five key trends ASC leaders need to know in 2023:
1. Value-based care
ASCs are primed for the transition to value-based care for their ability to offer low-cost, high-quality procedures.
"I'm most excited about the transition in healthcare from fee-for-service reimbursements and payments to value-based payment. I think it's important to have not just volume, which is the quantity aspect; too often the quality aspect has been undervalued," Rick Ngo, MD, founder and a general surgeon of Texas Surgical Specialists in Fort Worth, told Becker's.
Although the transition might hurt volume-based positions, Dr. Ngo said he believes bundled payments will be a contributor in the accessibility of affordable surgical care.
ASC chains, including Optum, parent company of ASC chain SCA Health, are also looking to value-based care. According to an Oct. 14 call with investors transcribed by The Motley Fool, OptumHealth's 31 percent revenue-per-customer growth is attributed to the increasing number of patients served under value-based care.
2. Physician pay cuts
Medicare's physician fee schedule final rule, released Nov. 1, will reduce the conversion factor by 4.48 percent to $33.06.
The conversion factor used to calculate physician reimbursement will decline by $1.55 in 2023. With the 4 percent statutory Pay-As-You-Go sequester, which was implemented to offset congressional spending outside of healthcare, physicians are looking at an 8.5 percent pay cut.
Leaders worry the cut will push physicians away from ASCs.
"Declining reimbursement will lead to additional physician employment by larger health systems. Will also cause declining quality and availability of physician services," Maxim Sheinman, director of business development of Hospital Corp. of America, told Becker's. "More physicians will become employed and will perform less cases in an ASC setting."
3. Staff shortages
Staffing shortages are one of the largest concerns ASCs are facing heading into 2023. Labor costs are skyrocketing, making it even more difficult for ASCs to rebound from COVID-19 losses.
"As we continue to hear about staffing and supply chain, these two aspects of healthcare operations can really be a challenge. There is no way to "cut corners" on qualified staff when candidates are limited, so ASCs must find a way to improve retention and recruitment. Qualified teams are essential for patient safety and efficient care. The cost of staff turnover is incredible," Brenda Carter, administrator at Wilmington (N.C.) Surgcare, told Becker's.
According to a report from VMG Health, many ASCs have to spend a quarter or more of their net operating revenue on employees to stay ahead of shortages.
4. Physician ownership
Investment and ownership in an ASC is a long-term strategy for physicians to thrive financially and gain more control over their day-to-day workflow.
"Including employed physicians as shareholders in ASCs gives them a "stake in the game" relative to efficiencies and operational throughput and incentivizes performance through the motivation that comes with shared ownership," Mark Townsend, MD, chief clinical officer of Richmond, Va.-based Providence Group at Bon Secours Mercy Health, told Becker's.
Self-employed physicians make 18 percent more than employed physicians, according to Medscape's "Physician Compensation Report 2022," and ASC ownership also offers ancillary revenue that hospital employment often lacks.
5. Stagnant reimbursement rates
ASCs are paid much lower rates than hospital outpatient departments for the same procedures. Private insurer payments to hospital outpatient departments were 2.6 times larger than payments to ASCs from 2018 to 2020, and Medicare payments were 2.1 times larger, according to research published by the Rand Corp.
As labor and supply costs soar, ASCs will be eyeing payer behavior to remain profitable.