Experts disagree over outlook for independent ASCs: What we heard in May

ASC leaders spoke with Becker's ASC Review on key topics in May, from the outlook for independent ASCs to the financial effects of current payer trends.

1. "Independently owned, single-specialty [ASCs] will have a competitive edge as more institutional buyers of healthcare realize the cost savings of moving cases out of the hospital setting and into ASCs. The quality gains will become apparent from the staffing models provided by these specialty surgery centers, offering surgeons more autonomy and the ability to develop a true team environment, not one assigned to them by hospital administration." — Doug Geinzer, founder and president of Las Vegas-based High Performance Providers, on which ASCs will win their markets in the next five years.

2. "It is unlikely individual ASCs will be successful on a stand-alone basis. Integration into larger healthcare networks will alleviate challenges ASCs are facing." — Matthew Searles, MBA, partner at ASC management and development firm Merritt Healthcare Advisors, on what presents ASCs with the best opportunities to thrive in the future.

3. "You look at these large orthopedic groups across the country, some of them are partnering with groups like ours while other groups have reached the size and scale that they can start to build out their own ambulatory surgery team, their own urgent care team, their own physical therapy teams. So what you're really beginning to see is the days of the two-, three-, five-man practices are numbered, because they just cannot access the resources they need, particularly around IT. We're in a very high-spend, high-investment stage right now within healthcare to really leverage the power of IT to help us make better informed decisions.

So I believe you're going to see a lot of the practices begin to take on outside capital from the private equity groups and either partner with groups like ours or try to determine, are we large enough and do we have the scale and resources and the people talent to build out our own surgery center infrastructure." — Chris Bishop, CEO of Westchester, Ill.-based Regent Surgical Health, on the opportunities for physicians in ASCs.

4. "I think that [a top challenge] going forward over the next 12 months and probably the next three to five years is the more and more intrusiveness of insurance companies and basically them practicing medicine without a license, I might add. I think that trying to figure out ways of keeping your reimbursements where they need to be so that you survive is essential. Physicians and medical facilities are having difficulty with increasing costs, particularly medical costs with [personal protective equipment]. We're still not producing a lot of PPE in the U.S., or a lot of our drugs and medical supplies." — Perry Haney, MD, board member of Lone Tree, Colo.-based SpineOne, on the top challenges in the near future.

5. "One of the primary things right now is the big shift of larger procedures that have historically been done in the hospital setting to the ASC, and that's mostly around total joints and spine. But many ASCs aren't built to actually accommodate those as well as they could, because many have smaller operating rooms. They may not have capacity for an overnight stay. For those types of procedures, you need a larger sterile processing capacity. So that is one of the reasons we are remodeling one of our ASCs to better accommodate those types of procedures. 

It includes the enlargement of two of the rooms — it's nice if they can be at least 500 square feet, up to as much as 600 square feet. And then also expanding the sterile processing capacity, because with a total joint, there are many more trays than if you're just doing an appendectomy or even carpal tunnel." — Kim Mikes, BSN, RN, CEO of Irvine, Calif.-based Hoag Orthopedic Institute, on important trends in healthcare.

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