Given their rapidly evolving role in America’s ailing health care system, ambulatory surgery centers (ASCs) are facing a constantly changing array of challenges and opportunities. As a new year approaches, a recent article in Becker’s ASC Review outlines some predictions from leading industry experts as to what 2017 could have in store for the ASC sector. Highlights include the following:
More partnerships for physician-owned ASCs
Strategic partnerships between hospitals and physician-owned ASCs will become increasingly common, given the many benefits they can offer to all parties involved. For an ASC, a partnership offers the opportunity to retain a solid patient volume, increase revenue thanks to an integrated referral base, and improve strategic positioning in managed-care negotiations. For a hospital, a partnership means the ability to offer additional or specialty services or boost existing service lines while ensuring that patients continue to receive a high standard of care. Likewise, physicians benefit from partnerships through the opportunity to expand or diversify revenue sources and meet additional patient needs, and patients themselves benefit by having a greater range of choice for both services and price.
More payors turning to ASCs
Given their solid track record for greater efficiency and accountability, ASCs will become increasingly popular with payors who are looking for new ways to manage both cost and risk more effectively. Alternative payment models like bundled payments help ASCs and payors better align incentives and ensure that clinical outcomes and cost management alike are prioritized through the entire continuum of care. Experts estimate that, in order to increase referrals to free-standing ASCs rather than hospital outpatient departments, more third-party payors will adopt the strategy of shifting a greater part of the financial burden of care to those patients who choose costlier settings for their procedures.
More high-acuity orthopedic and spine cases moving to ASCs
With 13 spine procedures having been added to the ASC payable list by the Centers for Medicare & Medicaid Services (CMS) over the last two years, and a further eight proposed for 2017, the outpatient landscape is expected to host an increasing number of spine and total-joint-replacement programs. Once performed almost exclusively in hospital settings, high-acuity spine and joint surgeries are transitioning very successfully to ASCs thanks to cutting-edge developments in minimally invasive technology, anesthesia, and pain management, as well as advances in both physician training and patient education.
A greater focus on location
In recent years, location has proved to be a very important factor in ASC success. When conveniently located—close to physicians’ practices, hospitals, or the local medical district, for example—an ASC’s popularity is greater with physicians and patients alike. However, when an ASC is difficult for patients to find and access—if it’s located in a medical office building, for example—its business can suffer in a fairly significant way. As more new ASCs are developed, therefore, the question of real estate is expected to be a serious ongoing consideration, as is the assessment of market demographics and population growth trends in areas that may be the future home of an ASC.
Increased M&A activity
Experts anticipate that mergers and acquisitions will proliferate in 2017 as more and more differentiation is seen among ASC companies vying to highlight their unique quality and performance in a competitive, value-based market. Alongside this, a wide variety of alternative payment models are expected to enter the market as ASCs test out which particular price structures offer the best competitive edge.
A greater focus on price transparency
As health care costs spiral out of control, all participants in the health care system—insurers, employers, and patients alike—are demanding greater price transparency in order to better understand what they are paying for and what they don’t need to be paying for. Fortunately, ASCs are in a unique position to offer such transparency; thanks to their lower cost structure and greater efficiency, ASCs are well placed to back up their value proposition as a cost-effective, high-quality option for surgery through allowing greater access and insight into costs and pricing. This level of pricing transparency is also expected to help patients become better-informed consumers, with more knowledge about the true cost of care, and thus more empowered to take action to reduce their personal costs and, consequently, the financial burden for other health care players.
The future will not be without its share of obstacles and difficulties for ASCs. Experts believe that 2017 may see ASCs suffering as more high-deductible plans discourage patients from undergoing the elective procedures that are staple ASC offerings, ASC reimbursement rates are slashed by commercial payors, negotiations for fair in-network contract rates prove difficult, case time is reduced due to an increased demand for electronic medical record implementation and more resources dedicated to advanced analytics, and hospital employment and ASC consolidation lead to dwindling referral sources.