The biggest trends 3 ASC CEOs are following

Recruiting and retaining staff amid a nationwide healthcare workforce shortage and finding ways to capitalize on the shift to outpatient are among the top priorities for ASC administrators in 2022.

Three CEOs of surgery centers in Michigan, Virginia and New York expand on the key trends occurring in their markets.

Note: Responses are lightly edited for style and clarity.

Tina Piotrowski. CEO, Copper Ridge Surgery Center (Traverse City, Mich.): One of the top priorities is maintaining a competent, well-trained workforce in a highly competitive market. Like many ASCs, we face competition for staff from hospitals that offer attractive sign-on bonuses and often much higher wages. Since the pandemic, we have seen a number of our clinical staff wanting to reduce their hours due to school and childcare issues related to COVID. We are working hard to offer more flexible part-time positions, but filling the gaps is increasingly challenging.

We're starting an initiative that is going to allow us to collect feedback from employees at each department as far as how to have a more flexible work-life balance and how to meet the needs of the center while also meeting personal needs.

Mark Schwartz. CEO, Blue Ridge Orthopaedic & Spine Center (Warrenton, Va.):I'm looking on the national level at the impact of changes in healthcare, the increasing cost of medical education and COVID as a catalyst for provider retirement, and then thinking about what that looks like for the provider shortages and healthcare delivery. That's something we saw prior to COVID: the forecast for shortages of physicians. I think that has only increased or accelerated with COVID. 

I'm seeing that in Virginia, but I think it's the whole [healthcare] delivery system if you don't have the primary cares and the urgent cares and enough staffing in those areas. We're seeing shortages in critical areas on a national level, whether it's anesthesia or other providers that affect the ability to deliver care. Those are the things I'm concerned about.

Also, what does it look like for people coming into healthcare as providers? Right now, the costs are only increasing for people going into medical school. And [with] hospitals and independence in terms of physicians, I think the hospitals have been able to have a [good] margin, and as hospital margins get challenging, they're typically taking a loss on the physician side. I'm not sure that is a sustainable model going forward, unless there's other changes in the pipeline in terms of physicians coming into the field or reimbursements.

Austin Cheng. CEO, Gramercy Surgery Center (New York City): In New York, there have been announcements by major players that certain procedures will not be approved for the hospital outpatient setting and they are going to try to push those procedures into the freestanding ASC setting. I think that has scared a bunch of different providers, and they are trying to figure out how to react to this.

Surgery centers are situated well to absorb a lot of the case volume. I don't think it's a zero-sum game. I don't think we're pulling away from one provider and that provider is losing. There's a lot of alignment that can be done; it's just a matter of the players figuring out how they fit into each others' roadmaps and development maps. That's a big puzzle to solve.

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