Dr. Richard Rosenfield: Creating the national model for successful gynecology-driven ASCs

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Gynecology procedures represent a fraction of the cases performed in ambulatory surgery centers, but there is a significant opportunity to change that equation.

Pearl Women's Center and Pearl SurgiCenter in Portland, Ore., have been open since 2005. The clinic and surgery center are geared entirely toward women's health and gynecology surgery. Founder Richard Rosenfield, MD, began his medical career as a physician with Kaiser Permanente in California, but never forgot his experience at surgery center during training. Frustrated with the restrictions of employment, he left to open Pearl Women's Center and the affiliated surgery center.  

For the past 10 years, the clinic and surgery center have flourished, but remain a relative anomaly. Simple gynecology procedures that had been done in the ASC were moving to the office and higher acuity cases stayed in the hospital. But, higher acuity cases in all specialties are migrating. "Bariatrics has come into view. Orthopedics and spine have become an exciting focal point," says Dr. Rosenfield. "Gynecology hasn't had its moment yet." But, he predicts that is all about to change.

Hysterectomy is one of the most common procedures performed on women in the United States, but it remains largely the province of hospitals. "It is not uncommon for hospital bills for hysterectomy to be in excess of $25,000," says Dr. Rosenfield. "We perform the procedures for a fraction of the cost." Payers are looking for the opportunity to push down costs, without sacrificing quality. Such a common procedure is ripe for the ASC setting, particularly as payer interest grows.

Pearl SurgiCenter works with a mix of in-network and out-of-network payer contracts, but the center is poised to ride the growing wave of high-quality, low-cost healthcare. "On a case by case basis, we are saving any payer $5,000-plus per case," says Dr. Rosenfield. "When you attach the quality piece, they could be willing to pay more." He is also seeing increased interest from self-funded employer groups. Employers funding their own health plans are interested in partnering with providers that can offer clear, consistent and reasonable pricing for quality care.

Given Pearl Women's Center and Pearl SurgiCenter's success, Dr. Rosenfield is working on rolling out a national model for other surgery centers to follow. "I've been able to find independent physicians and align them with ASCs that can take them in," he says. "We have brand rolling out, backed by Nobilis Health in Texas."

With branding efforts well underway, Dr. Rosenfield hopes to increase gynecology's penetration in the ASC industry. "We are looking for a quality product with decreased complications. That opportunity in healthcare is golden," he says. "If rolled out responsibly, gynecology could be the next big thing in the ASC space."

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