As CMS continues to phase out the inpatient-only list and expand the procedures approved for ASCs, new opportunities are emerging for ASC leaders looking to add or expand specialty service lines.
Three ASC leaders recently joined Becker’s to discuss the specialties and procedures they see as having the biggest growth potential over the next five years.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: Which specialty (or specialties) do you think will grow the most in the ASC space over the next five years and why?
David Horace. Administrator of Bel Clair Ambulatory Surgical Treatment Center (Belleville, Ill.): Cardiology will continue to grow rapidly. With the safety of PFA and efficiency of using catheters for treatment and mapping, EP physicians should do very well. With minimally invasive technology being introduced at a rapid rate, more cases can be moved to the ASC setting at a lower cost than HOPD and still generate an operating margin. Maybe the biggest constraint will be the supply of invasive cardiologists and EP physicians.
Rao Saladi, MD. Administrator and CEO of Atlantic Surgery Center (West Islip, N.Y.): I believe cardiology, spine, pain management and orthopedics will be among the fastest-growing specialties in the ASC space over the next five years. CMS has recently expanded the list of cardiovascular procedures covered in the ASC setting. This development should create significant momentum for cardiology by enabling more interventional cardiology and electrophysiology procedures to migrate from HOPDs to ASCs. Commercial payers are also likely to support this shift because procedures performed in ASCs can cost significantly (30-50%) less than comparable procedures performed in HOPDs. In addition, declining reimbursement for certain office-based procedures, coupled with increasing procedural complexity, will encourage physicians to move covered procedures into ASCs. The transition will be driven not only by reimbursement considerations, but also by the ability to provide care in a more controlled, specialized, and efficient environment. Demographic trends will further support this growth. The continued aging of the U.S. population is expected to increase demand for interventional cardiology and electrophysiology procedures. As more cardiovascular procedures become covered under an ASC setting, I expect cardiology to experience some of the fastest growth in the percentage of ASC procedures.
Bradley Schmidt. CEO of Northern California PET Imaging Center (Sacramento): Honestly, nearly all specialty ASCs will be migrating and growing over the next several years, with cardiology, gastroenterology, orthopedics being the leaders in this space due to the aging population. Expect massive ASC growth.
The surprise in this space will be how ASC services get purchased. Long term, I think insurance will play a smaller role for patients under age 65, while employers, price transparency, and quality will play a much larger role. Employers may increasingly fund healthcare directly in lieu of traditional commercial insurance.
We will likely see “shopper lists,” where ASC services are purchased at flat, transparent rates to reduce the cost of care compared with the hospital environment. This modernization will be driven by the growth of a direct healthcare marketplace as commercial insurance costs continue to rise in the U.S.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
