Released ASC applications shows cutthroat nature of CONs — 4 insights

Last week, The North Carolina Department of Health denied Chapel Hill, N.C.-based UNC Health Care, Durham, N.C.-based Duke University Health System and Raleigh, N.C.-based WakeMed's ASC development applications, releasing the applications to the public days later. Triangle Business Journal dug through the applications, describing a cut-throat environment.

What you should know:

1. The Business Journal describes the applications as, "a silent, cutthroat competition within the pages of these documents, [where] providers relentlessly call out every possible error their competition could have made."

2. For example, UNC and WakeMed harshly criticized Duke's $34 million ASC proposal, which sought out four of the six available operating rooms.

WakeMed's application read, "In an era where cost containment remains a significant issue in healthcare delivery, the Duke [ASC project] capital cost is unreasonably excessive when compared to other applicants."

3. In another example, Duke critiqued UNC's two proposals, a $16.6 million ASC in Cary, N.C., and a $16.2 million USC in Garner, N.C., pointing to the "significant delays" the health system experienced with its current developments as reason for denial.

4. WakeMed's project was also met with criticism. WakeMed sought to build two ASCs in Cary and Raleigh for $8.6 million and $11.3 million respectively. Unlike the others, WakeMed wanted to position its new centers by existing hospitals to increase efficiency.

UNC directly disputed the claims saying, "it implies that [WakeMed] has not worked with its potential surgeon partners to identify locations that would expand geographic access for patients as well as physician practices."

5. North Carolina approved one-room ASC proposals from RAC Surgery and Raleigh-based OrthoNC, leaving four ORs still available.

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