What's making ASC leaders nervous

From nurse shortages to the decline of independent providers, five ASC leaders shared with Becker's what's making them nervous.

Question: What in the healthcare industry is making you nervous right now? Why?

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

Christine Blackburn, BSN, RN. Administrator, South Kansas City Surgicenter (Overland Park): What I am nervous about right now is the direction I see for staffing to include certified registered nurse anesthetists. There appears to be a shortage of all staff with COVID-19 behind us and hospital salaries in front of us. I see retirement of staff that no longer want to work. COVID-19 was hard on so many. I see the salary increase of CRNAs, the fee structure of the CRNAs, and wonder how we can continue on this path to keep everyone profitable.

Alfonso del Granado. Administrator and CEO of Covenant High Plains Surgery Centers (Lubbock, Texas): What’s making me nervous in the healthcare industry right now is Medicare's continuing refusal to operate in a transparent manner regarding the methodology it uses to move cases to the ASC covered procedures list as well as its rationale for the 255 codes that it took back last year and did not bring back this year. As healthcare costs continue to escalate, it is disheartening to see this lack of accountability in an agency that manages nearly a trillion healthcare dollars and seems unwilling to find cost-effective solutions to deliver great care to its population.

Jerry Orloff. CEO of Southern Eye Center (Hattiesburg, Miss.): Ongoing difficulties with recruiting, trained and trainable staff who can be reasonably motivated to consistently provide a full day's work for a full day's wages and benefits on an ongoing basis. This will create overtime, delays in care, decreases in efficiency, decreases in access to care and has a frightening potential with regard to errors and safety.      

Jose Rivera. Administrator of Tri-County Heart Institute (The Villages, Fla.): It's not about now, but more of "as we are heading to." Why? Due to excessive regulation and monopolies, independent healthcare providers will vanish. Private equity will continue the takeover alongside hospitals. Health insurance will continue to pay less. The shortage of medical professionals…the future is not bright with what is going on today.

Cheri Smith, RN. Former ASC Administrator of St. John's Surgery Center (Fort Myers, Fla.) Recent trends of healthcare seem to show a stronger shift toward more and more regulations, whether it be on the federal or state level. These increased regulatory requirements will only further burden a greatly stressed health system. Whether it be additional reporting in the ASC realm or ensuring that patients are served crispy fries as inpatients, rarely do these regulations contribute to better quality healthcare application or outcomes. It effectively shifts the focus from medicine-driven, patient-centered healthcare to numbers-driven, ratings-centered hospitality care. When the quality is consistently and further assessed relative to factors that are largely based on subjective rather than objective conclusions, it creates a focus that is more difficult to manage. While a patient could receive superb care, leave a facility in a better condition than when he arrived, but document a concern relative to cold food or a long wait, ultimately affecting the reimbursement of the facility rendering care, it becomes a rocky hill to climb. Sadly, it will be the patients who suffer as fewer and fewer healthcare resources remain available. Such regulations are debilitating and do not lend to a reinforcement of systems in place.    

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