ASC execs are bullish on growth. Here are 5 strategies on their radar

The year 2024 is around the corner and ASCs are employing several strategies to prepare for growth. 

Here are five ways ASCs are looking to grow:

1. Adding service lines

Many ASC leaders are looking to add high-acuity, high-reimbursement procedures to their centers to spur growth. In particular, ASCs are eyeing total shoulder arthroscopy after CMS added it to the ASC-covered list in its final rule.

"With CMS' sudden unexpected release of total shoulder arthroscopy to the ASC-covered procedures list, I find myself scrambling to meet with our surgeons and staff to begin planning for the first of the year," Alfonso del Granado, administrator and CEO of Lubbock, Texas-based Covenant High Plains Surgery Centers, told Becker's. "This is an exciting time, and I haven't felt this bullish about the future since before the COVID pandemic."

Leaders are also continuing to focus on other orthopedic and cardiology procedures. 

"As we have plans to kick off our total joint program in the beginning of 2024 with total knee arthroplasties, I would like to see that service line grow into shoulders and hips as the year goes on," Erin Vitale, RN, director of nursing at Hoffman Estates (Ill.) Surgery Center, told Becker's. "We also have a general service line that has a great opportunity to expand its services."

2. Recruiting and retaining staff

ASCs faced many challenges in recruiting and retaining staff in 2023. Staffing costs are a huge burden on many ASCs, and some centers spend one-fourth or more of their net operating revenue on employees to stay ahead of shortages, according to a report from VMG Health. Many leaders are focusing on staff recruitment to drive growth in 2024. 

Andrew Lovewell, CEO at Columbia (Mo.) Orthopaedic Group, told Becker's that "attracting and retaining top talent is essential" to continue its growth strategy.

"In an extremely competitive labor environment, getting the right people in the door is important," he said. "We have overhauled our benefits package recently and are continually working to provide the best benefits to our staff. We are still facing critical shortages in anesthesia providers and diligently working to assure we are in the best position to recruit the top talent in the market in this field as well as all others."

Other leaders are focused on retaining and investing in existing staff. 

"In 2024, my primary focus is on nurturing and retaining our exceptional team," Andrey Ibragimov, BSN, RN, director at the Chicago-based Ingalls ASC, told Becker's. "We understand that the quality of care we provide is directly linked to the dedication and expertise of our staff."

Ms. Ibragimov said she is enhancing her team's strategies and policies and trying to collaborate with other groups to "create an environment where outstanding healthcare and fulfilling career paths flourish together."

3. Partnering with other providers

ASCs are looking to hospital and management company partnerships to access economies of scale amid skyrocketing operating costs.

For some, that means abandoning independence. 

Jayesh Dayal, MD, anesthesiologist at Rockville, Md.-based White Flint Surgery, told Becker's that "remaining independent is becoming impossible."

"We have absolutely dismal rates, no scope of negotiating anything at our scale — with the insurers or the vendors — and the personnel costs are out of control," he said. "For 2024, we have started talking to national chains, private equity firms and hospital systems to partner with so that the rates get better, the cost of disposables and implants get better, and the day-to-day operations and RCM are optimized. "

Some leaders have been able to ensure practice growth in 2023 with these partnerships. Grant Booher, MD, neurosurgeon at Fort Worth, Texas-based Longhorn Brain and Spine, told Becker's he was able to build out an ASC by partnering with a management group and several local surgeons. 

"The days of in-house billing, long-term relationships with one's team, the independence to run your own outfit, are sadly gone," Dr. Dayal said. "It was fun while it lasted, but it's time to bring in the suits — like the hospital days of yore. "

4. Focusing on payer contracts

ASCs are also focusing on reevaluating payer contracts to stay ahead of potential reimbursement declines. 

"With the inflationary curve on the rise and another looming cut to the physician fee schedule, it is imperative that we reexamine our payer contracts with all other payers in our market," Mr. Lovewell said. "Many of the Medicare Advantage plans in our market are trying to pay below the Medicare physician fee schedule, and none of them are accounting for the implant costs associated with doing surgery in our ASC."

Leaders also are focusing on providing risk-based contracts to reduce costs for ASCs and patients. 

Reuben Gobezie, MD, director of the Gobezie Shoulder Institute in Cleveland, told Becker's his growth strategy includes incorporating ASCs to his organization's "overall practice strategy to provide risk-based contracts to payers and employers in order to reduce their total cost of musculoskeletal spend."

5. Investing in technology

Because ASCs are largely independent, leaders in many markets do not operate on high enough margins to invest in costly technology. In 2024, however, ASC leaders are sure to keep an eye on the technology they need to grow.

For some ASCs, this comes into fruition with EHRs and EMRs. 

"My priority is building our new EMR system to ensure more efficient workflows within the system to better care for our patients and to be able to communicate more efficiently with other healthcare systems," Heather Liester, RN, director of pain management at York, Pa.-based OSS Health Pain Center, told Becker's.

Other ASC leaders and physicians are eyeing artificial intelligence and how it can affect care provision.  

"My priority for 2024 is to see the impact of AI in the field of gastroenterology," Pankaj Vashi, MD, department head of gastroenterology and nutrition at City of Hope Chicago in Zion, Ill., told Becker's. "Artificial intelligence is in its infancy, and we are already seeing it being used for screening for colon cancer and surveillance for Barrett's esophagus. New applications of AI will change how we practice in the near future."

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