This trend could reduce the number of ASCs

Anesthesia costs are skyrocketing, and some ASCs are worried about sustainability of these issues if payer reimbursements do not adjust. 

Michael Chwalek, senior financial analyst at Ambulatory Surgical Centers of America, joined Becker's to discuss the healthcare of which trends he is wary. 

Question: What healthcare trend are you most wary of right now?

Michael Chwalek: Anesthesia stipends for ASCs concern us. Anesthesia is asking for stipends because their personnel costs are rising dramatically and aren't supported by payer reimbursement. They have a strong negotiating position because of the limited number of providers and their critical role in providing surgery. You can't do a case without them, and it's not easy to change providers. Some surgeons are frustrated by this because they see it as anesthesia having the ASC pay for their salary increases. Just a quick note that ASCs pay for anesthesia equipment and supplies under most arrangements, so the majority of anesthesia's cost are personnel costs. I don't see this trend changing soon. It would require an increase in anesthesia providers, which I don't think can happen quickly, or an increase in payer rates, which I don't see happening.

Q: What are the potential dangers if this continues?

MC: I worry it reduces the number of ASCs. I don't see a quick solution to rising anesthesia costs or the stipends to support them. Some existing ASCs won't be able to afford them, and it will discourage the development of new facilities. Alternatively — and this is what we're seeing at our ASCs — it could galvanize independent ASCs to better utilize their centers, making both the ASC and anesthesia better off.

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