1. Unemployment will linger. Unemployment will stay high for many years to come. Dr. Pettine believes the U.S. economy has deep underlying problems that can’t be fixed quickly. Consumer confidence, the engine of any recovery, will take a quite a while to bounce back. This means a protracted period of lower volumes for many ASCs, which will prompt them to look for new sources of revenue.
2. Multispecialty ASCs will fade away. “We’re getting away from ASCs owned by 30 physicians from all different specialties,” Dr. Pettine says. “Those centers are inefficient. I worked in one and it went bankrupt.” Specialized centers – focusing on colonoscopies, spine, arthroscopies or ENT, for example – operate more smoothly and complication rates are very low. “The ASCs that make money tend to be the ones who have only one to two specialties and do those things very well,” he says.
3. Hospitals’ role will decline. “Some hospitals are dinosaurs,” Dr. Pettine says. “They’re inefficient and everyone is moving to outpatient care.” Even as the hospital sector goes downhill, new hospitals look ever more luxurious. “They look like Ritz-Carltons. They are living beyond their means,” he says. “There are duplicated services and they buy equipment they will hardly use.”
4. Push for case rates. One way ASCs could enhance volume is to negotiate “case rates” with payors. In this approach, the ASC would agree to one lump-sum reimbursement to cover all costs, including implants, the surgeon’s fee, the facility fee and even any complications that might arise. In return, the ASC would get an exclusive contract or some other preferential treatment as a “center of excellence.” The predictable payments would attract payors because “what kills insurance companies are question marks, the unknown,” Dr. Pettine says. ASCs could offer far better deals than hospitals could. For example, a spine ASC could agree to be paid $40,000 for the whole package of care for lumbar fusion, compared with the hospital’s global charge of $85,000 for the same services.
Learn more about Loveland Surgery Center.
Read more about the future of ASCs:
– Future of ASCs in Five Years: Predictions on the Most Common Ownership Model
– Predictions for the Immediate Future of ASCs With Jon Vick of ASCs Inc.
