As healthcare costs continue to rise, health systems are turning to ASCs to keep surgical costs down. Whether by partnership or new development, ASCs should be top-of-mind for every hospital leader right now.
Here, three industry experts offer insights into the ASC development and partnership process and shed some light on the thought process behind the development.
Note: Responses were edited for style and content.
Question: Is your health system considering either building or acquiring an ASC? Why or why not?
Joe Aguilar, partner with HMS Valuation Partners: The decision to build or acquire an ASC is a function of a variety of factors. Building an ASC from the ground will enable the health system to have greater flexibility on where it is located, who are the participating physicians and basic design. Acquiring an existing ASC limits this flexibility. The health system needs to ensure that the ASC they are acquiring meets their needs in terms of facility layout and location while also meeting their expectations on the physicians who will come with. Competition with private equity and management companies also makes acquiring an ASC more challenging for the health system. The most obvious benefit of acquiring an ASC is the ability to have it up and running fast.
As a valuation firm, we see a number of joint ventures in this space, which mitigates some financial risk to the health system. This partnership structure increases physician buy-in; however, as partners, they share in the profits and operational decision-making. After hurdling any negative associated with partnering with physicians, the health system needs to ensure that they are compliant with the JV partnership under Stark Law and [the] Anti-Kickback Statute.
Rodolfo J. Blandon, MD, president of Cleveland Clinic Weston (Fla.): As a destination for critical care, Cleveland Clinic Florida provides advanced-level care for the highest-acuity patients, including patients with cancer, cardiac and neurological conditions and those in need of organ transplant services. In September 2015, [we] announced a capital expansion program to include the construction of an ASC in Coral Springs, Fla. The Coral Springs Family Health Center, which opened in July 2018, is a 73,000-square-foot facility with 40 exam rooms, six operating suites, procedure rooms and physician offices.
The decision to open an ASC was driven by a number of factors, including the high demand for specialty care at Cleveland Clinic Florida, high occupancy levels at the Weston hospital, and increased volume in inpatient and outpatient surgical cases. As healthcare costs throughout the U.S. continue to rise, [we are] able to shift many inpatient procedures to the outpatient setting, allowing patients to benefit from high-quality care, faster recovery times and improved outcomes, while keeping costs low.
Technology, smaller incisions and advances in anesthesia and pain management techniques encourage the movement of cases to ASCs. In addition, patients prefer the outpatient setting, as costs are typically lower for those with high-deductible plans. By providing both outpatient surgical services and specialty care, the Coral Springs Family Health Center is positioned to meet the needs of our communities and provide patients with continuity of care close to home. Reflecting [on] Cleveland Clinic Florida's "patient first" philosophy, the patient experience was paramount in the development of the Coral Springs Family Health Center, which maximizes efficiency and quality outcomes for our patients.
Gail Cardoso, MSN, clinical manager at WellStar Acworth (Ga.) Health Park Outpatient Surgery Center: Great care means nothing if patients can't access it. Whether they have to look too hard or drive too far, [inaccessible care is problematic]. At WellStar, we are focused on delivering quality healthcare to our patients where they are with a fully integrated health system and personalized care. That means our patients don't just have a single hospital as a beacon of care for emergency needs, but a community of medical providers in offices and health parks, who treat our patients as individuals and support a variety of healthcare needs, from simple to complex, and preventive to immediate.
Instead of making the patient travel between multiple locations, WellStar Health Parks centralize patients' needs in one convenient campus with specialist appointments, outpatient procedures, pharmacy, urgent care, physical therapy and imaging, all at a single location. This provides an undeniable level of convenience for our patients; facilitates better coordination of care; and fosters a collaborative environment in which our patients and practitioners are in regular conversation about health needs, objectives, and challenges. We believe that integrated access to healthcare providers and solutions can positively impact patient health overall.
[With this in mind], WellStar's first health park, WellStar Acworth Health Park, opened in July 2012 in Acworth, Ga. In July 2019, [we added] an outpatient surgery center to the Acworth location. ... WellStar Acworth Health Park offers a convenient, close-to-home location for surgeries that do not require a hospital stay. The 25,000-square-foot expansion includes three operating rooms, three procedure rooms, and 15 pre- and postoperative rooms. The community-based, multispecialty outpatient surgery center includes state-of-the-art technology for various procedures and imaging techniques, and offers a wide variety of surgical services. We believe that caring for the whole person is vital to health and well-being, and that integrated, same-day access to healthcare providers and solutions can positively impact patient outcomes.
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