ASCs among the small businesses losing hope in the US economy

Small businesses are losing confidence in the U.S. economy amid soaring inflation, supply  chain delays and staff shortages, according to a May 22 Wall Street Journal report.

Fifty-seven percent of small-business owners are expecting economic conditions to worsen in the next year, according to a May survey conducted by the Journal, a percentage equivalent to the all-time low recorded in April 2020. 

ASCs are among the small businesses having trouble staying afloat. Surgery centers can't catch a break from the "rising cost of everything," Amy Noble, practice administrator for the Center for Pain Control in Wyomissing, Pa., told Becker's.

"From equipment to supplies to staffing, expenses continue to rise while reimbursements are stagnant," she said. "With supply shortages, we run into situations where a simple box of 10 surgical dressings can run upward of $1,000 compared to normal pricing of $200."

According to the Wall Street Journal survey, the portion of small businesses that expect revenue to increase in the next year fell to 61 percent, down from 79 percent in May 2020.

Small businesses like ASCs don't have the financial reinforcements found in larger companies, according to the Journal. Many ASCs can't compete with the deep pockets of hospitals for things like supply and payer contracts, staff salaries and technology advancements to attract patients. 

More than three-quarters of small-business owners who said they had difficulty recruiting qualified workers also said they are struggling to compete with larger employers on pay, according to a Goldman Sachs survey cited by the Journal.

ASCs are running into similar issues, with Walmart, Target, Amazon and other retailers vying for the same personnel using higher wages. Healthcare providers are having a hard time recruiting for office jobs and other positions because competing industries are able to offer higher pay, Bloomberg reported earlier this year.

"In my area, staffing and nursing wages are very competitive," said Lianne McDowell, CEO and administrator of South Portland Surgical Center in Tualatin, Ore. "I've seen a big increase in wages for nurses. There is a lack of staffing and nursing, there is a lot of competition with the hospital benefits and wages that are really skyrocketing, not just 2 percent or 3 percent, but more like 20 percent to 30 percent increases."

Some small businesses are still hopeful — 12 percent said they expect economic conditions to improve, and 28 percent predicted they would stay the same. With other factors, like the increased procedure migration to the ASC setting, surgery centers could still come out on top, despite facing rising costs and a shaky economy. 

"Particularly through the pandemic, ASCs have proven that they can provide safe and affordable access to care across a variety of specialties," Jennifer Cabrera, director of operations at Snibbe Orthopedics in Los Angeles, told Becker's. "Both patients and providers are more willing and accepting of moving their surgeries to the ASC setting. ASCs in our area are increasing specialties provided, adopting new technologies and working with payers on bundled payment structures — all pointing to a bright future for ASCs."

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