Six ambulatory surgery center physician owners discuss how the importance of the ASC to their practice has evolved over the past five years.
Robert S. Bray Jr., MD, DISC Sports & Spine Center, Marina Del Rey, Calif.: The ASC has given us the ability to control quality at a cost-effective price, not compromising care to the patient. We can still be competitive in today's market and meet or beat all national benchmark standards. For the practice, it allows us to maintain autonomy and financial stability. Being small, nimble and efficient places us in the best position to deal with economic change.
Scott Gillogly, MD, Altanta Sports Medicine Surgery Center: As reimbursements for professional services (doctoring) continue to take a precipitous downward spiral, the ASC revenue helps offset the disparity. As such, the efficiencies in operational costs of the ASC have become even more critical. Additionally, vigilance of payer history is even more necessary for out-of-network plans.
Donald Johnson, MD, Southeastern Spine Institute and Ambulatory Surgery Center, Mt. Pleasant, S.C.: Our ASC has become more valuable to us from both a business practice standpoint and professional standpoint. We have more insurance carriers that are reimbursing outpatient spine surgery procedures. This allows for a more cost efficient and pleasant patient experience. Outpatient spine surgery provides a platform for practice marketing.
Additionally, as revenues for all aspects of physician practice have decreased over time ancillary revenues have become more important for practices trying to maintain independence. Primarily driven by decreased cost, outpatient spine surgery done in ASCs will become more prevalent and important to spine practices over the next five to 10 years
Richard Kube, MD, Prairie SurgiCare, Peoria, Ill.: Five years ago I did not have a surgical facility. Now that I have one, I feel it is infinitely important. I now have a facility to perform procedures that consistently generate higher patient satisfaction scores. While our infection rates were always low, now infections are almost unheard of in the ambulatory facility (one to two in over 1,000 cases).
The convenience of scheduling for my staff is unmatched by any hospital. Levels of patient care are improved. If I have a patient with severe radiculopathy and a “hot disc,” I can do an epidural injection within an hour or so instead of days or even weeks later. I also have the ability to bring new technology into the facility without months of committees where decision makers don't even understand the technology. New options for patients are introduced almost immediately. We also have better capabilities to negotiate price. I could go on, but these are a few of the most obvious and important factors.
Michael Redler, MD, The Surgery Center of Fairfield County, Trumbull, Conn.: I think the ASC is ever more important, without question. I've been president of the medical staff at our surgical center for many years, and I've found my involvement with the center continuing to grow not only with the cases we do and the scope of cases done at the surgical center but also dealing with the politics and insurance carriers that we have to deal with to continue our success. I find myself dealing with that portion of the ASC more often, and I'm doing more cases there as well. Additionally, our surgical center's infection rate is 1/10 of 1 percent.
I think the ambulatory surgical center in today's healthcare environment has taken on a greater role than it did five years ago because as the nation has become more concerned with cost-efficient care, the fact that we can offer outstanding surgical care at a lower price and with higher efficiency and patient satisfaction has made the surgical center the center of my practice, without a doubt.
Joshua Siegel, MD, Northeast Surgery Center, Newington, N.H.: We have sold a portion to a national ASC manager and because of that loss of local control, I would say that it is less important than five years ago where the ASC was more integrated into the everyday practice with cross marketing and similar agendas. The national ASC manager as a publicly traded national company is less present and less focused on the local market in terms of advocacy for the physician partners of the ASC.
I think an ASC should complement the surgeon's practices in more ways than just providing a convenient efficient place to do surgeries and should be involved in marketing and advocacy for the physician members and their practices. There should be close cooperation and a cohesive business plan to allow the entities to be proactive and synergistically involved.
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