ASCs are poised to succeed, thanks to several developments over the past few years, according to Vertess Managing Director Hilsman Knight.
Seven trends to know:
1. Increasing reimbursement. CMS will update ASC payments from 2019 through 2023 using the hospital market basket instead of the index previously used to determine payments. The change means average reimbursement for ASCs is expected to increase 2.1 percent.
2. Expanding procedures. ASCs can now provide 140 new device-intensive procedures for Medicare beneficiaries because of CMS' decision to lower the device-intensive procedure threshold. A change in CMS' definition of "surgery" also added a dozen cardiac catheterization services to the approved procedure list.
3. Migrating care delivery. Procedures are shifting from hospitals to ASCs because of CMS' payment updates, as well as the increasing acuity of procedures that surgery center physicians are able to perform. Medical devices are facilitating the migration by creating robotic technology well-suited for ASCs.
4. Continuing transactions. Hospitals and health systems are acquiring or partnering with ASCs, while management companies such as Nashville, Tenn.-based AmSurg and Addison, Texas-based United Surgical Partners International pursue additional partnerships and build centers. More than 40 percent of hospitals and health systems own or are affiliated with a freestanding ASC, according to a 2018 survey of health leaders.
5. Mounting financial complexity. Although ASCs are paid less than hospital outpatient departments, the amount ASCs spend on human resources, technology, capital equipment and cybersecurity is rising. To maintain profitability, ASC managers are carefully watching expenses, optimizing scheduling and continuously seeking savings opportunities.
6. Introducing alternative payment models. ASCs are investing in technology and services to implement alternative models, such as bundled payment, capitation, clinical integration and shared-savings models.
7. Growing consumer demand. Surgery centers are increasingly adding ancillary services such as imaging, pathology and physical therapy to attract patients who want convenient, affordable and quality care.