Making the Decision: Can Physician-Owned Orthopedic ASCs Remain Independent?
According to Mr. Fink, there are several challenges facing ASCs, including market saturation, migration of surgeons to hospital employment and more stringent physician requirements.
From physician ASC-owner perspective, these five factors affect the viability of remaining independent, according to Mr. Fink and Mr. Feldman:
1. The physician and procedure/payer mix.
2. The managerial capability and efficiency at the center.
3. Contracting initiatives and whether a center has the capability to incorporate new reimbursement models, such as bundled payments.
4. Dependence on out-of-network revenues, as this is no longer a viable strategy.
5. Patient satisfaction rates as well as quality and outcomes reporting.
Another important factor is succession planning at the center, notes Mr. Feldman. It is helpful if ASC administrators are involved in this process. "I try and stay involved by meeting with new physicians coming into the center," he said. "I also share the financial and operational goals of the center with them."
However, there are situations in which ASCs might need to think about partnering with a hospital. "Physician-owned orthopedic ASCs might want to consider partnering with a hospital if they have high-cost environmental or capital needs, are having difficulty recruiting new investors, an increasing presence of narrow networks/ACOs and margins reliant on out-of-network strategy," said Mr. Fink.
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