The biggest threats to outpatient migration 

Procedures are continuing to move to the outpatient setting, which is driving ASC growth, but obstacles remain. 

Four ASC leaders joined Becker's to discuss the biggest threats to outpatient migration. 

Editor's note: These responses were edited lightly for length and clarity. 

Les Jebson. Regional Administrator at Prisma Health (Greenville, S.C.): The single greatest threat is not in bricks and mortar, or implants and supplies or payer reimbursements. Instead, it is systemic national shortages of perioperative professionals, starting with certified registered nurse anesthetists, surgical technologists and registered nurses. Those that create a team-based care environment, offer flexible staffing and benefits and tight orchestration of procedure scheduling at specific locations will be better positioned to deal with this threat.

Javier Marull, MD. Associate Professor of Anesthesiology at UT Southwestern Medical Center (Dallas): The greatest threat to outpatient migration is the costs of performing certain procedures. Advances in technology may enable more complex procedures to be done in ASCs, but the costs associated with these procedures combined with healthcare regulations can significantly impact the pace of outpatient migration.  

Angela Ross. Director of Surgical Services at Charlotte (N.C.) Eye Ear Nose & Throat Associates: Changes in multiple states regarding certificate-of-need laws, skyrocketing costs with booming inflation, exhaustive and overly prohibitive preauthorization processes, along with proposed physician pay cuts looming could confound the long-term ability of ASCs to remain the preferred location for services. These factors combined could annihilate outpatient migration patterns. Well-managed and strategic outpatient centers are wisely planning to mitigate each and every one of those factors not in isolation but in parallel to ensure a solid future outlook.

Andrew Weiss. Administrator of Summit Surgical Center (Voorhees, N.J.): It is the disparity in hospital outpatient departments vs. ASC rates for performing the same procedure. Our costs are increasing, especially salaries and benefits, which need to be competitive with HOPDs and hospitals, yet reimbursements still sit at 50% of the HOPD rates.

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