7 financial opportunities for ASCs

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Six administrators spoke with Becker's ASC Review about financial opportunities they see in the ASC industry.

1. Robotics

Jennifer Cabrera, a physician assistant at DOCS Surgery Center in Los Angeles, said robotics are creating a "unique opportunity for ASCs to offer these procedures without all of the red tape in the hospital setting."

"As the first ASC in Los Angeles with a Stryker Mako Robot, being able to offer this technology to orthopedic surgeons has definitely driven new business and new surgeons to our center," she said. "Vendors are also motivated to provide incentive-based rebate programs to make these advanced technologies feasible for the ASCs."  

2. Value-based care

While value-based care is controversial, some ASC leaders see financial opportunities in bundled payments. 

"The less obvious opportunities would be about value-based care and sharing risk and reward with the insurer market," said Glen Silverman, CEO of U.S. Orthopedic Partners and Mississippi Sports Medicine and Orthopaedic Center. "Many insurers like the idea of sharing risk, but didn’t really know how to adjudicate shared risk claims. Based on my experience they will figure this out pretty quickly and should have a strong willingness to work with ASCs."  

Ms. Cabrera agrees. 

"I would say there is an opportunity in adopting bundled payment programs that can provide a financial benefit to ASCs as well as its surgeons," she said.

3. Supply chain

Supply chain issues and implant reimbursements are an obstacle for many ASCs, but Mr. Silverman said he sees some opportunities for revenue in supply chain arrangements. 

He said that would require providers to look at sole source contracting and vendors be "willing to reduce price" in exchange for "more utilization consolidation in the future." 

4. Contracting

Harnessing payer contracts also can provide opportunities to increase revenue. 

"The biggest financial opportunities for ASCs is to widen the optics of traditional insurance contracting," said Robert Lerma, the administrator of Blue Springs Surgery Center in Orange City, Fla. 

5. Spine and joint procedures

Total joint procedures and other high-acuity procedures are increasingly moving outpatient. 

"It's becoming clear that outpatient minimally invasive total joints and spine are both the present and future," said Jarett Landman, CEO of The Orthopedic Surgical Center of the North in Peabody, Mass. "Very infrequently in healthcare are all interests aligned between provider, facility, patient and insurer, but I think all would agree that this transition has been valuable to all parties."

Moving these procedures to an ASC can help eliminate postoperative hospital stays and maximize reimbursement opportunities, said John Stewart, CEO and founder of Physician Advisors and Total Spine & Wellness.

"We’ve seen an increased demand for multilevel ultra-minimally invasive spinal fusions that can be done outpatient," Mr. Stewart said. "My surgical teams are pioneers, trailblazing authorities and leading educators in this arena." 

6. Medicare additions:

Some ASC leaders see hope in the expansion of reimbursement for more complex procedures in the outpatient setting. 

"ASCs have proven that we can provide a safe environment in which many more procedures can be performed and oftentimes, with better outcomes," said Suzi Cunningham, administrator of Advanced Ambulatory Surgery Center in Redlands, Calif. "For our center, this would mean expanding the allowable procedures to include more complex spine cases, including 3- and 4-level fusions."

7. Cardiology procedures:

Cardiology procedures are increasingly moving outpatient, which could mean financial opportunity for ASCs.

Tracy Helmer, administrator at Seven Hills ASC in Las Vegas, said  increasing cardiology outpatient options can lead to financial success. 

"Patients are leery of going to hospitals due to pandemic concerns, so ASCs can provide that peace of mind," he said. "Our center provides cardiac catheterization care in addition to multispecialty surgery, so that option is becoming a huge benefit for certain patient populations."

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