What will affect patient volume most at ASCs? Here's what 7 leaders say

Seven ASC leaders told Becker's ASC Review what they believe will affect patient volume the most this year.

Note: Responses have been lightly edited for style and clarity

Meredith Warf, administrator at Jackson-based Mississippi Sports Medicine and Orthopaedic Center: As consumer confidence returns to the area and as sports have resumed practices and scheduled seasons, we have seen the beginning of volume normalization in our sports specialties. In addition, people in need of joint arthroplasty now are not limited by CMS in place of service and are very happy with the quality of care and ease of the ASC setting. We also believe payers will continue to help drive the place of service, as the ASC is the lowest-cost option for higher-acuity cases such as joint arthroplasty and spine fusion cases. 

The potential challenges will stem around capital to provide the needed equipment as well as capacity issues in current spaces — all good problems to have. Centers that have prepared the way establishing methods for data collection and quality measurement will have a leg up in the new post-pandemic normal. We believe there is no better time to seek strategic partnerships in the ASC space.

Mai Nguyen, administrator at San Jose, Calif.-based Montpelier Surgery Center: Montpelier Surgery Center is abundantly fed a constant stream of patients from a local group of nine gastroenterologists, and we also have many resources to acquire the necessary PPE. Therefore, one of the main sources of constraints causing a potential drop in our volume is the challenge of having adequate staffing due to COVID-19 exposure or infection causing staff to not be able to come to work. Another challenge is that San Jose has an overwhelmingly high HMO population, which requires prior authorization from health plans and medical groups. The schedules have to be filled 14 days out to allow adequate time to acquire authorization, and if some patients cancel at the last minute, we are unable to fill those slots due to authorization requirements.

Jim Stilley, COO at Southfield, Mich.-based Smithfield Surgical Partners: Our partnered centers are experiencing 5 to 10 percent growth in higher-acuity cases that were historically performed in hospitals. Some of this growth is based on long awaited changes to the CMS approved list, and some of this is based on physicians looking for operating rooms when hospital resources were dedicated to COVID-19 response and restricted hospital outpatient surgeries.

Craig Filippi, administrator at Chicago-based Gold Coast Surgicenter: In general and applying to all specialties, as patients increase confidence in seeking medical care as risks diminish, case volumes should increase. In regards to orthopedics specifically, the above in addition to the return of full sports and activity participation, will have a positive impact on orthopedic demand.

Lastly, the continued momentum of cases shifting from the hospital setting to ASCs because of the convenience, quality and lower cost of care.

David Horace, administrator/owner of Belleville, Ill.-based Bel-Clair Surgical Center: The rollout of the vaccine will have the biggest impact on ASC volumes. If herd immunity can be reached relatively soon, patients will feel safe returning to facilities for treatment. Quarantine restrictions and stay-at-home recommendations will also need to be lifted by local authorities before patients feel safe. I am personally putting off an EP procedure until I can obtain immunization for the coronavirus, as an overnight stay will be necessary in the hospital setting as mandated by the insurance carrier.

Crystal Baisch, administrator at Meridian-based Sinus Center Idaho: [The ACA] will play a big factor. There has been a significant decrease in patient volume due to the expense of [the ACA]. Patients can't afford to pay for insurance and use it.

Lori Sylvester, MSN, RN, administrator of Columbus, Ohio-based Riverside Surgery Center:  The biggest factor contributing to the ASC patient volume is the aftermath of 2020. Depending on the unemployment rate, insurance coverage and deductibles, and awaiting COVID-19 vaccine administration, patients are slower to schedule surgery. We are seeing a slow start to 2021. On a positive note, we are seeing [payers] driving volume to the ASC where it is more affordable, delivers high quality care, and great patient satisfaction.

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