Outlook for ASCs in the next 6-12 months: Key trends and concepts from SCA's Dr. Dan Murrey

Dan Murrey, MD, is a pioneer in the ASC industry and at the forefront of growing centers across the country as the chief medical officer of Surgical Care Affiliates.

The COVID-19 pandemic was financially challenging for centers across the nation, but is also a huge opportunity for centers to capture additional cases as the high-quality, low-cost setting of care. Here, he discusses where he sees the field headed and how SCA plans to grow in the future.

Question: What is your outlook for the ASC industry over the next six to 12 months?

Dr. Daniel Murrey: We have surgeons that are looking for alternatives to hospitals and our current surgeons are working on the backlog of cases postponed during the pandemic. The surgeons and patients don't want to have surgery in a place where COVID-19 patients were cared for; they often prefer to have surgery in ASCs because they know we takesafety seriously and have minimized exposure to the virus. That is creating one additional reason for patients and surgeons to consider ASCs; we already know they are a far lower cost setting than hospital-based surgery centers and are convenient for patients and surgeons.

Q: Earlier this year, SCA temporarily closed or limited cases at ASCs due to the pandemic. Do you think those centers, and independent centers in a similar situation, will be able to bounce back?

DM: Having to close facilities or limit case volume can be a significant financial hit to those independent facilities. It remains to be seen if they will be able to bounce back, seek a buyout or realign. We certainly had to contemplate how to manage the economics ourselves. As SCA, we were fortunate to retain our employees during the pandemic as well as maintain our childcare and benefit programs, and in some cases extend them. We also had an effort where our team members could donate to others that experienced financial constraints.

When elective procedures ramped up again, we didn't have to rehire anyone; we just had to call them back. That helped us ramp up faster and it was efficient because team members know our systems and how to work well together.

Q: What are the smartest ASCs doing today to build a stronger foundation for the future?

DM: ASCs that are doing the best or have the most potential going forward are focused on moving higher acuity cases out of the hospital and into the ambulatory setting. We see cost, quality and patient experience being high in the ASC, and we want to expand our capacity to provide more services, including spinal fusions and total joints. Those that are able to build systems to do appropriate preoperative and postoperative care and infrastructure for higher acuity cases are setting themselves up for a strong future.

We are also looking to new partnerships with our specialty practice division and with value-based care. SCA and other ASCs have a clear value proposition and are part of the process of lowering costs on ancillaries, including imaging and lab testing. We want to integrate with PCPs so information can go back and forth easily and we can share common quality metrics and treatment algorithms so we can develop pathways and get a sense of how we are working in the healthcare ecosystem.

Q: Do you expect to grow at all in the cardiology space?

DM: We do see a big opportunity there as Medicare has changed its regulations around receiving cardio procedures in office-based labs and ASCs. We are moving in that direction, but we want to do it as carefully and responsibly as possible. There are many cases that can be performed safely in our centers and we will strategically grow cardio.

Q: Where is the best opportunity for ASCs to grow post-pandemic?

DM: I think exploring higher acuity cases and integrating into larger systems is important. Some independent or solo ASC sites could benefit from becoming part of larger networks of ASCs. We are looking at more opportunities to partner as well as multisite acquisitions. We aim to provide the type of infrastructure and clinical support as well as technology systems that ASCs needed during the pandemic, which has been a wake-up call for many solo centers.

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