ASCs eye business growth, but headwinds persist

ASC administrators see exciting times ahead for their centers and the industry as a whole, despite reimbursement challenges and continued staffing issues.

Three ASC administrators from across the U.S. recently shared their perspective on exciting trends for surgery centers and what they're most focused on today with the Becker's Ambulatory Surgery Centers Podcast.

Nyleen Flores, Administrator of Total Surgery Center (Naples, Fla.): Right now I'm excited about business development and the growth opportunity in the ASC space. With more patients being comfortable and more surgeons supporting the outpatient space, growth and expansion of all kinds of service lines within the ASC [is happening].

As we've talked about so much, [the biggest issues are] insurance problems, insurance denials and payer enrollments and ways to increase revenue without affecting processes and compliance. We spend a lot of time also dealing with employees and adapting to the changes within the workforce. With the arrival of the new generation in the workforce, it's forced us to change the way we staff, and it forces us to interact with our staff a little bit differently.

Bruce Feldman. Administrator at Bronx (N.Y.) Ambulatory Surgery Center: The thing I'm most excited about is the transition of more and more procedures that have been traditionally done in the hospital setting into the ambulatory surgery center arena. We saw that with orthopedics about three to five years ago with joint replacements, and now we are starting to see that with cardio cases and the insertion of pacemakers, internal defibrillators and peripheral vascular stenting. As more and more procedures move out of the hospital into the ambulatory surgery center, that growth will continue.

The biggest issue would be staffing and getting the right staff. COVID really played a number on staffing in healthcare. The other biggest issue is reimbursement; getting the insurance companies to pay you the proper amount for the procedures you're doing. As we get more and more of the complex procedures from the hospital into the ASC industry, those procedures are also more costly to do. Reimbursement has to change and has to be on par with the hospital outpatient department.

Nicholas Grosso, MD. President of The Center for Advanced Orthopaedics (Bethesda, Md.): The market is poised to swing back toward private practice. For years the market has gone away from private practice. We've seen that trend in the numbers of physicians actually in private practice shrinking from 70 percent 10 years ago to 24 percent now, which is obviously concerning. But I think the pendulum is getting ready to swing back. The reason I think that is with the onset of [value-based care], I think private practice is the setting that is going to provide the best care to patients in the most efficient way possible. Hospitals tend to be more expensive. The rash of [private equity] purchases of practices aren't going to do anything to lower the costs in those practices since they're revenue-driven models.

I'm really excited about the future of private practice, and that's the reason we created MedVanta, to get private practices together and work as one, even though they retain their own tax ID number and their own identity. Working with MedVanta, we are building the platform with tools necessary to win at risk. To really win at risk, you need the analytics, you need the digital platforms, you need tools in your toolbox. They are hugely expensive to build, and we are funding that ourselves. We're not taking any outside money; we're doing it strictly with physicians. We want to be completely physician-led and physician-owned, and that's taking all my time right now.

Unlike other [managed service organizations] that have been in the marketplace before, there have been some spectacular failures and we feel the reasons were: one, they didn't provide the full suite of services necessary to get risk, and they also didn't provide the opportunity for everyone who works with them to have equity in the company. We've designed MedVanta where any group who wants to invest will have the same opportunity as the original owners did, and we think that's the only way to make it fair to where surgeons will want to participate.

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