As ASCs nationwide grapple with sicker patients, anesthesia shortages and the operational complexity of rapid growth, leaders like Leah Shaler are finding that standardization and smart automation are the keys to staying ahead.
Ms. Shaler, senior vice president of ASC operations at NVISION Eye Centers, has spent her career at companies like SCA Health, AmSurg and Banner Health, building a blueprint for what high-performing ASCs look like.
Ms. Shaler joined Becker’s to discuss the staffing pressures reshaping ophthalmology ASCs, the hidden advantage of single-specialty focus and what the rest of the industry can learn from how eye centers scale.
Editor’s note: This interview was edited lightly for clarity and flow.
Question: NVISION has grown to 135+ locations across multiple states. What are the biggest operational challenges that come with managing ASC operations at that scale?
Leah Shaler: Process standardization and process automation via AI and shared resources. Examples include insurance verification via shared RCM resources, leveraging key partners to manage cash collections from patients and choosing market leaders to manage billing, collection and reporting processes.
Q. What shifts are you seeing in the types of cases your centers are handling, and how is that changing your investment and staffing priorities?
LS: Patients are increasingly sicker and having more comorbidities requiring increased nursing skill and resources to safely manage at the ASC level. As a result, this increases the pressure and need for anesthesia coverage to ensure patients are cared for safely. Unfortunately, this shift increased the anesthesia shortage epidemic and cost burden to the ASCs in the form of stipends, per diems, and cost offset type agreements.
Q: What has that breadth of experience at SCA Health, AmSurg and Banner Health taught you about what makes an ASC truly run well? What do you think ophthalmology-focused ASCs do differently than general multispecialty centers?
LS The single specialty ophthalmology center creates economies of scale, because every case is very similar it allows for standardized care processes in areas where a multispecialty center cannot as each case may be drastically different, i.e. moving from an orthopedic case to say a gynecology case has different needs.
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