When ASCs face opposition: 3 cases

ASCs often face opposition from health systems, physicians or hospitals in the region that feel more operating rooms are unnecessary or will overrun the market. 

Here are three examples of ASC plans moving forward or stalling because of opposition. 

1. ASC moves forward despite opposition

Mobile, Ala.-based USA Health is moving forward with a 25,000-square-foot, $20 million surgery center in Fairhope, Ala., despite opposition. 

Mobile-based Infirmary Health, the state's largest nonprofit health system, is challenging the certificate of need board's unanimous decision to approve the ASC last year. The health system operates Bay Eyes Surgery Center in Fairhope and Thomas Hospital in Daphne, about 4 miles from where USA Health broke ground on its ASC May 24. 

The center will be next to a 50,000-square-foot physician office building that is expected to be finished this fall. The surgery center will have six operating rooms, two procedure rooms, 14 pre-op areas and 13 recovery rooms.

2. ASC plans halted 

In April, Boston-based Mass General Brigham halted its $223.7 million plan to build three suburban ASCs after facing opposition. 

In April 2021, a coalition of healthcare providers, community groups and business groups joined to fight the Mass General Brigham project. The coalition includes healthcare providers Wellforce, Shields Health Care Group and UMass Memorial Health, as well as 12 other community and business groups.

The decision to halt construction came after the Massachusetts Department of Public Health said it would not recommend the plans for approval. A 75-page analysis from the Massachusetts Health Policy Commission, an independent state agency, found that the expansions would increase commercial healthcare spending by $46 million to $90.1 million.

Mass General Brigham had planned the ASCs in Westborough, Westwood and Woburn, all in Massachusetts. They would have offered surgery, physician services and diagnostic imaging. 

3. Opposition backs down

In March, state regulators granted a certificate of need to Steindler Clinic's $19.2 million ASC in Iowa City, Iowa, after a last-minute withdrawal of all opposition to the facility. Opposition to the surgery center, slated for completion in November 2023, included the University of Iowa Health Care, Johnson County Surgical Investors and Iowa City Ambulatory Surgical Center. 

The opposition previously urged state officials to deny the request to build an ASC, arguing the project was unnecessary and unlawful because 13 of the clinic's physicians are also part owners of the Johnson County Surgical Investors and signed an agreement that prohibits them from working for or investing in a competitor.

Johnson County Surgical Investors had said it would enforce those noncompete agreements to block the ASC if necessary. In addition, University of Iowa Health Care argued in January that the "construction of six new ambulatory [operating rooms] would duplicate existing, not fully utilized capacity at Mercy Iowa City."

Iowa City Ambulatory Surgical Center and Johnson County Surgical Investors withdrew their opposition to the ASC an hour before the hearing on Steindler's application. An attorney representing Steindler Clinic told state officials the "parties have reached a resolution" but did not detail what the parties agreed to because of "confidentiality provisions." 

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