Can ASCs handle the boom in case volume?

ASC surgery volume is projected to grow 25 percent in the next decade, according to an analysis from Sg2 Healthcare Intelligence, but it's unclear whether ASCs will be able to accommodate these new cases with rising staff and supply costs. 

ASC costs must remain low for the centers to remain financially viable, a difficult feat amid a 40-year inflation apex. Staffing costs are soaring with a tightening job market, with many employers setting aside an average of 3.9 percent of payroll this year for wage increases, according to The Wall Street Journal

Surgery centers spend on average $2.2 million on employee salary and wages, about 21.3 percent of net revenue, according to the VMG Health's "Multi-Specialty ASC Benchmarking Study." 

The rising cost for staff is creating a massive financial burden for many ASCs. 

"The inflationary market pressure on all of our collective purchasing power and the 'great reshuffling' have created extreme wage competition and a hyper-competitiveness within the market," Andrew Wade, CEO of OrthoSC in Myrtle Beach, S.C., told Becker's

Nurses are among the most difficult staff members for ASCs to recruit, and these shortages are expected to get worse. According to a May 11 McKinsey report, the United States could see a deficit of 200,000 to 450,000 registered nurses available for direct patient care by 2025. The U.S. Bureau of Labor Statistics projects the need for 1.1 million new registered nurses nationwide by 2030.

With a worsening nurse shortage, ASCs could have trouble attracting patients and accommodating the expected increase in case volume. According to an April 5 poll from the Medical Group Management Association, a lack of nurses lowers staff morale and leads to patient dissatisfaction. 

In a time when patients comparison shop for healthcare, they have high expectations. During medical visits, they expect to see ample staff for such tasks as setting up referrals and scheduling.

The cost of retaining and recruiting nurses isn't the only budget concern of ASC leaders, who often have to get creative to keep supply costs down.

"I spend a lot of time trying to identify waste and cost savings," Helena Levenson, senior clinical consultant of ambulatory surgery at Cardinal Health, told Becker's. "I can help facilities make more cost-effective custom packs, or if they are currently using them, identify waste in the packs, or products we can add to the packs to make them more effective and efficient."

And while CMS raised ASC payment rates by 2 percent for 2022, many leaders don't expect the rate to cover the costs. 

"Reimbursement is a huge issue that ASCs keep facing. As we see the push for single-payer healthcare, it's getting harder and harder to negotiate good rates with insurance companies," Allison Stock, BSN, RN, administrator of Lenox Surgery Center in Lenox Township, Mich., told Becker's.

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