Shelly Harris, RN, administrator of Advanced Surgical Care Clearwater (Fla.), told Becker’s the boldest bet in ASC strategy right now is going after higher-acuity, higher-paying cases that can safely move out of the hospital.
The opportunity keeps growing as the ASC keeps “getting more and more codes approved,” she said.
The economics don’t always follow, though.
“The reimbursement doesn’t always align with the cost unless you have the volume and right payer mix,” she said.
Whether the bet pays off depends a lot on the anesthesia model, she said. Many ASCs were built around quick, straightforward cases that let staff flip rooms efficiently. Higher-acuity cases change that.
“When you move into higher acuity cases with longer OR times but physicians still expect to flip rooms, you quickly become very inefficient in your anesthesia spend, which would cut greatly into your profit margins,” Ms. Harris said.
The risk comes from how anesthesia is paid for.
“Many anesthesia models are a fixed cost, so you are paying whether a room is running or not,” she said. “Unused time comes out of your overall profit margin for the center.”
In the end, Ms. Harris said, the bet depends on physicians. Centers need surgeons to bring the cases and to operate in ways that support the center’s finances, not just their own schedules.
That’s a big change in mindset. Convenience was historically the biggest selling point for bringing cases to an ASC. Now centers need physicians to put efficiency first.
“Physicians are busy and many times in multiple places a day, so this would require more intentional efforts on their part to value the efficiency over convenience,” Ms. Harris said. “Blocks released last minute, late starts and gaps between cases are all conveniences that should be better managed.”
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.
