Rural ASCs face unique challenges compared with their urban counterparts as they often manage more severe staffing shortages and gaps in specialty care coverage.
Despite this, rural ASCs may have a significant advantage in the shift toward value-based care, Daniel Decker, MD, a urologist and co-founder of Vitality Plus Urology Clinic in Mountain Home, Ark. Dr. Decker has lived in the area for over a decade and has worked in both employed and independent settings.
In December, when CMS awarded $50 billion across all 50 states through its new Rural Health Transformation Program, Dr. Decker immediately recognized the potential value for his organization — especially with regards to technology and innovation in its ASC.
“It could really transform a lot of things that need to be fixed,” he said. “I’m at that point in my career — 15 years in — and we’ve got a ton of patients. We’re overwhelmed and we’ve got to be more efficient and innovative.”
He added that his organization has already been on the front lines of robotic surgery in Arkansas.
“You can do stuff at a high level in these rural areas,” he said. “But we have a lot of things that are different in practice here than in urban areas.”
These differences, however, may prove to be advantages. Dr. Decker said that because ASCs in rural or remote areas are likely to be the only, or one of only a few, ASCs in the area, they may be held more accountable by the surrounding community.
“In rural areas, people will find out quickly if you’re having problems,” he said, which forces rural ASCs to adhere more tightly to quality standards. This has also put them on the front lines of the transition to value-based care, he said.
“CMS wants value-based care, but how are you really going to make that happen?” he said. “I think rural ASCs have an advantage there, because we can keep track of this stuff. We’re smaller, and then you grow from there.”
Despite having less access to resources than a hospital or health system, investments in rural ASCs — like that of the RHTP — may have a bigger impact as money is more directly placed into the hands of physicians.
“There really is an opportunity for funding that can make a difference,” he said. He noted that administrative growth has long outpaced the growth of the physician workforce, which has resulted in valuable resources and funding often being placed in the power of nonpatient-facing roles.
This creates gaps in the rollout and implementation of new initiatives and innovations, as providers themselves are often too busy to focus their efforts on developing new programs.
“[W]hat we need to do is get back to letting the people who are seeing these [programs] be involved in this,” he said, “I think it’s [important] to have a bigger voice in what we’re seeing in patients.”
