How private equity will affect ophthalmology ASCs: Q&A with Robert Nelson

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Robert Nelson is executive director of Island Eye Surgicenter in Westbury, N.Y. He told Becker's about how he thinks private equity investment will affect ophthalmology and shared his biggest concerns about the winter season. 

Question: How do you predict private equity investment will affect the ASC industry?

Robert Nelson: Within the ophthalmology specialty, private equity investment has been well established over the past five-plus years. The impact on ASCs for the most part has been positive with regard to streamlining and improving business, accounting, HR and inventory management processes. Where PE is lacking is in its understanding, appreciation and support for the important regulatory, accreditation and clinical requirements essential to the success of ASCs. Their primary focus [understandably so] is to improve profitability to prepare the company for the next transaction. 

On the flip side, ASC management companies have a comprehensive understanding of ASC operations and the importance of maintaining strict compliance to the regulatory and accreditation standards. Additionally, they have a keen business acumen. My sense is that private equity activity will continue within the ASC industry and that eventually there will be several larger regional and then national rollups.

Q: What are your biggest concerns for the upcoming winter season?

RN: Obviously, COVID-19 had an enormous impact on ASCs in the winter and spring of 2020 — essentially shutting the industry down. I am hopeful that the delta variant or another variant doesn't have a similar impact this winter. But another concern I have is the cost and availability of medications and supplies. Now more than ever, ASCs must have a laser focus on their supply costs. Review every contract, and if you are not taking advantage of prices available through a group purchasing option, you must do so. More specifically, there are specialty-specific GPOs that are experts at working with vendors within their specialty. With proposed cuts to reimbursement, managing costs becomes imperative.   

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