The future of independent spine ASCs

 Three orthopedic and spine leaders recently spoke with Becker's about the future of independent spine and orthopedic ASCs. 

Question: Will there be more or fewer independent orthopedic and spine ASCs five years from now? Why?

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

James Chappuis, MD. Orthopedic Surgeon at Spine Center Atlanta: Unfortunately, there will be a significant decrease in independent ortho/spine ASC practices. This change will be caused by the constant decrease in reimbursement and the increase in cost due to inflation. The profit margin then becomes minimal, if there is any at all. Without any profit to reinvest into independent ASCs, they will falter and turn to a profitable sale to a local hospital or a merger/acquisition as an exit strategy. 

Corporate takeovers in our country's medical sector march on because of the depersonalization and lack of emphasis on exceptional patient care. There is a glimmer of a future with well-run ASC centers of excellence if there are changes in compensation. The types of compensation that could flourish this specialized type of care could be cash-based or another alternative to the insurance-based system.

Philip Louie, MD. Medical Director of Research and Academics at Virginia Mason Franciscan Health (Seattle): With the projected growth of ASCs, I think there will be fewer independently owned centers. I think the cost savings afforded by larger entities (of various backgrounds) owning and managing multiple ASCs will be difficult to compete with in the long run.

Bruce Prager, MD. Orthopedic Surgeon at the Orthopedic Center of Arlington (Texas): I think there will probably be more as we find that more and more procedures can be done at an ASC. Also, I think that ASCs will start accepting patients that they presently recommend being done at the hospital.

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