Independent ASCs are facing major obstacles amid increasing healthcare consolidation and shifting payer behavior.
Three ASC leaders joined Becker's during a June 22 panel at the 21st Annual Spine, Orthopedic & Pain Management-Driven ASC + The Future of Spine Conference in Chicago to discuss some of the biggest threats to independent ASC success.
1. Payer behavior
For Hardy Sikand, CEO of Carmel-based Indiana Spine Group, payer relationships and reimbursement pressures are the biggest challenge his team is facing as a wholly independent spine practice.
"It's been extremely, extremely hard," Mr. Sikand said. "They were very favorable to us when we opened our facility, but it's become really challenging to deal [with large payers in our market]. But when you can offer members the cost savings that we get, they have to be able to offer us contracts."
Other leaders agree.
"I think that the single biggest challenge is really payer consolidation," Joy Taylor, COO of Axion Spine & Neurosurgery, added during the panel. "We've recently had to start a de novo facility, … and getting payers to give you the time of day, even though you represent substantial savings over the [explanation of benefits] that are coming out of the hospital, it's very, very difficult to get on their radar. So that's really been the single biggest challenge for us."
2. Anesthesia coverage
John Brady, CEO of Geneva, Ill.-based Fox Valley Orthopedics, said another big challenge for his team is securing anesthesiologists amid the provider shortage in Illinois and other parts of the country.
From 2021 to 2022, more than 2,872 anesthesiologists left the workforce, according to a report from Definitive Healthcare. And in 2021, the Association of American Medical Colleges predicted a shortage of 12,500 anesthesiologists by 2033.
3. Device costs
Mr. Brady also added that device costs have been a challenge for his team.
"We were all so happy when it was announced that you could do Medicare shoulders in ASCs, but when we looked at the cost and what the vendors were charging us for the implants, we had to do some hard and fast talking and really lean on them, hard to bring the cost down, getting standardized approaches," Mr. Brady said.