ASCs prepare for the Trump administration: 5 notes

President-elect Donald Trump will take office for the second time in January, and ASC leaders are preparing amid his plans to appoint a swath of new leaders to oversee aspects of the healthcare system.

Here are five key notes:

1. Several health systems and ASCs are bracing for potential supply challenges heading into a new presidential term. Mr. Trump plans to levy new tariffs against several key countries, likely increasing prices for American businesses.

Many ASCs have struggled to come back from supply shortages brought on by the COVID-19 pandemic, they will now likely be hit with new challenges in the coming months, including tariffs and potential port strikes. 

"My organization is preparing for the potential proposed tariffs in 2025 by diversifying our vendor relationships for the procurement of our medical supplies and medications," Janet Carlson, MSN, RN, executive director of Louisville, Ky.-based Ambulatory Surgery Centers of Commonwealth Pain & Spine, told Becker's. "Supply chain pressures have been very labile since COVID, things still haven't settled down from that significant disruption."

2. With the nomination of Mehmet Oz, MD, as CMS administrator, many ASC leaders are keeping a sharp eye on Medicare Advantage. 

"I think ASCs should be prepared for an emphasis on Medicare Advantage by CMS and needing to overcome the current frustrations and lack of reimbursement they bring," Marjorie Reiter, administrator at North Brunswick-based Surgery Center of Central NJ, told Becker's. 

Dr. Oz proposed expanding Medicare Advantage plans to "all Americans who want them" during his bid for Senate, CNN reported in 2022. A spokesperson for Dr. Oz's campaign told CNN the plan was called "Medicare Advantage plus."

Dr. Oz and former Kaiser Permanente CEO George Halvorson published an op-ed in Forbes in July 2020 proposing an expansion of Medicare Advantage plans to everyone not already enrolled in Medicaid. The proposal included rebranding the program as "Medical Advantage" and funding coverage for all citizens through a 20% payroll tax, with half paid by employers. 

3. Some ASCs are also keeping an eye on a potential impact on research and education funding. 

"Any ASC with an academic relationship should be watchful for any impact on research and education funding," Ms. Reiter added. 

4. Amid a push to cut costs, some ASC leaders are hoping that the new administration could support site neutral payment policies. Medicare rates for ASCs are, on average, 50% of what HOPDs receive for the same services, according to the Ambulatory Surgery Center Association. 

"I'm not sure I can offer any unique predictions, but I would expect that the pursuit of site-neutral payment policies might reduce or eliminate the price premium that hospital outpatient departments currently enjoy over ASCs," Mark Dietrich, a certified public accountant at Doshi & Associates in Bloomfield Hills, Mass., told Becker's. 

5. ASC leaders are also hopeful for a potential expansion of the ASC-procedure list. In 2023, CMS added 11 procedures to the ASC-covered list in the ASC Payment System Final Rule.

"As cost cutting is now in vogue, one might expect the range of procedures that are approved for ASCs to be expanded," Mr. Dietrich added. "One can be certain that the powerful trade associations will be vociferous in defense of their respective turfs."

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