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ASCs in 2014 — 3 Key Trends

It’s a quickly changing time for surgery centers. Those centers that thrive will have a committed group of core physicians, great lay or physician leadership, a smart, hands-on administrator and will be willing to both contain costs and look constantly to add opportunities and revenues. Here are three things to think about.

1. Centers built heavily around GI, orthopedics and ophthalmology are proving to be quite resilient and continue to thrive. Many of these specialties remain fairly independent. As long as this is the case, these specialties should continue to drive volumes at surgery centers (Single Specialty ASC Transaction & Valuation Outlook: Bright or Dark?). Here, orthopedic cases typically represent moderate case volume and medium to high reimbursement for ASCs. Ophthalmology and gastroenterology represent higher case volume but lower reimbursement per case. ASC company attitudes reflect the desirability of these specialties. According to the HealthCare Appraisers 2013 ASC Valuation Survey, orthopedics and GI were considered very desirable to have in a center, with 100 percent desirability for orthopedics and 82 percent desirability for GI among survey respondents. Fifty-nine percent of respondents considered ophthalmology desirable.

2. Centers are making more of an effort to reconnect again with specialties like pain management (high volume), dermatology (Mohs surgery), gynecology and general surgery to fill emerging volume gaps. ASCs and companies view these and other specialties as vital to overall ASC same store growth, as both volume and reimbursement is tepid. Per the 2013 HealthCare Appraisers survey, both general surgery and pain management were desired by 88 percent of ASCs companies. For more information on growth in specialties, see "11 Things to Know About ASCs."

3. Employer movement to high deductible plans has had a tough expected impact on first quarter revenues, but ASC companies like SCA, USPI and others continue to plug along. This impact on early year volume due the dramatic increase of high-deductible plan enrollees is no surprise; it has led to lower utilization of healthcare services overall among those with the plans, who make up approximately one-third of those insured through an employer, according to Kaiser Health News. The impact of high-deductible plans is not limited to ASCs and has generally affected most providers (Chalenges and Opportunities of Forming ASC Joint Ventures).

To see first quarter results for USPI, SCA and AmSurg click on the company names.

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