What ASCs are worried about as 2023 comes to a close

Six ASC leaders joined Becker's to discuss what they are most concerned about as the end of 2023 approaches. 

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

DJ Hill. CEO of Compass Surgical Partners (Raleigh, N.C.): We see anesthesia as a concern that has existed all year and will continue to exist as a concern in 2024. The ASC industry will need to find new and creative ways to deal with the shortage as well as work with payers to address it as a collective. Additionally, we also see inflationary trends in supplies, services and staffing as a concern, but we have been happy that our team has responded with innovative solutions.

Ira Richterman, MD. Orthopedic Surgeon at OrthoUnited Spectrum (Canton, Ohio): As we enter December, ASCs are always forced to navigate a very difficult balance of surgeon availability, ASC operating room capacity and anesthesia coverage with the patient's desire to maximize healthcare benefits prior to restarting a new year’s deductible.

John Critser. CFO of Eye Associates of Tucson (Ariz.): This is really a perennial issue: accounts receivable. More and more payers make it difficult to collect legitimate claims.  Stonewalling, system errors, prior authorization complications, etc. We have a lot of money tied up in accounts receivable that legitimately should be in our bank account. 

Julie Baker, RN. Administrator of Andover (Mass.) Surgery Center: The biggest concern for us is staffing and increased pricing on medical supplies. We are getting into our busy season where everyone wants to finish surgery before Jan. 1. Making sure we have enough hands without blowing our budget is a hard line to toe. Along with the increase in raw materials price that makes up most of the medical supplies available, we have to make sure we are constantly looking at what we did last year versus this year without overspending in areas that have increased.

Larry Bauss, MD. Medical Director of Surgery Center of Kalamazoo (Mich.): As an anesthesiologist and a medical director of an ASC, I'm acutely aware of the issues related to the shortage of anesthesia coverage. The anesthesia workforce supply issues have not spared the ASC world. At our ASC, we are concerned about meeting our caseload needs between now and the end of the year with the anesthesia coverage that is available to us. Obviously, December is generally a very busy month for elective surgeries. 

Shawna Alfano, MSN, RN. Administrator and Director of Nursing of BASS Surgery Center ( (Walnut Creek, Calif.): As we near the end of the year, I am not necessarily thinking of things that impact the now, but more the future. By this I am referring to, for example, what potential changes payers are making as we speak that will impact the bottom line of consumers, i.e. our patient population that will directly impact whether these folks have surgery or not. Will policy premiums, deductibles and co-insurance amounts finally reach a point where patients simply have to choose between a fracture repair and the costs of daily living? If so, how will this impact our already hammered healthcare workforce and the viability of ASCs?  

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