3 biggest opportunities for ASCs today and 4 healthcare reforms that will affect ASCs most in the future

How will healthcare reform affect ASC planning and development?


Scott Kulstad, executive director of musculoskeletal services at Minneapolis-based Fairview Health Services and a member of the board of directors for Minneapolis-based Ridges Surgery Center and Fairview Maple Grove (Minn.) Surgery Center, discusses how to approach strategic planning in today's volatile healthcare environment and what to expect in the future.

Join Mr. Kulstad at the Becker's ASC 24th Annual Meeting – The Business and Operations of ASCs on Oct. 26 to 28 in Chicago. Mr. Kulstad will speak on a panel about the future of ASC development amid healthcare reform. Click here to learn more and register.

Q: What future healthcare reforms do you expect to affect ASCs and physicians the most?

Scott Kulstad: The next several months, I believe we will see the following reforms:

• Reimbursement will continue to decline, and payment parity will accelerate the migration of cases to the outpatient/ASC settings;
• Medicare will remove “inpatient only designation” on certain procedures (i.e., TKA), which will accelerate the migration of cases to the OP setting;
• Employers and payers will direct cases to lower cost settings more than they have historically.
• Technology will (continue to) transform how, when, and where patients access care, information, and engage with providers, including those in the ASC.

Q: Where is the biggest opportunity for ASCs to succeed in healthcare today?

SK: No. 1: collaboration with hospitals. The systems will work best when there is equilibrium, collaboration and clinical integration.

No. 2: appropriate titration of cases. The ASCs will succeed when they appropriately titrate the cases that can — and should — move from the hospital outpatient department to the ASC with those that should remain in the HOPD. There is plenty of volume that will move out of the hospitals, but ASCs that move clinically inappropriate cases to the ASCs will risk losing more than they gain if/when there are complications.

No. 3: Maintain focus on high-reliability systems to ensure cost effectiveness, high quality outcomes and patient safety.

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