'More skin in the game' — Tips for surviving in a consumer-driven market

As healthcare becomes increasingly focused on the patient, the market for ASCs will continue to rapidly expand. Board-certified anesthesiologist Matthew Verdone, DO, outlined key strategies ASCs can utilize to overcome obstacles at Becker’s 22nd Annual Meeting: The Business and Operations of ASCs.

The recovery time for complicated procedures has rapidly decreased with the evolution of technology. A patient spent an average of seven days to 10 days in a hospital recovering from an open gallbladder procedure 35 years ago. Ten years later, a patient had an average recovery period of three days to five days following a laparoscopic gallbladder procedure. With the leaps in technological advancements today, the majority of patients are discharged in less than 24 hours.

"As we enter the age of consumerism, efficiency becomes very important," said Dr. Verdone. Dr. Verdone serves as the director of ambulatory services at North American Partners of Anesthesia, which is comprised of over 1,500 clinicians and serves 72 hospitals in nine states.

Patients are demanding cost-effective care, which is driving the market for ASCs. ASCs can handle more complex episodes of care, and thus a sicker patient population. ASCs are pertinent to this shift in the marketplace from inpatient care to outpatient care. As Dr. Verdone explained, the role of the patient is increasingly important as patients have "more skin in the game."

Although ASCs are taking on more complex cases, they still face challenges. The consumer-driven market is both fueling the ASC market and posing challenges for the centers. The age of the passive patient is a thing of the past, and more patients are doing their homework. Dr. Verdone said, "Consumers are driving the decisions, and perception is key." Therefore, the patient's experience should not be overlooked as patient satisfaction scores increasingly determine reimbursement rates.  

Providers in ASCs are also encountering physician demographics that could inhibit a productive working environment. The recent influx of millennial has, in part, altered the work/life relationship. "Millennial are more about lifestyle balance," Dr. Verdone explained. While efficient workers, younger physicians generally prefer to work from 7 a.m. to 5 p.m., which may prove a strange concept to physicians from different generations. Communication and collaboration among all healthcare professionals is necessary to ensure the generational gap does not negatively impact the work environment.

Although benchmarking and data collection can pose challenges for ASCs, Dr. Verdone explains they also can act as an opportunity. Dr. Verdone said, "With benchmarking, ASCs can show how good they are." A center's benchmarks can be utilized to recruit top surgeons to a center, and therefore a center must efficiently utilize its data to its advantage.

Bundled payments may continue to be a challenge for ASCs. Dr. Verdone describes bundled payments as the "800 pound gorilla in the room. "Payers are in favor of bundled payments because they can articulate what to expense going forward," Dr. Verdone said. "You need good data to use bundled payments."

To address these challenges, NAPA has a symposium twice a year to discuss the key issues and potential ways to solve them so all clinicians are, "putting out the same product," as Dr. Verdone explained. NAPA operates under the philosophy, "Patients come first," and this motto may serve the organization well in this patient-centric healthcare market.

Healthcare will continue to evolve, particularly for ASCs. With the technological advancements in surgery and anesthesia, centers are able to perform ASA II and ASA III cases.  Age, in some cases, is not a factor when providers consider taking on a patient. "It is more important to look at functional capacity than age," said Dr. Verona.  "[NAPA] does not use age as an absolute criterion."

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