4 major obstacles for the ASC industry 

Andrew Lovewell, administrator at the Surgical Center at Columbia (Mo.) Orthopaedic Group and CEO of the Lodge at Keene Street, joined Becker's ASC Review to discuss his biggest concerns in the upcoming year. 

Editor's note: This interview was edited lightly for brevity and clarity. 

Andrew Lovewell: The biggest thing that concerns me is probably the same thing many of my ASC colleagues are concerned about. They consist of governmental overreach, the ongoing COVID-19 pandemic, staffing shortages and patient safety. With vaccine mandates from CMS being upheld in many states by the Supreme Court, I have a huge concern about retraining staff and assuring that I can provide the best care to my patients. All our staff are tired from the pandemic and adding another layer of complexity with vaccine mandates doesn’t do us any favors. I know, like many ASCs, we have excellent staff that do a great job with our patients and physicians, and if they continue to be bombarded with more strenuous federal requirements, we will undoubtedly lose some of them.

Tying into governmental involvement, I am extremely concerned about removal of codes from the ASC-approved list and the announcement that the inpatient-only list is here to stay. The focus of value-based care is to lower cost and provide high(er) outcomes. If we are keeping cases in an inpatient facility where there are several COVID-19 positive patients and adding cost to the procedure, I see value-based care taking the back seat in this approach. Taking this nonprogressive stance is one thing, but continuing to see a large gap between hospital outpatient department rates and ASC rates is equally a concern. 

In today’s world, we see ourselves at a crossroad. We want to provide high quality cost-effective care to patients, and we strive to be a value-based provider, but the external pressures are becoming daunting. At some point in time, we will find ourselves in a dire position if these trends continue. In some regard, I think many people think it’s an us (ASCs) vs. them (hospitals) battle. But in all reality, we are ALL fighting to retain staff, do the best we can for our patients and survive these trying times.

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