How ASCs are adapting for success

Five ASC leaders recently connected with Becker's to share how their ASCs have evolved to ensure success in the ever-changing healthcare landscape.

Editor's note: Responses have been lightly edited for length and clarity. If you would like to contribute to our next question, please email Paige Haeffele at

Question: How have you updated your strategy for success in ASC/outpatient care recently? 

James Chappuis, MD. Orthopedic Spine Surgeon and Founder of Spine Center Atlanta: At Spine Center Atlanta, we have embraced technological advances to streamline communication and stay connected with our patients after they leave our ASC after outpatient care. 

We are partnered with OSPITEK, who provides software and technology solutions promoting better patient experience and workforce productivity. OSPITEK keeps our staff, patient and patient's caretaker on the same page to help keep full transparency of the trajectory of treatment with a visual representation and automated tracking of the patient's journey. We have seen an increase in satisfaction from caregivers and patients alike by keeping them included every step of the way. 

Additionally, we have increased our digital presence to stay linked to our patients through email and social media.

Richard Cunningham, MD. Orthopaedic Sports Medicine Physician and Surgeon at Vail-Summit Orthopaedics and Neurosurgery (Frisco, Colo.): 

1. It is so critical to my success to work with an experienced physician assistant, athletic trainer and scrub tech in surgery. Although insurance often does not cover it, most surgeries require several skilled assistants in order to achieve an optimal result. 

2. Having a good anesthesia care team who can reliably place indwelling pain catheters and then sending patients home with pain pumps that stay in place for the first three to five days after surgery.

3. Having a knowledgeable and experienced representative from the orthopedic implant company you prefer to work with.

4. Having knowledgeable and friendly pre-op and post-op nurses.

5. Having some good country music playing in the background during surgery.

Earl Kilbride, MD. Orthopedic Surgeon at Austin (Texas) Orthopedic Institute: In terms of metrics that we consider important, i.e. patient outcomes, patient satisfaction, efficiency and cost, ASCs and hospitals don't compare. With that being said, as a provider, I am trying to deliver the best outcomes for the patients. I'm looking at it as a whole and all of the metrics I mentioned are extremely important. As a result, I try to bring as many cases as I can to an outpatient center. As a matter of fact, some insurances will only let providers bring outpatient cases to outpatient centers. Unfortunately, as someone who also does a lot of hospital work, I realize it's not all good for the inpatient hospitals. Because COVID-19 changed the way medicine is practiced, the ASC and hospital models have continued to drift just a little bit further apart. Fortunately, the reimbursement models are totally different, and hopefully the hospitals can continue to survive.

Specifically for the ASC, we have incorporated many facets into specific patient care. Preoperatively, all of our patients were screened. Intraoperatively, many facilities are using similar technology, such as computer navigation and robotic assistance. Postoperatively, my particular ASC actually brings in a licensed physical therapist to mobilize our patients. Through it all we use regional anesthesia to assist with pain control.

Ashish Sahai, MD. Orthopedic Spine Surgeon at Spine & Orthopedic Center and Associate Clinical Professor at Florida Atlantic University (Boca Raton, Fla.): Certainly, the healthcare landscape, especially in the field of spine surgery, has undergone significant transformations in recent years, making it imperative for professionals to adapt to these changes. In my pursuit of success in ASC and outpatient care, I have implemented a range of strategies and improvements.

With the emergence of new technologies and techniques, there are now more opportunities for minimally invasive spine procedures. These procedures not only shorten recovery times but also often permit same-day discharges. Their compatibility with ASCs, where efficiency is paramount, has made them a cornerstone of my approach.

Equally crucial is patient education. In the outpatient setting, it is essential that patients possess a comprehensive understanding of their condition, available treatment options and how to anticipate post-surgery. I have intensified my commitment to patient education, recognizing that well-informed patients generally experience better outcomes.

Effective communication and collaboration play a pivotal role in outpatient care. I collaborate closely with an interdisciplinary team consisting of nurses, anesthesiologists and physical therapists. This collaborative effort ensures a seamless patient journey, from pre-op to post-op care.

Our commitment to patients extends beyond achieving successful surgical outcomes. We diligently track patient outcomes and satisfaction, using this data to continuously refine our processes and elevate the quality of care we deliver. Given the dynamic nature of the medical field, I remain steadfast in my dedication to ongoing education and training, keeping me at the forefront of advancements in spine surgery and outpatient care.

In summary, my strategy for success in ASC and outpatient care revolves around adapting to evolving healthcare trends while upholding a patient-centric approach. It centers on delivering exceptional care that respects the unique needs of each patient we serve.

Ken Schaff. Administrator of Brentwood (Tenn.) Surgery Center: For almost everyone in ASCs, strategies are focusing on total joints. They have become and will likely remain the biggest disrupter in the ASC business since the dawn of the business itself. The only difference today, is that now more than ever, the hospital systems are part of the strategy.

Total joints have been performed in ASCs for 20 years. In the early years, this movement was disrupting the industry by pulling business away from the hospital systems. Now, with more and more consolidation of ASCs to hospital systems/ASC companies, they have become part of the disruption. Even though most total joints in ASCs are commercial payers, the catapult to real change was when Medicare approved payments for them in ASCs starting in 2020. Since then it has been a race to the finish line. All ASC companies and hospital systems are working to capitalize on the migration in a "can't beat them, join them" campaign.

Many multispecialty ASCs are now further pushing out lower revenue specialties like OB-GYN, urology, podiatry, ophthalmology, pain and even gastroenterology, to make room for total joints. ASCs that have not adopted or planning to adopt this strategy, are behind the curve and missing out on the Great Migration.

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