Top fears for ASC execs

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There are many uncertainties in healthcare right now as COVID-19 surges across the U.S., large corporations eye health systems for acquisition and healthcare workers exit the field in large numbers.

Four ASC executives shared their top concerns with the "Becker's Ambulatory Surgery Centers Podcast" in July and August. Below is an excerpt from those conversations. Click here to download the full episodes.

Karen Albright. Nurse Administrator at Riva Road Surgical Center (Annapolis, Md.): I am most nervous about our staffing crisis. It seems like post-COVID, a lot of people spent time reevaluating their priorities, and work didn't come to the top of peoples' priority list. People found that time off at home with their families was more important than time at work. We had six or eight nurses cut from full time to part time because they spent time reprioritizing or they needed to stay home with young children or grandchildren, or any of the many reasons people decide to decrease their number of hours at work and increase the number of hours at home.

As part of a large network, I can see this isn't just a problem for us here regionally. It's not just in the state of Maryland, but it's all across the country. I want to make sure we have good quality care providers, and that becomes harder to find. You don't want to staff your center with many new people who can't handle everything that comes along, because we need to be prepared to handle anything that comes along.

Matthew Ewasko. Administrator of Physicians Alliance Surgery Center and Surgical Services Business Analyst at St. Francis Healthcare System (Cape Girardeau, Mo.): I'm most nervous about dealing with commercial payers. They're looking at their bottom line as much as we are, so trying to enter into negotiations with them is always a bumpy process. I want to make sure we have all our information to support our side of things as my No. 1 priority. Another issue we've been dealing with in the past several months is staffing shortages. I know that's common across the country and it's not just for ASCs; hospitals are hurting as well. Staff recruitment and retention is something we are trying to keep an eye on.

Luckily for us at the ASC, we have the benefit of not working nights or weekend holidays. Our staff is not on call. While our pay scale isn't going to match what the hospital has, some of our facility benefits can exceed their offerings and have helped us gain some employees in the past. Sometimes all staff look at is the almighty dollar, and when they're being offered a considerable amount more per hour at the hospital, that's always something that keeps us a little bit nervous on the ASC side. We want to maintain current employees, but we also want to attract new ones to fill any gaps that may occur in the future.

Krishna Jain, MD. CEO of National Surgical Ventures and Limb Preservation Centers of America (Chicago): What worries me the most is the big corporations owning hospitals and doctors. The doctors are actually not able to provide the care they want to provide in that situation. When mergers happen, it's often touted that quality of care will go up. But over a period of time, it has been proven by multiple studies that the quality of care has never improved, while the cost of care has gone up significantly.

One of my biggest fears is that if more doctors continue to be employed by hospitals and hospitals continue to merge, then the cost of medicine will actually go up and the quality of care may not because the corporations and big hospital systems are focused on profit margins. They talk about quality of care, but ultimately if the hospital isn't making profit, the quality of care usually suffers.

Christina Holloway. Administrator of ASC Bala Cynwyd (Pa.): My fear is that we aren't going to educate enough [nurses] to meet the demand. We can only hope that young people growing up see how nurses change the world and they want to be part of the spectacular and amazing team.

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