'Concentrating the power in the hands of a few entities has proven to be bad for healthcare': 8 key quotes from ASC leaders 

Patsy Newitt - Print  |

From CMS' proposal to remove procedures from the ASC payable list to President Joe Biden's executive order to scrutinize hospital mergers, ASC leaders have had an abundance of news to reflect on.

Here are eight recent, key quotes told to Becker's ASC Review:

"It’s an obvious step backwards. It brings into question so many factors within the decision-making process at CMS. If the real reason for what seems like indecisiveness is truly patient safety, then what was the process of evaluating the procedures to decide that they were appropriate for the ASC? That needs to be looked at, assessed and be as transparent as possible," Gabriel Figueroa, administrator of Manhattan Reproductive Surgery Center in New York City, said of CMS' plan to cut procedures from the ASC payable list.

"Just as the decision to eliminate the inpatient-only list had no immediate direct impact on the kind of procedures ASCs could perform, the decision to reinstate it has no immediate direct impact on ASCs either. However, if CMS does overturn last year's decision to eliminate the IPO list, some language adopted at the same time that would prohibit new procedures from moving into ASCs in the future would also be eliminated, and that would be a positive development for ASCs," William Prentice, CEO of the Ambulatory Surgery Center Association, said of CMS' proposed rule to reinstate the inpatient-only list, which it previously planned to dissolve in 2024.

"This sounds like a terrible idea fueled by some backroom politics between hospital executives and the government. Unless there is solid data to support this movement, it is a clear move by hospitals to protect revenue more so than ensure safety," Richard Rosenfield, MD, executive medical director and chief of gynecology at Pearl Women's Center and Pearl Surgicenter in Portland, Ore., said about CMS' proposal to cut procedures from the ASC payable list.

"Concentrating the power in the hands of a few entities has proven to be bad for healthcare. ASCs are a dynamic space that have multiple potential purchasers and operators. I don’t think there will be a reduction in quality and the continued scrutiny will benefit ASC growth," Adam Bruggeman, MD, surgeon at Texas Spine Care Center in San Antonio, said about whether President Joe Biden's executive order to scrutinize hospital mergers will negatively affect ASC joint ventures.

"A truly bold thing that could happen would be that the insurance (commercial) payers come out and actually launch steerage programs to centers of excellence across the nation. This can’t be a race to the bottom, though. It has to be a focus on quality work with possibly a tiered approach for outcomes. For years, ASCs have been doing total joint and spine cases but haven’t been as handsomely rewarded as they need to be," Andrew Lovewell, administrator of the Surgical Center at Columbia (Mo.) Orthopaedic Group, said about his bold predictions for the payer market. 

"Being a member in a single-specialty group is not bad as a decision, albeit what is wrong is the decision being made due to lack of confidence in the ability to run my own business. The price I paid was always being considered the second man in the group. At this later point in my career, I would have appreciated framing the vision and the style of running the practice after my philosophy and approach to medicine and my instincts that I should have trusted," Abedelrahim Asfour, MD, of Beaumont Hospital in Southfield, Mich., said about how his worst financial decision was starting his own private practice. 

"At heart, I am an optimistic person. That said, with the challenges we continue to face related to reimbursement, panel status and supply shortages, I am concerned about the viability of freestanding centers such as ours. In addition, the increased burden of regulatory administrative paperwork has an increased layer of expense in terms of time and staffing," said Karen Wood, the administrator of Advanced Pain Management Center and Cedar Hills Surgery Center in Portland, Ore., on why she's concerned about the survival of independent ASCs.

"Togetherness may not be a current buzzword, but it describes the ethos that allowed this center to thrive during the pandemic. What kept patients coming was the knowledge that we were doing everything possible to keep them safe and take care of their needs. What kept the staff loyal was the physicians' willingness to sacrifice their profits to keep them fully employed and to share the health risks at their side. What kept the physicians engaged was the desire to preserve and protect the organization they had created and the people they served. This sense of mutual obligation and shared risk brought and kept everyone together through the tough days of the shutdown and the tougher days of the recovery," said Alfonso del Granado, administrator of Covenant High Plains Surgery Center in Lubbock, Texas, on how his ASC survived the pandemic.

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