1. Physician consolidation. All three panelists agreed losing physicians to hospital employment was the top concern for ASCs. Mr. Hazen has seen his physician staff drop from 48 to 28, most bought by the ASC’s hospital joint venture partner. “And now my hospital partner just built a new hospital across the street that has become a surgical hospital,” he said. “Makes me wonder, are they really my partner?”
2. Declining reimbursements. “Private payers don’t want to work with us,” said Mr. Flaxman. Blue Cross Blue Shield has a 40 percent market share in his ASC’s market, and his ASC went three years without a reimbursement increase and only recently got one after four months of negotiations. “We also have no voice as an ASC on Medpac,” he said, “and if our Medicare goes down then we will be in a very difficult position.”
For Mr. Pankey, the issue is an increasingly unfavorable payer mix. The number of patients with government insurance has increased in his market from 45 to percent to 55 percent in recent years, coupled with an increase in self-pay and charity care. “That’s where we’re seeing the declining reimbursements,” he said.
3. Volume depletion. All the panelists have concerns about decreasing volumes at their centers. Mr. Pankey has seen a drop in volume from a lack of insured patients in the area due to the decline of the textile industry in South Carolina.
Mr. Flaxman has seen the patient volume at his ASC remain steady, but is concerned about a local hospital’s efforts to develop a narrow network with a major insurer in the area. “If they can pull that off, that will definitely affect us,” he said.
4. Healthcare reform. “For us, seeing more people with insurance is a good thing,” said Mr. Flaxman, though the $7,000 deductible on his state exchange’s “Bronze” plan has him concerned about patients’ abilities to pay. “We’re ramping up efforts to let people know the exact price or copayment of a procedure, and working on ways to push procedures back to fit in with a payment schedule,” he said.
“Price transparency may be the best way to offset high deductible plans,” said Mr. Pankey, who joined Mr. Hazen in saying he sees advertising procedures’ prices as a way to lure patients away from hospitals.
More Articles on ASC Strategy:
Outlook for Investment and M&A Activity in the ASC Sector
Hospital Employment, Office-Based Procedures & Specialist Shortages: How They Impact Ambulatory Surgery Centers
Stay Competitive: 5 Enhancements for GI/Endoscopy Groups
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.
