The biggest roadblocks in 2021: 7 ASC leaders share their predictions

 As the year comes to a close, ASC leaders are thinking about the year ahead and preparing for potential challenges. Seven leaders told Becker's ASC Review what they anticipate will be the biggest roadblock in 2021.

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

Suzi Cunningham, administrator at Advanced Ambulatory Surgery Center in Redlands, Ca.: If I had to pinpoint one of my biggest struggles, [it] is dealing with so many “appropriate for outpatient surgery” CPT codes not being on the Medicare ASC Fee schedule. Medicare has got to keep up with the times.

Both patients and surgeons want to have their surgeries performed at a specialty center. There is a much less likelihood of getting an infection, it is a lot less hassle for the patient, and it makes so much sense from a financial aspect. Yet, we are forced to obtain carve-outs, amend contracts, etc. just to be able to provide this care. Waiting year after year for things to change is painful and unnecessary.

Raghu Reddy, chief administrative officer at SurgCenter of Western Maryland in Cumberland, Md.: The biggest roadblocks in 2021 will be the continuation of the pandemic in our area, increased case migration from the hospital to our ASC, space, block time and the logistical requirements to accommodate the case migration beginning of the Medicare hip arthroplasties on Jan. 2, 2021.

We are currently a one [operating room] and three procedure room ASC and are diligently working to remove any roadblocks while navigating the patient and staff safety during this pandemic. One other trend we have observed is the high deductible plans are on the rise. With an already slowed economy in our demographics, it will be challenging to address the loss of case volume due to the shutdowns and patients losing health coverage.

We are prepared to handle these roadblocks with team effort and crisp execution daily. It becomes a bit easier when we get additional resources and support from our hospital partner, UPMC Western Maryland Health System.

Deb Goodman, co-administrator at APAC Surgery Center in Crown Point, Ind.: The biggest roadblock? The pandemic — having healthy staff and physicians, trying to get the vaccine, healthy patient population, supply chain (personal protective equipment is first), but all supplies are getting hard to get. We are an independent center, with no hospital affiliation.

Georgianne Maxwell, administrator at Salem ASC in Salem, N.J.: Our biggest challenge as an ASC in 2021 will be lobbying our state government to keep outpatient services open and running throughout mandatory COVID-19 shutdowns.

Patients who are receiving outpatient services are not occupying inpatient facilities, are not taxing the inpatient healthcare system, and in most cases – [centers] keep people healthier by providing necessary care. Delaying care in these vital areas of medicine only promotes a sicker population of elderly patients to care for.

Staffing shortages in the hardest hit COVID-19 areas would be the only viable reason for shutting down outpatient services — to redirect staffing — however, outpatient medical staff generally do not fill the inpatient staffing void. Most outpatient medical staff workers are in the lower paying realm because of quality of life reasons, and generally cannot fill the inpatient void.

Deborah Herdman, administrator at Paragon Surgical Center in St. Thomas, U.S. Virgin Islands: We anticipate our biggest issue will still be dealing with the pandemic or the aftermath, which has resulted in many long delays in getting routine supplies and equipment. It has been quite a challenge for us to get some of our vendors to send supplies or to travel to the Virgin Islands to provide services, products and equipment. As the pandemic abates there will be much "catching up" to do for most of us, and since we are not a major client we may not be at the top of the "lists" even though we have an abundance of patients waiting for care.

Robert Lerma, administrator at Blue Springs Surgery Center in Orange City, Fla.: The biggest roadblock I believe is the economy – specifically the closing of small businesses. As some politicians seem to have a fervor for business shutdowns and using the COVID-19 pandemic as a reason, there will be thoughtful decisions made by patients to postpone needed elective medical procedures.


Joe Peluso, administrator at Aestique Surgery Center in Greensburg, Pa.: I am persuaded that balancing site-of-service reimbursement models with buy-in from patients for more complex procedures safely performed in an ASC, and working with independent physicians to provide resources to support their surgical practices will be our biggest challenges in 2021 along with pandemic fatigue.


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