6 things to know about the New York ASC market

New York is considered one of the most difficult ambulatory surgery center markets to break into. Jordan Fowler, founder and CEO, and Roy Bejarano, president, of New York-based Frontier Healthcare offer are six insights into the state's ASC environment.

1. There are approximately 120 ambulatory surgery centers operating in the state, according to the New York State Department of Health.

2. New York has had a certificate of need program, which regulates ASC development, since 1966. "ASC projects must go through public review," says Mr. Fowler. "Hospitals have the opportunity to oppose projects. They covet their ambulatory work and can be very predatory."

Hospital opposition can have a large impact on the fate of New York ASC projects. For example, a Kaleida Health and physician group joint venture proposal for an Orchard Park, N.Y., ASC earned initial CON approval from the state department of health. But the project came up against opposition from nearby Catholic Health, Lake Shore Health Care Center and Bertrand Chaffee Hospital. The ASC was ultimately denied a CON. Kaleida and its joint venture partners are now wading through the appeals process.

3. The state has a high level of regulation dictating what parties are able to participate in the ASC market. "In other states, there is a much larger representation. Here, you are mostly dealing with hospitals, physician groups and a relatively short supply of companies that have been able to understand and navigate the restrictions," says Mr. Bejarano.

4. Though regulation makes the market more difficult in some respects, New York is not without opportunity for ASC growth and development. "Approximately 10 percent of the national GDP is in New York. It is one of the largest economies in the world, to be able to participate in the marketplace is an opportunity in and of itself," says Mr. Bejarano. "Providers are sophisticated and fluent in the ways of business, which makes for very credible and positive partnerships."

5. While consolidation has swept through healthcare, New York City has remained relatively unaffected. "New York was probably one of the most fragmented markets in terms of providers," says Mr. Fowler. "The city has lagged, but the state has gone through some consolidation." Additionally, hospitals have expressed a growing interest in the ASC space.

6. Like the rest of healthcare, the New York ASC sector has been forced to face the realities of declining out-of-network reimbursement and higher-patient financial responsibility. "It is a deflationary environment for everyone on the provider end," says Mr. Bejarano. "This has forced the community to tackle head on the inefficiencies built into the industry."

More articles on ASC issues:
Where is all the ASC data?
4 recent ASC industry leadership moves
What the slowdown in ASC growth means for the industry: 5 questions answered

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