5 hurdles to ASC ownership stake 

Alejandro Fernandez, CEO of San Diego-based Synergy Orthopedic Specialists, joined Becker's to discuss the obstacles to ASC ownership.

Question: What are the biggest obstacles to ASC ownership right now?

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

Alejandro Fernandez:

  1. Capital investment: Establishing and operating an ASC requires significant upfront capital investment. This includes facility construction or lease costs, equipment procurement, staffing and ongoing operational expenses. Securing funding for these investments can be challenging, especially for individuals or groups without access to substantial financial resources. 
  2. Reimbursement and payer negotiations: ASCs rely heavily on reimbursement from government programs like Medicare and private insurance payers. However, negotiating favorable reimbursement rates with payers can be difficult, and reimbursement policy changes can significantly impact an ASC's financial viability.
  3. Physician recruitment and engagement: Recruiting and retaining skilled physicians and surgeons is crucial for the success of an ASC. However, competition for talented practitioners can be fierce, particularly in areas with high demand or limited physician supply. Building relationships with physicians and ensuring their active involvement in the ASC can be challenging.
  4. Market competition: ASCs face competition from other healthcare providers, including hospitals and larger healthcare systems. These competitors may have greater resources, stronger negotiating power with payers and broader referral networks, which can make it challenging for ASCs to attract patients and secure a steady stream of cases.
  5. Regulatory compliance: ASCs are subject to a multitude of regulations at the federal, state and local levels. Meeting these requirements and maintaining compliance can be complex and costly, particularly as regulations continue to evolve.

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