ASCs look to high-acuity service lines as operating costs skyrocket

As procedures, particularly orthopedic and cardiology cases, migrate to the outpatient setting, many ASC leaders are looking to add high-acuity service lines to meet margins as operating costs soar. 

"As CMS allows more procedures to be performed in centers, it gives centers the option to be open for more procedures," Catherine Retzbach, BSN, RN, director of ASC operations at Marlton, N.J.-based Virtua Health, told Becker's. "Cardiology and spine procedures offer patients more options to have procedures be performed in a high-quality, low-cost environment."

Jeany Dunaway, RN, administrator at Effingham (Ill.) Ambulatory Surgery Center, and her team started a total joint program in 2021. While the ramp-up has been slow, she's excited to see it continue as "both the surgeons and our staff become more comfortable with the processes," she told Becker's

"It's exciting to see the excellent results our patients are experiencing and how pleased they are with our services," she added. 

Big ASC chains are looking to high-acuity procedures to encourage growth. By the end of the third quarter, orthopedic and spine procedures made up 20 percent of ASC chain United Surgical Partners International's volume. 

In an Oct. 20 earnings call, Saum Sutaria, MD, CEO of Tenet Healthcare, USPI's parent company, said the chain is doubling down on its high-acuity growth strategy. He cited growth at an ASC in Tennessee, where the center boosted revenue by 46 percent by replacing high-volume, low-acuity procedures with high-acuity orthopedic cases.

UnitedHealth Group's Optum, parent company of ASC chain SCA Health, is also looking to higher-acuity surgical procedures to lead growth, CFO John Rex said in an Oct. 14 earnings call

Small ASCs' growth strategy also includes service line additions. Shannon Parisi O'Leary, regulatory compliance manager for the Mason-based Southwest Ohio Pain Management, runs a "very small" center focused on "a very efficient day-to-day operation," she told Becker's

"With the addition of new service lines, it will allow for more opportunities for growth as an ASC and as employees, which is the most exciting of all," she said. 

But adding service lines in an unstable economy isn't always the best option, and ASC leaders need to weigh the costs before committing to the investment, Ms. Retzbach said. 

"Adding service lines takes research and commitment. Also, sometimes difficult decisions need to be made, such as decreasing days of service if volume does not warrant being open every day," she said. "If you want to add a new service line, will you have enough procedures performed to cover the costs?"

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