ASCs are in a great position to capitalize on the trend to value-based care. Surgery centers are the high-quality, low-cost setting for care and could save Medicare, insurers and patients billions of dollars every year by migrating outpatient surgeries to the low-acuity setting. But there is one thing holding them back.
Technology.
"Technology is key as we move toward an outcome-based payment structure from the traditional fee-for-service," said Jeffrey Flynn, administrator and COO of Gramercy Surgery Center in New York City. "Many payers are approaching us about bundles and outcome data."
Hospitals and insurers have sophisticated EHRs and data management systems to capture information about patients and deliver a high level of care. They have a huge advantage over ASCs when it comes to value-based care and risk-based contracting because they have the data and analytical capabilities to negotiate rates and contracts beneficial for them.
ASCs, on the other hand, were left out of the digital transformation, and the price of even specialty-focused EHRs is out of reach.
The federal government required hospitals to implement EHRs in 2009 with the Health Information Technology for Economic and Clinical Health Act and provided financial assistance through the meaningful use program. Surgery centers did not receive similar support to go digital and had to foot the entire bill if they wanted the latest technology. Many are still operating on paper records.
More than one-third of the 157 ASCs in New York do not have EHRs, according to Mr. Flynn, who is also the vice president of the New York State Association of Ambulatory Surgery Centers. He sees the lack of digital transformation among member centers as concerning.
"Without [EHRs], it will be very difficult to track outcomes and can have a detrimental effect on [ASCs'] future payment structures," Mr. Flynn said. "However, those centers that are thinking of this now and implementing the technology to track outcomes will benefit greatly as this new payment model takes place."
EHRs can also make ASC operations more efficient and effective, according to Rick Liwanag, MSN, administrator of Gulf Coast Outpatient in Biloxi, Miss. The long-term savings help centers realize a return on investment for the expensive EHR systems.
"ASCs are slow to take advantage of the benefits of an EHR," he said. "We are just now moving from paper to electronic, even if it has been proven to save so much time and cost."
The lack of digital capabilities will also put ASCs behind in the race to attract patients, who increasingly demand a seamless healthcare experience. Patients are searching for healthcare providers online, and an attractive digital front door with the ability for them to schedule appointments online and pay at their convenience will be necessary moving forward.
ASCs are on tight budgets with rising supply and labor costs, but the most forward-looking administrators are making room in their budgets to invest in EHRs and data analytics to prepare for the future.