'Archaic health systems' a threat to some ASCs, says one administrator

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Trudy Wiig, RN, administrator of Kerlan-Jobe Surgery Center, an affiliate of Cedars Sinai, in Los Angeles, spoke with Becker's ASC Review on how she feels health systems can undermine their partner ASCs. 

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

Question: What is the biggest internal threat to ASCs?

Trudy Wiig: The biggest threat to ASCs from within stem from archaic health systems (for-profit and tax-exempt) that don’t understand the benefit of ASCs currently or in the future as a meaningful partner. 

The companies may inadvertently or on purpose undermine their partner ASCs by failing to understand their once-lucrative service lines (such as total joint arthroplasty, interventional cardiology and back or spine services) are moving to ASCs. This migration is driven by the patient and payers, despite their best efforts to hold them in hospital or in hospital outpatient departments. In some cases, they outwardly thwart them going to a partner ASC. 

There is a failure to understand that payer contracting can’t serve two masters. Either separate individuals conducting contract negotiations, or separate the contracting divisions so they each have a vested interest in the favorable outcome of a contract. 

It is human nature to protect the larger entity hospital at the expense of the smaller ASC instead of creating synergies among the two groups. Having been on both sides, make no mistake, it will be painful for many health system hospitals to move business into a partner ASC not on their campus because of the lack of payment parity among both venues. Meaning, what the health system hospitals lose to the ASC (partner or not) cannot cover their loss because hospital outpatient departments are paid three times the amount of money that an ASC partner will receive for the exact surgery case. 

Only forward-thinking health systems will position themselves to capitalize on the partner ASC benefits and prepare for this out-migration despite the short term pain.  

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