Referral patterns are changing for ASCs as physician groups join health systems and payers narrow their networks.
Specialists traditionally relied on primary care physicians and word-of-mouth referrals from former patients. However, consolidation of physician practices accelerated during the pandemic, and a recent Avalere report showed that around 50 percent of physicians are employed by hospitals while around 20 percent are employed by corporations, including insurers and private equity groups.
Employed physicians often refer within their network, drying up the patient pipeline for independent surgery centers. But as one door closes, another opens. ASCs are finding fresh pipelines for patients, including contracts with employers, insurance companies and third-party administrators.
"ASCs that have an ability to bundle their services for specific procedures will have the opportunity to negotiate directly with self-insured employers, enabling their employees to get concierge-type services at reduced rates," said Christina Goodall, RN, DNP, administrator of Atlanta Orthopedic Institute. "By doing so, employers will reduce their lost-time injuries and ensure that their employees receive high-quality services in a controlled environment."
Other centers are adding service lines and focusing more on cultivating referral sources to help their businesses grow.
"Since we don't employ physicians, we must maintain and grow our referral sources," said Taylor Cera, COO of Orthopaedic Surgery Center in Youngstown, Ohio. "We've added multiple service lines and have plans to grow and expand even more. We collaborate with physician groups, train staff, communicate to all stakeholders and integrate the latest state-of-the-art technology."
A strong and diversified referral source also can attract new physicians to the ASC.
"From the standpoint of getting doctors in the facility, I think developing referral networks is important," said Randy Reynolds, senior vice president of field operations for HealthCrest Surgical Partners in Edmond, Okla. "If you can match up doctors with cases that need to be performed, or through some type of arrangement with employers or third-party administrators, then you have something to offer a doctor if you're trying to recruit."
Patients also are increasingly interested in directing their care and researching high-quality, low-cost settings.
"There's going to be increasing migration of cases toward the surgery center," said Harel Deutsch, MD, co-director of the Rush Spine Center in Chicago. "I think there's going to be more marketing to patients, and patients are going to be greater consumers and do more research. It's going to be less about referral and more about how you reach the patients, who are going to have more information available to them to make decisions about healthcare in the future."