The bright future of ASCs

ASC popularity is continuing to grow as hospitals, health systems and physicians accelerate their investment strategy — more than 7 out of 10 systems intend to continue investing in and affiliating with ASCs, according to a recent survey

Here are six reasons ASCs are primed for growth:

Cost savings

ASCs can save patients and physicians money by offering lower out-of-pocket costs. Most procedures cost substantially less at an ASC when compared to hospital outpatient departments — including cardiology, orthopedics and gastroenterology

Financial gain for investing physicians 

ASC ownership is a rewarding investment for many physicians. 

"I invested in myself for intellectual property and the ASC model," Robert Bray Jr., MD, founder of Newport Beach, Calif.-based DISC Sports & Spine Center, told Becker's. "When I began over 25 years ago, I could not get a bank loan or contract to start. Be cautious with management companies. Although, after learning from missteps in the past, I am extremely happy with our current private equity partner. It’s a large commitment of time and passion, but building your own or part of a larger, well-run network is personally and financially rewarding."

High-acuity procedure migration

Cardiology and orthopedics remain huge opportunities for growth for ASCs. ASC companies and leaders are eyeing these high-acuity specialties' continued migration to the outpatient setting. 

Optum's ASC arm, Deerfiled, Ill.-based SCA Health, quietly purchased at least two cardiovascular providers in 2023, and Tenet executives have said orthopedics is United Surgical Partners International's biggest growth opportunity. 

"Cardio and orthopedics are a big deal," Philip Blair, CEO of Surgery Center Services of America, told Becker's last year. "We've seen a huge push especially in the last couple years during COVID-19 — ASCs with catheterization labs and with office-based lab hybrid models. That's a huge push. A lot of cardiologists are out there trying to protect their practice, their referral patterns, and make sure that everything stays in house and picking up procedures out of the hospital or maybe other ASCs. That's a huge deal. So I would say my big focus is cardiology."

Patient popularity 

As the "shopping era" of healthcare continues, patients are looking to ASCs for the convenience they provide to patients compared to hospitals. 

"Providing procedures on an outpatient and/or short-term hospital stay basis encourages patients to recover in a home or rehab setting, allowing them to be with family and/or an environment focused on recovery to reasonable self sufficiency," Paula Autry, CEO of Leadership DNAmics, told Becker's last year. 

Payer behavior

Federal and commercial payers are continuing to push procedures to the outpatient setting. 

CMS added 11 procedures to the ASC-covered payment list earlier this year, which include total shoulder and ankle joint reconstruction and meniscus transplants. Additionally, payers are increasingly pushing procedures to the outpatient setting. UnitedHealthcare's 2023 site-of-service policy, which went into effect April 1, is one effort from payers that could push procedures to the ASC setting. 

Physician autonomy

Physician ownership allows for control over the clinical environment and the quality of care. Physician autonomy is top of mind for many industry leaders as more physicians migrate to the employed setting.

"The doctors need, as a whole, to regain some control. I have never been more fulfilled with my ability to practice the way I wanted, old fashioned," Dr. Bray said. "I spend time with patients and try to emphasize quality since I started my vertical ASC structure from the first clinic through delivery of the episode of care. It has improved our relationship with the payers and delivered a more cost-efficient, quality-driven product. In short, the physicians need to regain and be given control."

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