As publicly traded companies and private equity-backed platforms expand their ASC footprints, Daniel Tasset said the trend is moving healthcare in the wrong direction.
Mr. Tasset is founder, CEO and executive chairman of Leawood, Kan.-based NueHealth, which develops and manages physician-owned ASCs, including Oswego, Ill.-based Kendall Pointe Surgery Center.
The largest corporate operators also rely on physician partners. Tenet-owned USPI has about 6,000 physician partners among more than 11,000 affiliated physicians, and HCA Healthcare’s surgery center arm, Surgery Ventures, has more than 3,400 physician partners. Bain Capital-backed Surgery Partners calls its joint venture model a core strength. Mr. Tasset said those structures still don’t put physicians at the top of the food chain.
He spoke with Becker’s about ownership models, physician alignment and what he thinks it will take to change how healthcare is delivered.
Editor’s note: This conversation has been edited for length and clarity.
Question: How does NueHealth’s physician-owned partnership model compare with a private equity rollup?
Daniel Tasset: I really believe that if we don’t put the physician at the center of healthcare, at the top of the food chain, we will never see transformation happen in healthcare. And if we don’t see transformation happen, we will have no choice but to go to a single-payer system or a two-tiered system like the U.K.’s.
There are two categories here. There are publicly traded companies: USPI is owned by Tenet. HCA has its own surgery center division. SCA is owned by Optum, which is owned by UnitedHealth Group. Surgery Partners is a publicly traded company. Then there are companies with private equity as their parent, and private equity is now getting into orthopedic ownership.
Whether it’s a publicly traded company or a private equity parent, those companies are engineered to take profit away from physicians. Period.
In my opinion, more ASCs controlled by publicly traded companies or by companies whose parents are private equity firms is a movement in the wrong direction, because we’re not putting the physician at the top of the food chain.
There are some health systems out there that embrace the site-of-service shift and eventually downside risk, and that partner with physicians in a real, meaningful way. I think that kind of provider alignment, like what we’re doing at Kendall Pointe, is a bright spot.
Q: Beyond the economics, what does physician ownership mean for a specific center or community?
DT: Different consumers value quality, convenience and cost differently. What we’re trying to do is improve all of them: clinical quality and outcomes, patient satisfaction and Net Promoter Score, while always trying to decrease cost.
When a facility is built like a Taj Mahal, with a grand piano in the middle of the lobby, that doesn’t help cost and it’s not going to improve clinical quality. It might impress the patient, but patients are really impressed when they feel cared about. What tells them that is 24/7 nurse navigation after surgery, and follow-up for a year after surgery to make sure things are still going the way they were intended to go.
Q: What would it take to transform the healthcare system?
DT: I think there are three foundational blocks. The first is consumer empowerment: real price transparency, the ability to shop for the highest value at the lowest cost, and well-designed benefit plans that give people an incentive to shop. The second is providers competing on value, with physicians at the center. The third is technology. If the first two are in place, technology will come out of the woodwork to measure the things that predict clinical quality, like how long a patient is in the OR and how quickly they walk after surgery.
But as long as we have monopolies, physician noncompetes and certificate-of-need states, there’s not a level playing field for competition. State and federal legislators have to make sure the playing field is level.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
