Phoenix-based Banner Health manages 10 ASCs through a joint venture with Atlas Healthcare Partners, and the entities plan to open at least five more by the end of the year.
Joan Thiel, Banner Health's vice president of ambulatory services, spoke to Becker's ASC Review about what specialties she's watching closely, the advantages of working with Atlas to grow in those areas, and why she views partnerships as beneficial for healthcare overall.
Note: Responses were lightly edited for style and length.
Question: As Banner Health plans rapid expansion in the ASC space, what specialties do you see as key growth areas?
Joan Thiel: Both orthopedics and spine. CMS keeps approving more and more of these codes as being appropriate for an ASC. So we've really got our eye closely on those two, but we're watching across the board. In general surgery, more and more procedures are safely being done in the ambulatory setting. Then, the typical kind of ASC cases like gastroenterology, ophthalmology, pain, ENT — in all of those, we're seeing growth.
Q: Is cardiology a low-priority ASC specialty for Banner, or is this also an area of interest?
JT: We're very actively pursuing an ASC-cardiovascular center strategy, and we have several on the drawing board right now. We think that is another very important space to be in and will be part of our competitive advantage to be able to [perform] PCIs and stents that are approved for ambulatory cath labs. We want to be on the forefront of that movement.
Q: Are you seeing a lot of hesitation around the outmigration of cardiovascular procedures, or are providers generally on board?
JT: I can tell you that the cardiologists are very, very interested. In both the ambulatory surgery space and in the cath lab space, we work very closely with both independent and employed physicians. We syndicate these centers so they have an opportunity to invest in the center, and we think that makes for better quality outcomes as well as the physicians being more interested in the sustainable operations of that center. So, certainly in the cardiology space, the groups that we work with are very interested in doing this.
I don't know about competing health systems. Some of them may be sitting back and hoping to hold on to their inpatient volumes, but I think that's short-sighted. As care is able to be safely delivered in an ambulatory setting, that's what consumers are wanting and that's what payers are wanting, so we want to work with them.
Q: What are the key advantages of partnering with Atlas Healthcare Partners as part of your ASC strategy?
JT: We've been very pleased at our partnership with them. They are leading experts in both ASC management as well as development. Banner has a long history in acute care operations. As we decided to move rapidly into the ASC space, we wanted to work with some experts in the field. So, Atlas has brought that expertise to the table. They both run the daily operations of our centers as well as work with us on strategy and development opportunities.
[The partnership has] allowed us to go further, faster. They bring a lot of expertise in ASC regulations, accreditations, how to structure these for efficient operations — and they have a lot of credibility with physicians in the community. Their expertise is recognized not just by Banner, but also by the physicians that are practicing in these centers.
Q: Not everyone is sold on the idea of partnerships being beneficial to healthcare. Can you explain why you are?
JT: Healthcare is diversifying and moving into spaces that perhaps traditional health system operators aren't well versed in. By being open to partnerships — and you need to choose those partners carefully so that you make sure you're fully aligned with them culturally and in all other ways — it allows us to be competitive in a rapidly diversifying arena of healthcare.
When you look at nontraditional entrants into healthcare, like Amazon, CVS, Walmart — whoever you want to name — I think part of their competitive advantage is that they're nimble, they're able to move rapidly. And I think for traditional health systems to be able to compete with them, we need to be open to new and innovative ways of doing things.
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