Andrew Hayek, Chair of the New ASC Advocacy Committee, Discusses its Origin, Makeup and Objectives

The burgeoning ASC community has a new organization to represent its interests in Washington. The ASC Advocacy Committee, launched in August, is sponsored by the ASC Association and by the ASC Coalition, an affiliation of ASC associations and companies. The new committee is chaired by Andrew Hayek, president and CEO of Surgical Care Affiliates, which owns and operates 127 ASCs and surgical hospitals. Here, Mr. Hayek discusses the new committee and its goals.

Q: Why was the ASC Advocacy Committee created?

Andrew Hayek: With all the attention on healthcare reform, with its possible ramifications for ASCs, and the growing reimbursement and regulatory pressures on the industry, it is more important than ever that we speak with one voice. Advocating in a highly collaborative manner is particularly important for our industry. We are a much smaller segment than, say, acute-care hospitals. We're not as well understood and we don't have the political resources that they do. This means that ASCs need to marshal all their resources and work closely together.

We plan to launch a broad effort to educate legislators and regulators on the great value that we provide to the healthcare system. ASCs offer clinical quality at a substantially lower cost, which is a key goal of healthcare reform.

Q: How does the ASC Advocacy Committee work?

AH: It unifies the work of the ASC Association, many ASC companies and, we hope, a number of state ASC associations. All advocacy efforts are now coming under one structure that will communicate, execute grassroots efforts, fund studies and engage with decision-makers on Capitol Hill, in the Administration and with CMS, MedPAC and other important groups.

We have a 12-member board, consisting of six members from the ASC Association and six from the ASC Coalition. Marian Lowe at Strategic Health Care in Washington, D.C., provides day-to-day management. We are also retaining a PR firm and additional lobbyists, and we will be funding analysis to support our advocacy efforts.

Q: How is the committee funded?

AH: By pooling resources, the Advocacy Committee will increase the total amount of funds for ASC advocacy. The ASC Coalition will match and perhaps even exceed contributions from the ASC Association, based on strong support from a broad number of ASC companies and from state associations.

Q: Will it be difficult to find funding in the recession?

AH: It's challenging to ask for funds from ASCs in this economy, but we're finding a great deal of interest. We welcome participation from all parties who would like to ensure the continued success of ASCs, and I encourage your readers to contact either Marian Lowe or me if they are interested.

Q: How much does this new committee have to do with the prospect of healthcare reform?

AH: The stakes have never been higher for our industry to speak with one voice, and not just because of healthcare reform. Providers face increasing rate pressures in the coming years and we need to address questions on the impact of physician ownership. The healthcare reform bills in both the House and Senate include a restriction on physician-owned surgical hospitals. We need to vigorously educate policymakers and legislators on how physician-owned ASCs can improve quality and lower costs.

After going without an update for six years, ASCs are due for a 0.6 percent rate increase in 2010. But the House healthcare reform bill calls for a negative 1.3 percent "productivity adjustment" in rates for ASCs in 2010. Combined with the planned 0.6 percent increase, this amounts to a 0.7 percent reduction for ASCs. The Senate reform bill, on the other hand, calls for a positive update in 2010. The threatened decrease is an example of the kind of rate pressures we'll likely be facing, as Congress looks for ways to fund healthcare reform and reduce massive budget deficits. 

Q: What are the major issues for ASCs in Washington?

AH: We face three major issues, which can be broken down into reimbursements, regulations and physician-ownership.

On reimbursements, we believe that ASCs should receive an update based on a market basket of healthcare input costs, used for hospital rates, rather than the Consumer Price Index. The CPI is based on the cost of housing, gasoline, food and other household expenses, which are unrelated to ASC costs. It makes sense to tie ASC rates more directly to rate adjustments for hospitals. Inflation in both settings is driven by the same factors.

As to regulations, we are proud of the outstanding clinical quality of ASCs, and we seek greater transparency of quality information among providers. We are concerned about changes that add new burdens to ASCs without benefit, such as cost-reporting or restrictions on same-day surgeries. 

Regarding physician ownership, we believe that when physicians directly own and manage centers, they produce better clinical outcomes and lower costs. There is no doubt that ASCs are significantly more efficient than hospital outpatient departments, and active physician management of ASCs is vital to attaining that efficiency.

Q: What can people within the ASC industry do to contribute to this effort?

AH: The ASC Advocacy Committee welcomes wide participation. We think our work to ensure a strong future for the industry will appeal to many people. We want to help ASCs continue to provide outstanding patient care and a level of efficiency that improves the whole healthcare system. This advocacy requires raising funds and asking centers to get directly involved in grassroots efforts. This industry has a strong, positive message to make about high quality and low cost.

Contact Mr. Hayek at Andrew.Hayek@scasurgery.com and Ms. Lowe at marian.lowe@shcare.net.