From physician influence to fear of COVID-19 infection, 17 ASC leaders joined Becker's to discuss what's drawing patients to ASCs over hospitals.
Editor's note: These answers were edited lightly for clarity and brevity.
Scott Thellman, MD. Surgeon at Lawrence (Kan.) Plastic Surgery: The providers. As more surgeons recognize that ASCs are more efficient and easy places to work they move their patients to those settings over a hospital-based facility. Patients prefer the convenience and lower out-of-pocket costs typically seen at an ASC.
Andrew Wade. CEO of OrthoSC (Myrtle Beach, S.C.): Efficiency, access and experience. When patients choose an orthopedic ASC, they're choosing a hyper-focused center of care where, in most cases, all that center does is orthopedic care. We eat, sleep and breathe the work of getting patients in to be taken care of quickly, making the process seamless, and ensuring that our teams are focused on creating really great experiences. Additionally, while most consumers don't recognize it yet, ASCs are substantially lowering the cost of care for the healthcare system as a whole. We're big fans of our hospital partners within our community, and they play a vital role, but they are much bigger organisms, and they have significantly greater complexity to take care of under their roofs. We get to zero-in and really deliver focused excellence.
Catherine Llavanes. CEO of Sante Health Partners (Los Angeles): One of the biggest drivers in the increase of surgical procedures in ambulatory settings is the comfort of knowing that every patient who is scheduled for elective surgery that day is most likely in good health and COVID-19 tested. Healthy patients have fear of contracting COVID-19 and having to go home to heal in the comfort of their own home has been added plus.
Brenda Carter. Administrator of Wilmington (N.C.) SurgCare: Patients and providers are heading to ASCs for the ease of access, lower costs and patient experience. ASCs are less intimidating, more accommodating and personable. I have heard that patients don't feel like "just a number" here like at hospitals. Patients also tell us they have been trying to stay away from the hospitals since the pandemic due to the fear of inadvertently being exposed.
Benita Tapia, RN. Administrator of 90210 Surgery Medical Center (Beverly Hills, Calif.): Patients feel safer going to ASCs now rather than hospitals because ASCs do not intake sick COVID-19 patients, and that is still a concern to patients. The cost of having surgery is often at less of a cost to the patient than having surgery in the hospital
Erika Wilcox, RN. CEO of Surgery Center of Boerne (Texas): Patient selection is key in the ASC setting. These patients are directly involved in their care, choosing to have services provided — such as a total joint replacement — and knowing that they will be going home after their procedure. There are always opportunities to educate them about cost savings involved with an ambulatory setting as well — just one of the many perks of being in this environment.
Ann Cook, RN. Director of Nursing at Best Surgery and Therapies (Cincinnati): I believe one of the main factors drawing patients to ASCs over hospitals right now is the belief that ASCs tend to deliver more patient-centric care. Within the ASC, the patient is not seen as just a number. The ASC industry has done an outstanding job in conveying the message to patients that we can provide the expert medical care they need, in the convenient manner they desire, while meeting the highest standards of care.
Bill Lindsey. CEO of OrthoGeorgia (Macon): Patients are still concerned with the transmission of COVID-19 in the hospital. Other concerns are increased infection rates along with the use of non-traditional staff (i.e., travel nurses, etc.).
Laura Galeazzi. Administrator of Antelope Valley Surgical Institute (Lancaster, Calif.): I believe, for the most part, patients trust their physicians and the decisions their physicians make on where their surgery should take place, whether it be in a hospital or as an outpatient at an ASC. With that being said, patients are more knowledgeable now since the COVID-19 pandemic, and many patients believe ASCs are safer when it comes down to being exposed to the virus and prefer ASCs over a hospital setting.
Cherise Brown. Administrator of Andover (Kansas) Ambulatory Surgery Center: There are many reasons patients choose an ASC over the hospital setting. Patients generally have anxiety when a surgery is scheduled. ASCs aren't as institutionalized, and being in a smaller environment is more desirable. A lot of ASCs are freestanding, and there aren't several floors to navigate and check-in is readily available when they enter the building. ASCs are less expensive and they pay less co-insurance for their procedure. The upfront transparency of what the patient will owe out of pocket is another big reason patients prefer an ASC. In addition, patients are able to schedule their procedure much quicker versus having to work around the OR schedule of a hospital as emergency cases take priority.
Debbie Smith. Administrator of Heart of Texas Surgery Center (Woodway): I believe what draws patients to ASCs is cost and convenience.
Brandon Thompson, RN. Administrator of CarePlex Orthopaedic ASC (Hampton, Va.): I think that it's the surgeons that are driving this. When COVID-19 was at its height, the only option for most was to perform procedures within the ASC. Through this, surgeons discovered that the processes that ASCs have in place for efficiency, cost containment and consistent staffing provides a much more stress-free environment for them to work in.
Kathleen Hickman, RN. Administrator of Dutchess Ambulatory Surgical Center (Poughkeepsie, N.Y.): I think the COVID-19 pandemic has certainly contributed to patients moving to the ASC setting as they look for environments where transmission may be reduced. I also feel that the efficiencies of an ASC setting are becoming more apparent to patients and, as consumers, they look for a "quicker" way to manage their surgical care. They do not want to wait in the hospital for long periods of time when they can have a scheduled time for admission and discharge, which can generally be achieved.
Amy Fox. Administrator at ORA Orthopedics (Moline, Ill.): Cost and healthy patients being served in ASC settings.
Allison Stock, BSN, RN. Administrator of Lenox Surgery Center (Lenox Township, Mich.): Patients are becoming much more insurance savvy. Patients' deductibles keep climbing, and they are looking for the best low-cost care. I believe patients are seeking out ASCs over hospitals because they recognize the more personalized and efficient care that they receive in the ASC setting. When the pandemic hit, patients were afraid to go to the hospital because of fear of the virus. The pandemic helped push even more patients to the ASC space, and now they don't want to return to the hospital unless necessary.
David Horace. Administrator and Owner of Bel-Clair Surgical Center (Belleville, Ill.): Getting procedures done in a perceived "safe environment" due to lack of COVID-19 patients and lower Medicare coinsurance than the hospital setting.
Andres Duran. Administrator of Brownsville (Texas) Surgery Center: Faster turnaround times, and that all the cases are outpatient procedures. Less expensive, high-quality outcomes.