The challenges future ASC leaders are up against

If current trends continue, tomorrow's ASC leaders will face a litany of obstacles just as the leaders of today are.

Here are three challenges future ASCs leaders may have to face: 

Continued consolidation 

Seventy percent of ASCs are independent, according to a report from VMG Health. However, this doesn't mean that all ASCs will remain that way. One-third of hospital revenue is shifting to ASCs, office-based labs and other outpatient sites, according to JLL's "Healthcare and Medical Office Perspective" report. As more eyes, and dollars, drift toward ASCs, the lure of partnerships becomes more alluring. 

"You have more purchasing power with a hospital, you get better group purchasing rates," Melissa Hermanson, DNP, RN, administrator of Vineland, N.J.-based Ambulatory Care Center, told Becker's. "There's a lot of advantages that may help you to lower your prices on the procedure. And, hopefully, they have the strength to help you get a better reimbursement as well."

The ASCs that can expect to see the most consolidation include those in certificate-of-need states, single-specialty centers and those in markets with strong health systems.

Economic uncertainty

Though inflation rates in 2023 have begun to cool down month-by-month, it doesn't mean the U.S. economy is in the clear. High rates of inflation combined with high operating costs and low reimbursement rates make it difficult to run an ASC on a tight budget.

Supply chain issues, which were exacerbated by the COVID-19 pandemic, continue to be a challenge for surgery centers.

"Everything seems to have inflated prices and the supply chain problems, including back orders, are cutting into the profit for ASCs," Michelle Eilander, RN, administrative director of Ankeny (Iowa) Medical Park Surgery Center, told Becker's. "There are many times that we have to order a higher-priced item due to the back order of the regular-used item."

Lastly, keeping an ASC well staffed and that staff well paid is no small feat, and it becomes more challenging in times of economic uncertainty. Read more about ASC labor cost here

Regulation roadblocks

In its 2023 final rule, CMS considered 64 recommendations for new procedures to be added to the ASC-covered procedures list, but only four procedures that are typically performed in an outpatient setting were chosen.

If the roadblocks that prevent the shift to outpatient care are not removed, future ASCs will have to continue offering limited services. This is especially true with specialties such as cardiovascular — a specialty primed for outpatient growth if regulations will allow it.

In cardiovascular's case, CMS already reimburses several cardiology CPT codes, but some state regulations may be holding the specialty's outpatient potential back.

"First and foremost is that Medicare now reimburses several cardiology related CPT codes," Prashanth Bala, vice president of ASC operations at Shields Health in Quincy, Mass., told Becker's. "But secondly, something that you have to keep an eye on is our state regulations. State regulations either allow you to move [cardiovascular procedures] into an outpatient setting or restrict the types of procedures that can be performed in the outpatient setting. That may be another reason why you're not seeing too many of those cardiovascular ACS popping up just yet." 

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