The ASC industry in 2021: An administrator's perspective and predictions


Raghu Reddy, administrator at Cumberland-based SurgCenter of Western Maryland, told Becker's ASC Review his predictions for the industry over the next 12 months.

Note: Responses have been lightly edited for clarity and style.

Question: How do you see cardiology evolving in the ASC space?
Raghu Reddy: We are noticing a trend in the rapid migration of cardiovascular procedures in the ASC space. The CMS' addition of cardiovascular CPTs to the list of Medicare-covered ASC surgical procedures over the past few years is the key driver for increased development activity in this space. Of course, this is combined by ASCs' already proven measures such as patient outcomes, efficiencies and costs per case. Patient selection continues to the key even in the space and cardiology will continue to grow in the ASC space with either co-management or hybrid models.

Q: How do you predict the role of robotics will shift into the next year?
RR: The role of robotics will continue to evolve in the coming years in the ASC space. The ASCs are typically set up for [a] high-volume of cases combined with acuity and profitable payer mix. The very word "robotics" will bring capital investment costs to the forefront of decision-making. Currently, there is not a lot of evidence that proves that robotics significantly improves clinical results especially in orthopedics, where some ASCs are adopting robotics. We could see the competitive advantage the robotics bring to an ASC, but the thing to keep in mind is the reimbursement from the payers to cover the entire capital and maintenance costs of the robotic program in the ASC. We should continue to study the evolving clinical evidence for the outcomes before a justification can be made to include robotics and the footprint needed to accommodate this program. 

Q: What do you think mergers and acquisitions will look like going forward?
RR: There has been a lot of activity in the ASC space with mergers and acquisitions. Hospitals and private equity groups are acquiring ASC's at a faster pace than before. The catalyst here is the CMS approval of total joints, spine and cardiovascular procedures. The pandemic certainly helped to migrate the ASC-eligible procedures from [hospital outpatient departments] to ASCs. The insurers are also playing an instrumental role in migrating the cases to the ASC due to all the obvious advantages that ASCs provide. The national ASC management companies [are] also increasing the joint-venture partnership with hospitals and private equity groups. Shrinking reimbursement and threat of survival, especially in difficult or competitive markets, have also accelerated the M&A activity.

More articles on surgery centers:
4 new joint-venture ASCs — September 2020
Work begins on new ASC in Arizona — 3 details
SCA centers added 1,000+ new surgeons in 2020 so far: 5 things to know

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