Beth LaBouyer, executive director of California Ambulatory Surgery Association, joined Becker’s to discuss the issues affecting ASCs in California.
Editor’s note: These responses were edited lightly for clarity and length.
Question: What factors are most impacting financial sustainability of ASCs in your state?
Beth LaBouyer: There are three major issues currently impacting financial sustainability for California ASCs:
– Reimbursement rates: In general, low Medi-Cal reimbursement rates have posed significant financial challenges for ASCs and healthcare providers. California’s rates are notably lower than Medicaid rates in other states, making it difficult for ASCs to cover surgical costs. Increasing Medi-Cal reimbursement is critical to expanding access to care and keeping pace with medical advancements, including the use of robotics in surgery, which remains underfunded. The recently passed a managed care plan tax in California, which is anticipated to increase reimbursement rates for primary care and specialty care amongst other Medi-Cal services, will help, but more is needed to reflect the true cost of care.
– Staffing and physician shortages: A shortage of anesthesia providers and other key personnel threatens ASC operations. Limited staffing affects scheduling, service expansion, and financial sustainability. Additionally, anesthesia providers increasingly request guaranteed stipends which is challenging for ASC financial stability.
– Consolidation: Physician ownership has been central to the success of ASCs, and as consolidation efforts grow to improve efficiency, it is essential to preserve physician leadership and oversight in both surgical and business decision-making.
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