The last decade has seen a dramatic shift in the handling of surgical procedures in the American health care system. Once performed almost exclusively in hospital environments, a variety of surgical procedures are now taking place in outpatient settings; specifically, at ambulatory surgery centers, which have experienced exponential growth over the past 40 years.
Industry experts predict that outpatient volumes at ASCs will continue to substantially outpace inpatient discharges in the years to come—a trend that is being driven by these five major factors.
Health care costs
There seems to be little question that rising health care expenses are behind the explosive growth of ASCs, and the spiraling cost of even basic procedures is taking its toll on employers, third-party payors, and the government. In fact, a rising portion of the financial burden is put upon the patients themselves, who are increasingly facing bigger premiums and higher deductibles and co-payments.
Consequently, everyone in the system is looking for ways to bring costs down, and ASCs, which are able to provide lower-priced procedures due to their lower cost structure, are becoming the alternative of choice. The numbers are certainly compelling: according to a 2010 report from the Ambulatory Surgery Center Advocacy Committee, an additional $2.3 billion in health care costs could be saved every year if even just half of eligible outpatient surgeries were performed in an ASC setting.
Efficient delivery of care is one of the most widely recognized qualities of ASCs—and one of their biggest draws, particularly from a patient perspective. Unlike a hospital, which must incorporate a huge variety of services and accommodate large-scale demands for resources, space, and management oversight, ASCs focus exclusively on offering a smaller number of specialized procedures, at a higher volume. This means that surgeons are able to move patients through more efficiently, as they are not constantly switching between tasks. Additionally, scheduling can stay on track due to the rarity of complications and the predictability of procedure times. Physical resources, such as the coordination of operating room block times, can be arranged at an ASC so as to maximize efficiency, and there is no danger of emergency surgeries interrupting or preempting previously scheduled procedures. By reducing turnover times while maintaining exceptional standards of quality and safety, ASCs are attracting more and more patients who want efficient, on-schedule care without the inconvenience of a hospital stay.
Personal ownership of anything leads to a greater interest and investment in its success, and that’s certainly been proven to be the case with ASCs, the majority of which are owned by the physicians who work within them. Hospitals are not always able or willing to make investments in patients, but physicians who have a direct financial interest in their center’s success are (in terms of both their time and their financial resources); this typically leads to better equipment, better medications, and better results. Furthermore, physicians who are hospital employees are not always as emotionally invested in their patients, whereas the physician ownership dynamic of ASCs allows for better doctor-patient interaction and more opportunities for patients to bring concerns directly to their physician, who has detailed knowledge about each case, rather than to a hospital administrator.
More predictable outcomes and higher patient satisfaction
ASCs are increasingly outranking hospitals in patient satisfaction rates. This is not only due to the efficiency and high quality of care offered by ASCs, but also to the greater likelihood of a predictable outcome at an ASC versus a hospital. ASCs are so practiced in the procedures they offer, in addition to being independently regulated by Medicare certification, voluntary accreditation, and individual state licensures, that complications or post-procedure infections are extremely rare. This greater degree of reliability has played a significant role in boosting the popularity of ASCs among patients.
A physician-owned ASC is proving to be the ideal environment for promoting and fostering the latest innovations in health care strategies and surgical improvements. Bureaucracy often prevents hospitals from being truly innovative institutions. Bound by strict diagnosis-related group (DRG) codes, which are one of the main elements in determining appropriate hospital payment, hospitals are not generally free to push boundaries when it comes to trying new techniques or implementing recent improvements. ASCs, on the other hand, have the opportunity to offer patients innovative procedures that do not yet have a DRG code—something which greatly boosts both success rates and patient satisfaction. In addition, because ASCs allow for and encourage maximum specialization of surgeons and physicians, they also pave the way for these highly specialized experts to make important new discoveries.