ASCs around the country are facing two major care disruptors: Rising labor costs and anesthesia provider shortages.
Here's a breakdown of these disruptions:
Labor costs
High labor costs are affecting ASCs' ability to staff their centers.
The percentage of healthcare providers with an internal minimum wage of more than $15 per hour went from 15.6% to 29.1% from 2022 to 2023, according to a recent survey from consulting firm SullivanCotter.
"The increase in wages necessary to retain and recruit to skilled professional positions continues to well outpace any real or even projected rise in reimbursements," Thomas Feldman, CEO of Peoria, Ill.-based Center for Health ASC, told Becker's.
In the last year, 56% of ASCs have seen an increase in volume, but 68% of facilities are still having a more difficult time recruiting experienced operating room nurses, according to a survey from ORManager.
"Many nurses that could retire during COVID-19 did and others left the field or took jobs that can be done remotely," Karen Sumida, RN, interim administrator of Surgery Center of Athens (Texas), told Becker's. "Applicants for both positions are requiring higher salaries, and with the ASC industry getting lower reimbursements than hospitals, we cannot compete with the rising salaries."
ASCs are looking for creative solutions, such as a four-day workweek and predictable hours, to recruit staff without breaking the bank.
Anesthesia provider shortage
Finding a reliable and affordable anesthesia strategy is affecting ASCs in most markets.
"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."
More than 2,872 anesthesiologists left the workforce from 2021 to 2022, according to a report from Definitive Healthcare.
Facilities with lower utilization are at the most risk for disruption, according to Kris Mineau, CEO and co-founder of Avon, Conn.-based Constitution Surgery Alliance.
"Even the busiest ASCs in certain markets may be subject to schedule compression or anesthesia subsidies in the near term," he told Becker's. "In the longer term, they must pressure payers to bear some of the burden and hope the anesthesia provider market better meets the demand."
In terms of keeping providers around, stipends are used as a way for ASCs to retain anesthesia providers as the shortage continues. But many ASCs can't afford these stipends, adding a further obstacle to care.
"The request for stipends poses a difficult position for ASCs as they continue to look for ways to operate the business with less. ASCs will find creative ways/new models to provide the same safe/quality of care while keeping the financial impact low," Joyce White, RN, facility administrator of the Wichita, Kan.-based Cypress Surgery Center, told Becker's. "Certified registered nurse anesthetist models have been used for years and are now being looked to in a broader region as they are more affordable while providing the same quality and safety to patients in ASC settings."
Other ASCs are employing their own anesthesia groups to keep up with procedures, and in some cases, avoid shutdowns.