5 Reasons for ASCs to Be Optimistic About 2011

With decreasing reimbursements, increased regulatory requirements and a struggling economy, ASCs may expect a challenging 2011. But hope springs eternal: here are five reasons for ASCs to be optimistic about the coming year.  

1. ACO development gives ASCs the opportunity to be on the "inside" of change. The driving force behind accountable care organizations in each community will be the major hospital system. In the next year, that hospital system will be tasked with looking at the various facilities and healthcare delivery methodologies within its catchment area and determining where low-cost care exists. "As the programs and regulations needed to support and implement healthcare reform continue to be enacted, ASCs continue to emerge as a key part of the long-term solution to meeting America's surgical needs," says William Prentice, executive director of the ASC Association. "Through federal initiatives like value-based purchasing, ASCs will have new opportunities to demonstrate the exceptional care and value they provide."

In order to take advantage of ASC development efforts, ASCs should think about which episodes of care they participate in and how they can demonstrate their cost efficiency and quality, says Mark Lutes, attorney with Epstein Becker & Green. "If more patients in such an episode were directed to [the ASC], there could be an additional cost savings relative to other sites of care," he says. He says this opportunity means gathering data on patient satisfaction, cost savings and quality outcomes and approaching the local hospital system to discuss ACO development.

2. ASCs are claiming their "seat at the table." According to Mr. Prentice, when healthcare policy was debated and enacted a decade ago in the state legislatures and on Capitol Hill, ASCs were mostly absent from the discussions surrounding the decisions made. "Today, ASC advocates are visiting their elected and appointed officials in their state capitols and Congress, participating in national coalitions with likeminded interest groups and making their voices heard," he says. "While we still have much to accomplish in this area, we have come a long way in raising awareness of ASC issues and the many important ways ASCs contribute to their communities and the nation's healthcare."

This growing voice means ASCs across the country should consider involvement with their state and the national ASC association. Mr. Prentice says in 2011, the ASC Association and the Ambulatory Surgery Advocacy Committee will attempt to expand its capacity to reach key decision-makers regarding policies that affect ASCs. The more ASC representatives who can stand behind these associations, the better.  

3. Failing centers will give stronger centers more market share.
As some ASCs close their doors, many driven to do so by the financial downturn, other ASCs should look to profit from the increased availability of market share and physicians. Ed Hetrick of Facilities Development & Management says ASCs should keep an eye on the local community and watch for struggling ASCs that may have an interest in merging or sending their physicians to another center once they close. "You may need to be proactive in [approaching] a struggling center and saying, 'We will move all your doctors into our center,'" he says. "That could mean either a merger or just moving all the physicians and accepting them as partners and members of your center."

Brice Voithofer and Bill Gilbert of AdvantEdge Healthcare Solutions agree that the opportunities will be there for those ASCs who choose to capitalize on them. "Some people have said that easy money has been made [in ASCs] and now it's going to get harder, but to us who have worked in other industries, harder really looks like the normal course of business," says Mr. Gilbert. "It's really about being businesslike in running the surgery center and not just thinking you're going to make money easily."

4. Technological advances will introduce new patients and cases to ASCs. According to Mr. Prentice, ASCs can expect technological advances to introduce new cases into the ASC. "If the history of the ASC industry is a reliable means of predicting the future, as I believe is the case, we can expect improved patient and physician satisfaction levels as the number of procedures ASCs perform continues to grow," he says. For example, ASCs have recently been able to introduce discectomy cases into spine-focused centers, bringing profit that was only available to the hospital in the past.

5. Physicians will pursue ASCs as professional fees decline.
Physicians may be more attracted to ASC investment in 2011 as professional fees decline and endanger their compensation, Mr. Hetrick says. "This is truly one of the few ways [physicians] can have an alternative revenue source," he says. He adds that the attraction to ASCs doesn't only apply to physician-owners. Since physicians can perform cases efficiently in the ASC setting, they'll likely be able to perform more cases in a shorter period of time than in other settings. "For those people who aren't part owners of the center, it's a place where they can really get 'bang for their buck,'" Mr. Hetrick says.

For these reasons, ASCs in 2011 should keep a close eye on sources of new physicians in the community who can help an ASC expand. This could mean communicating more closely with existing physicians about new providers. It could also mean watching medical school graduations for providers that introduce a new, profitable specialty or fit with your existing specialty.

Read more tips on how to maintain and grow your ASC in 2011:

-6 Steps Your ASC Can Take to Become More Profitable

-5 Ways ASCs Can Keep in the Black

-10 ASC Best Practices From 10 ASC Physicians

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