Four ASC leaders spoke with Becker's ASC Review on how President Joe Biden's administration has affected ASCs in the last year.
Question: One year into Joe Biden's presidency, how has his administration affected ASCs and physician owners?
Editor's note: These answers were edited lightly for clarity and brevity.
Susan Feigenbaum, PhD. Professor at University of Missouri-St. Louis' Department of Economics: The real question is what hasn't President Biden done that will have an enormous impact on ASCs in 2022. First, supply chain issues will continue to plague ASCs, thereby driving up the cost of supplies.
The president has not gotten involved in the battle for "site-neutral" payment policies between ASCs and hospital outpatient departments, although a Supreme Court ruling in June 2021 may serve instead to solidify this policy. This would have a dramatic, positive impact on ASC sector growth. Unfortunately, under the Biden administration, CMS restored Medicare's inpatient-only list, reversing a Trump plan to phase out the list over the next three years.
The one thing the president did was enact a vaccine mandate for ASC employees, which would have had a potentially negative impact on upward of 20 percent of ASC personnel. The courts have set this aside for a number of states. Given the tightness in the labor market, this court action was definitely a welcome relief.
Jeff Dottl. Principal at Physicians Surgery Center (Ventura, Calif.): Unfortunately, I don’t see much positive in what has gone on so far. Both sides of the aisle seem to have gone off-the- rails crazy and spend their time sparring over anything and everything. If it doesn’t score political points, then I don’t see it getting much traction on the Hill. Maybe I’m overly pessimistic, but I don’t expect anything but more of the same over the next three years. At least I won’t be disappointed if Congress, the Senate and the executive branch actually acted responsibly and without hypocrisy.
Bo Neichoy, MD. Co-owner of Surgery Center of Amarillo (Texas): The ignorance on a federal level as to what actually affects patients continues with the current administration. Because the government will always focus on providing insurance, they will continue to miss the big picture, which is the cost of delivering care. CMS removing 255 procedures from the ASC list and moving them back to the inpatient-only list is a perfect example. As technology, techniques and medicines advance, more and more procedures can safely and effectively be done in the outpatient setting.
There is no reason that hiatal hernias, appendectomies, gastric band removals, total shoulders and many more procedures cannot be done as an outpatient. Moving these back to the hospital setting increases patient responsibility and the amount the insurances have to pay for the facility fee portion, which ultimately gets passed back on to the patient in the form of increasing insurance premiums and deductibles.