ASCs in the next 5 to 10 years: 4 key thoughts

The ASC arena is changing quickly as CMS contemplates moving total joint replacements to the ASC payable list, site-neutral payments and increased price transparency mandates.

Here, four leaders in the ASC industry answer questions about big trends affecting the future.

Q: How do you think the ASC space will evolve in the next five to 10 years?

Kari Gantt. Administrative Director of Gastroenterology Associates of S.W. Florida (Fort Myers and Cape Coral, Fla.): Consolidation. I believe there will be a marked increase in the number of joint ventures between hospitals and ASCs due to patient care shifts to outpatient markets — hospital systems will be forced to look at outpatient options to capture lost inpatient volumes. More private equity firms will invest in centers providing capital to expand centers. Insurance companies may look to purchase ASCs as they begin to open more of their own physician clinics. I believe that insurance companies will continue to develop incentives for patients to use ASCs versus hospitals.

Read the full interview here.

Q: What do you think the ASC industry will be like in three to five years?

Louis Levitt, MD. Vice President and Secretary of the Centers for Advanced Orthopaedics (Bethesda, Md.): There will continue to be strong growth, driven by high patient satisfaction rates and better outcomes compared to the hospital setting. In 2017, ASC volumes increased by 22.9 percent nationally, and the market is forecast to surpass $40 billion by 2020, according to the Advisory Board.

The initial push for ASCs was driven by common, simple musculoskeletal processes, and the orthopaedic community served as the impetus for ASC profitability. With better anesthetics and pain control, better management of blood and blood products and a healthier patient population, we can now offer outpatient services that were traditionally primarily done in the hospital setting. What's more, there are very few elective surgical procedures that require patients to stay in the hospital for longer than one day, so expanding ASCs to offer 23-hour stays will further increase the volume and type of outpatient procedures.

In the future, I believe ASCs will expand beyond just orthopedics, and patients will also have access to more sophisticated procedures in the outpatient setting. I expect we will begin to see outpatient cardiology procedures such as cardiac stents and limited procedures on the heart valves, which can be done effectively and safely on the right patients who qualify for outpatient surgery. We'll also see continued increase in outpatient spine surgery.

Read the full interview here.

Q: How do you see the ASC and outpatient surgery arena changing in the next 18 to 24 months? What is driving that change?

Marvella Thomas. Senior Consultant for Clinical Operations at Cardinal Health: A lot of change will be driven by the regulatory challenges facing the ASC community. Regulatory authorities such as the Joint Commission and the Centers for Medicare & Medicaid Services (CMS) are basing their requirements on an acute care model, and it's becoming more and more difficult for ambulatory surgery centers to meet them.
For example, many ASCs need to remodel because their facilities don't meet new regulatory requirements for processing instruments. Again, it's a question of whether they have the resources to accommodate these more stringent regulations.

The regulatory challenge becomes even more pronounced as more complex procedures with higher acuity continue to migrate to the ASC space. Physician owners in particular will need to make informed decisions about which complex procedures are a good fit for their organization, based on available resources.

Read the full interview here.

Q: Where do you think the ASC industry will be in the next three to five years?

Peggy Wellman. Pacific Market President of United Surgical Partners International: I was reflecting on how we've pivoted from working directly with physicians, making sure that they have a say in who we employ, what policies are in place clinically for the care of their patients and the equipment we support. Then we moved to speaking directly with the payers, helping them to understand what we were capable of, and then we progressed with partnering with hospitals and health systems. Now we're having to focus on the patient as a consumer. We're more focused on patient experience with third-party measurements that can stand on their own, measuring how good our experience is for patients. [ASCs] offer transparency on cost — if you need to have a surgery done in a surgery center, it's easy for us to tell you what your benefit is, what your share of the cost will be — there shouldn't be any surprises when you go to a surgery center. It's a much simpler place to understand what your expenses will be.

We're moving into new types of technologies that allow us to communicate better with patients on the front end. Some IT platforms offer up to 85 different languages. In California, we have many different people speaking languages other than English, so the ability to get health information from them through this technology has been wonderful. Being able to communicate with our vendors, we can assure that items needed for patients' care will be available with us. It's pretty exciting.

What's also important in looking toward what's next for surgery centers has been the ability to do more things with the capacity that we have. There is a wide range of [procedures] hospitals are able to provide on an outpatient basis that we may be able to provide efficiently as well. It's way past anything that's considered appropriate for us to do, but I do think there will be some push for that in the future as well.

Read the full interview here.

Angie Stewart and Rachel Popa of Becker's ASC Review contributed to this article.

More articles on surgery centers: 
Why ASCs should be cooperating & not competing: 5 Qs with Jeffrey Flynn, COO & administrator of Gramercy Surgery Center
Physicians in the '$3 million club' & 4 other must-read articles
Faith Regional Surgery Center marks 2 decades

© Copyright ASC COMMUNICATIONS 2019. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.

 

Top 40 Articles from the Past 6 Months