1. Increasing government oversight. David Kwiat, MD, an ophthalmologist and part-owner of Fulton County Ambulatory Surgery Center in Johnstown, N.Y., predicts that ASCs will be additionally pressed for resources due to additional governmental control and oversight coupled with decreasing reimbursements.
"This provides a situation that decreases the profit margin of an ASC as the government pays less and their reporting requirements increase our overhead through the need to hire more staff," he says.
2. Different survey standards. Craig J. Bakken, CMPE, CEO of Rocky Mountain Gastroenterology Associates and Endoscopy Centers, says one major change affecting ASCs in 2010 will be new survey requirements that reflect the new CMS Conditions for Coverage for ASCs.
"ASCs across the country are going to scramble to comply with state survey standards for Medicare recertification and state licensure where applicable as the new standards associated with the updated Conditions for Coverage are utilized in surveys in 2010," he says. "Endoscopy centers will be challenged with new requirements for history and physicals prior to the date of the procedure when practicing "open endoscopy" scheduling."
3. Increased pressure on medical suppliers to reduce costs. If healthcare facilities continue to receive pressure to cut costs, additional pressure to reduce these costs will be passed on to medical suppliers and manufacturers whose products can play a large role in case costs, predicts Vicki Merrick, RN, CASC, director of operations for Health Inventures.
4. Continued tight credit market. Corbett Jackson, administrator of Sutter Roseville Endoscopy Center in Rosville, Calif., predicts that continued tight credit markets will keep new ASCs from breaking ground and existing centers from expanding or adding new equipment. However, she says this may leave many existing centers poised for a successful 2010 if they are able to appropriately oversee payor mix and collections.
"Tightly managing payor mix and collecting patient payments before service will remain a priority as high unemployment percentages remain and patient deductibles and coinsurances continue to rise," she says. "Just like it was 40 years ago when the first ASC opened, centers that are able to grow volume will win in 2010."
5. Continued interest in joint ventures with hospitals. Increasing oversight and decreasing reimbursement will continue to drive ASCs toward considering joint ventures with hospitals, says Dr. Kwiat.
"The higher reimbursements and preferential government treatment that hospitals receive has made [considering a hospital joint venture] the best strategic move for us at this point in time," he says. "I think given the current environment the trend may be toward consolidation and joint ventures in the future regardless."
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