The biggest disruptors of the ASC industry

From high patient deductibles to supply chain issues, five ASC leaders joined Becker's to discuss the biggest disruptors of the industry. 

Editor's note: Responses were edited lightly for clarity and brevity. 

Jackie McLaughlin, RN. Administrator of the Northwoods Surgery Center (Woodruff, Wis.): For me, the two biggest disruptors in the ASC industry are the decreased availability of healthcare professionals and the uneven increase in business operation costs vs.  reimbursements. Physician and nursing shortages are projected to exponentially get worse in the next coming years while our current physicians and nurses are already being asked to do more to compensate for the shortages. 

I fear industrywide burnout will create a snowball effect with the looming shortages. Adding to that, with uneven increase in costs versus reimbursements, ASCs will continue to have to operate on slimmer margins than they have in the past. Administrators and business managers will need to have exceptional foresight in strategic planning for success in the future.

Eric Anderson, MD. Pain Management Physician in Lewisville, Texas: I think the biggest disruptor is going to be the ever-increasing high patient deductibles. This squeezes the pain management space in the ASC setting for procedures that could be done in an office setting.  Patients simply have difficulty affording these large out-of-pocket costs for pain conditions that require more than one procedure, such as medial branch blocks.

Brenda Carter. Administrator of Wilmington (N.C.) Surgcare: As we continue to hear about staffing and supply chain, these two aspects of healthcare operations can really be a challenge.  There is no way to "cut corners" on qualified staff when candidates are limited, so ASCs must find a way to improve retention and recruitment. Qualified teams are essential for patient safety and efficient care. The cost of staff turnover is incredible.

As for the supply chain, where to start? The lists of backordered or unavailable items continues to grow every day. Everything from medications to tubing is more difficult to get, and a new mindset and process is required to have what you need without causing materials staff to lose their minds. It is challenging beyond words, so everyone must adopt the thought of substitution should a preferred item be unavailable — this is easier said than done for complex surgical cases. This task has become more time-consuming and less efficient than ever before.

Harry Aslanian, MD. Advanced Endoscopist at Yale School of Medicine (New Haven, Conn.): From the perspective of a gastrointestinal endoscopist, ASC endoscopy volumes appear quite stable. Potential disruptors include a dominant colon cancer screening modality other than colonoscopy and insurance limitations on the use of propofol sedation for endoscopy procedures in patients, neither of which appear likely in the near future. 

Myrna Loida Chang, RN. Director of Surgical Services at HCA-Good Samaritan Hospital (San Jose, Calif.): Patient safety is paramount. If complications increase in the ASC setting, these cases might go right back to being done inpatient.

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