How Will Hospital Employment Impact ASCs in the Future?

At the 20th Annual Ambulatory Surgery Centers Conference in Chicago on Oct. 24, Scott Becker, JD, CPA, publisher of Becker’s ASC Review and chairman of the healthcare department at McGuireWoods, moderated a panel discussion on the future of surgery centers.

One of the current trends that will have the biggest impact on the future of surgery centers is that of physician employment.

In some markets, the employment of primary care physicians by hospitals has hurt the referral volume of surgeons that aren't employed or closely aligned with the hospital.

Bill Hazen, RN, CHT, administrator of The Surgery Center at Pelham in Greer, S.C., remarked that many of his physicians are afraid of private practice because the hospital employs primary care providers, who control referrals. As narrow networks become more popular, independent physicians risk losing referrals.

Kenny Hancock, president and chief development officer of Meridian Surgical Partners, said in one particular market an aggressive hospital eventually led the physicians and his company to divest ownership in the center, but overall many surgical specialists hope to maintain their independence, and therefore, control, of the services they provide.

Linda Ruterbories, RN, ANP, director of surgical services at OA Center for Orthopedics in Portland, Maine, said she sees desire for employment most noticeable among younger physicians. "They want the salary that's a known entity," she said, but added that there still are physicians out there who see the benefits of independence and want to be entrepreneurial.

Ms. Ruterbories added that a strong "brand" can help practices compete with hospitals. "As long as you have the brand...patients know that, and strive to be there."

While hospital employment could prove a challenge to independent surgery centers, there remain opportunities for centers, which offer a lower-cost site of care compared to hospitals. Mr. Hazen said he sees an opportunity, as more patients enroll in high-deductible plans, to offer low-cost bundled payments to patients, payers and employers.