The most pressing issues facing ASCs in 2021

The ASC landscape has changed significantly in the past year due to the pandemic and payment updates from CMS.

As the high-quality, low-cost provider, the future is bright for ambulatory surgery centers. However, there are looming challenges as centers recover financially and operationally from the pandemic and carve out their place in the new normal. At the Becker's Healthcare ASC Virtual Event on Oct. 16, a panel of experts discussed the most pressing issues facing surgery centers in 2021.

The panel included:
Don Shreiner, CEO of OrthoIllinois in Rockford
Sarah Paul, CEO of Dublin (Ohio) Surgery Center
Mahir Patel, MD, of OrthoIndy in Indianapolis

Below is an excerpt from the conversation. Click here to view the entire conversation on demand.

Note: this article is edited for clarity and length.

Question: Is the future bright or dark for ASCs?

Don Schreiner: Well, we're convinced that independent surgery centers will do well. Our physicians are of a high quality. I think everyone tends to believe that, and we do too. We're in a unique position to be able to deliver care in so much more cost-effective manner than the hospital systems that aren't gearing themselves for that. Dr. Patel, I'm sure they're a more entrepreneurial and value based than a typical hospital because they're orthopedic driven. But the key here is we're embracing risk, we're embracing more and more capabilities within our surgery center.

We've been doing total joints for almost four years now. We could have done it sooner, but we just didn't have the buy-in; now I think we do. We're going to expand into spine. Of course, other surgery centers have been doing that for quite some time, but we're getting more complicated cases. Our new center in Deloitte, Wis., is going to have a care suite so there will be overnight stays; just one single night overnight just for the patient to recover, and concierge service, if you will. We're able to put in a little bit more complicated cases in there than if we didn't have an overnight stay.

Dr. Mihir Patel: With the whole pandemic, it's kind of like real estate, it's all about locations, and independent ASCs happened to be in the perfect locations. Most of them are; around Indianapolis many are out in the suburbs in high-traffic areas. With that, basically you have the patients who want to stay out in their local areas and they want to keep it local as far as their procedures and doctors. A lot of patients are working from home, so it makes it really convenient for them overall to get the care that they need. The hospitals are all trying to sort of do the similar kinds of things just a little bit further behind at this point. So with the independent ASCs already out in suburbs, going forward it's going to be a great thing for patients and providers alike.

Q: Sarah, what keeps you up at night?

Sarah Paul: We were just talking about this at the center. Where am I going to find more independent physicians to recruit? We have three big hospital systems in central Ohio and they're all trying to scoop up as many independent physicians as they can. So that's the tough part as we're staying independent is to find physicians to recruit, and then the other part is with the unemployment from the pandemic. How many of the patients are we going to be losing because they've lost their commercial insurance and are now maybe on Medicaid? That's the payer shift that's coming with the high unemployment.

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