What ASCs can expect more of in 2022

ASCs are in a great position to take advantage of high quality, low cost care trends next year. But they will face the same challenges as other companies when it comes to supply chain and staffing shortages.

Ten projections for ASCs next year:

1. Commercial payers will direct more of their members to ASCs and increasingly require the low-cost setting for coverage. In some areas, payers already are sending letters to members explaining why they should have procedures in ASCs, according to Christine Blackburn, BSN, administrator of South Kansas City SurgiCenter.

2. The nursing shortage will worsen. Registered nurses are retiring at a rate of 100,000 per year, according to the American Nurses Association, and the U.S. Bureau of Labor Statistics projects there will be a need for 1.1 million new RNs in 2022.

3. ASCs will transform into a more "boutique" healthcare business as patients demand a more comfortable care experience. Surgery is stressful for patients and family members, even for nonemergency procedures, and the "boutique" feel of a facility is calming for patients, said Ms. Blackburn.

4. ASCs will dive deeper into data collection with more sophisticated IT systems and quality reporting requirements. They also will need to collect and analyze data to enter into bundled payments and other episode-of-care contracts, including direct employer arrangements.

5. Insurance companies will require more documentation and question prior authorizations after surgery is complete. ASCs in many areas already are seeing heightened scrutiny from insurers, and the CMS decision to move 255 procedures off the ASC-payable list in 2022 will spark more time-consuming and costly requests from commercial insurers.

6. Higher supply costs likely will continue in 2022. PwC projects the medical cost trend will be up 6.5 percent next year over 2021, with supply spending as an inflator. Prices of personal protective equipment, especially, will increase as facilities stockpile in preparation for future emergencies.

7. ASCs will be in a strong position to recruit physicians as more physicians decide to leave employment contracts. The Biden administration's attack on noncompete agreements may make it easier for physicians to join independent medical groups. Hospitals also may shy away from physician hiring because of the rising costs to attract specialist talent.

8. The biggest ASC companies will keep getting bigger through organic growth and a sharp acquisition strategy. United Surgical Partners International acquired SurgCenter Development for $1.2 billion in early November, and the two plan to develop 50 ASCs in the next five years. There are several other midsize ASC companies that are attractive targets for large chains, such as AmSurg and Surgical Care Affiliates.

9. There will be an explosion of ASCs in areas where populations are rapidly growing, such as in Texas, Florida and North and South Carolina. The U.S. Census Bureau's world population review shows all four states are among the top 10 fastest-growing ones this year.

10. There is plenty of opportunity for independent ASCs to thrive with the right relationships to drive referrals, add service lines and enter into beneficial payer contracts. ASCs with a strong reputation will also increasingly contract directly with large employers, bypassing the traditional insurance model.


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