The strategic expansion of ambulatory services beyond the ASC

Trends in the ASC industry are rapidly changing.

At the Becker's ASC Review 22nd Annual Meeting, two representatives from Regent Surgical Health — Christine Henry Musa, vice president of development and operations, and Jeffrey Simmons, chief development officer — discussed how ASCs are developing.

Ms. Musa began by listing three key trends in the industry:

  • The shift toward outpatient services
  • The convergence of retail and healthcare
  • The movement to outsource

"All trends are shifting toward outpatient," she said. "Flat growth and volume is the new normal in our industry." In fact, Sg2 forecasts that from 2015 to 2025, outpatient services will grow by 14 percent while inpatient services will decline by 4 percent.

In the same vein, thousands of "big boxes" have sprouted up across the country. These big boxes are exactly what they sound like — outpatient centers designed with floor plans in the shape of a box. Examples include Jacksonville, Fla.-based Memorial Hospital, New York City-based New York Presbyterian and Farmington, Conn.-based UConn Health. The discussion of such big boxes also leads to a discussion of bedless hospitals, such as Stamford, Conn.-based Tully Health Center.

But the shift toward outpatient services isn't the only trend ASCs face. Healthcare delivery is also transforming. The model of the classic retail mall is slowly declining — approximately 15 percent of malls are expected to close within the next decade. At the same time, there's an increasing demand for consumer-centric medical care. These two developments create the perfect opportunity for a paradigm shift toward integrated medical malls. "They create a destination for patients," said Ms. Musa. "It goes back to the theme of making the environment less intimidating to the patient and more inviting."

Health systems are also moving toward outsourcing key clinical and non-clinical services. Systems can reduce overhead costs by utilizing partners such as Conifer, Sodexo, Crothall and TeamHealth to outsource services like radiology, dialysis and anesthesia.

Mr. Simmons then outlined Regent's model, which allows health systems to optimize their joint venture strategy. "We've always been a minority partner when working with hospitals," he said. "That's the model we continue to use." Overall, Regent serves as a "general contractor" for health systems and facilitates the joint venture with each business in the ASC.

"We can help you bring in a hospital partner. You don't have to be a huge system to work with us," said Mr. Simmons. "Instead of just a surgery center partnership, you develop a business model."

Regent, which was founded in 2001, has developed and managed more than 35 surgery centers and two acute-care hospitals. Though many of the ASCs it has worked with are in the northeastern United States, Regent has worked with centers across the country. It has partnered with various prominent health systems, including Renton, Wash.-based Providence Health & Services, Columbus-based OhioHealth and New Brunswick, N.J.-based Robert Wood Johnson University Hospital.

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