The 'looming' disruptor of the ASC industry 

ASCs nationwide are struggling to recruit and retain amidst the 'Great Resignation' and rising operating costs. 

"Physician and nursing shortages are projected to exponentially get worse in the next coming years while our current physicians and nurses are already being asked to do more to compensate for the shortages," Jackie McLaughlin, RN, administrator of the Northwoods Surgery Center in Woodruff, Wis., told Becker's. "I fear industrywide burnout will create a snowball effect with the looming shortages."

The competition for staff is fierce, and many ASCs can't afford to compete with hospital salaries, often because of lower reimbursements. 

"ASCs' reimbursement rates are notoriously and appallingly lower than hospital reimbursement rates," Ann Cook, RN, director of nursing at Best Surgery and Therapies in Cincinnati told Becker's

Staffing is already costing ASCs. On average, ASCs spend $2.2 million on employee salary and wages, or about 21.3 percent of net revenue, according to VMG Health's "Multi-Specialty ASC Benchmarking Study." Battling low reimbursement rates and record-breaking inflation, ASCs are struggling to compete. 

"[Hospital outpatient departments] offer the same hours as the ASC, with the added hospital benefits and increased wages," Sandra Berreth, RN, director of the Foothill Surgery Center at Sansum Clinic in Santa Barbara, Calif., told Beckers. "How can ASCs compete with that? Simply, we can't, so every day, we work at breakneck speed and efficiency, employing everything we know to maintain the cleanest environment and safest working conditions, and above all, we keep the patient safe, with the highest patient satisfaction rate in the industry.

There's also non-healthcare competitors. Walmart, Target, Amazon and other retailers are competing with ASCs for some of the same personnel, and they're willing to pay higher wages than in previous years. CVS Health and Walgreens Boots Alliance have boosedt their minimum wages to $15 per hour. Target and Amazon also have minimum wages of at least $15 per hour, while the national minimum wage is $7.25.

This means office staff candidates and sometimes nurses can receive higher pay for entry-level jobs outside of healthcare. 

To mitigate these shortages, many ASC leaders are investing in people over service lines or technology. Some ASCs have started offering $5,000 sign-on bonuses for administrators. Other ASCs hope flexible scheduling and workplace culture will draw candidates. 

"The ability to hire good people and keep them has changed immensely over the last two years," Jeremy Statton, MD, orthopedic surgeon at Arthritis & Total Joint Specialist in Atlanta told Becker's. "We used to take outstanding staff for granted, and now that has changed. We are working on finding new ways to show our staff how much we appreciate them. "

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