At the Becker's ASC 21st Annual Meeting in Chicago on Oct. 23, Linda Ruterbories, director of surgical services at Portland, Maine-based OA Centers of Orthopaedics, and Mary Ryan, administrator of the Tri-State Surgery Center in Dubuque, Iowa, discussed hurdles the ambulatory surgical center industry will face 10 months and 10 years into the future. Ellie Rizzo, lead editor with Becker's ASC Review, moderated the discussion.
Payment structure. Patients' out-of-pocket costs are growing as reimbursements decrease. Out-of-network patients will be particularly challenging for ASCs, according to Ms. Ryan. Her center doesn't see many out-of-network patients because the payment structure puts patients in the middle. "It's a great bridge, but not sustainable long term," said Ms. Ryan.
Recruiting. ASCs face challenging competition with hospitals when recruiting physicians. There has been a mass exodus of physicians and owners from ASCs to hospitals in the past five years, according to Ms. Ruterbories. As physicians' salaries decline at hospitals, they are beginning to return to ASCs, she said, especially younger physicians who are family oriented and attracted to better work hours at ASCs. Ms. Ryan said she agrees with this analysis for now. However, in 10 years, surgery day schedules will be longer and this may no longer hold, according to Ms. Ryan.
Shortages. Ms. Ryan predicted the physician shortage will be the biggest challenge for ASCs to survive. Choose physicians wisely and consider the culture of the ASC, she advised.
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