Five ASC leaders joined Becker's to discuss the healthcare trends they're concerned about, from private equity to workforce shortages.
Question: What healthcare trend are you the most concerned about right now?
Editor's note: These responses were edited lightly for clarity and length.
Jason Jundt, MD. Vascular Specialist in Bend, Ore.: The current attacks on private equity involvement in healthcare are concerning to me because they are one-sided. Most of the states pursuing legislation are imposing limits to the constitution of the boards of the companies that want to invest in healthcare in these states. I agree with physician representation on the boards of these companies at 50% or more but disagree that hospitals, healthcare systems and insurance companies are asking for, and getting, exemptions to these legislative actions. Physician representation at these other entities should be mandated as well. This is especially true; since, we’ve been legally excluded from ownership in most of them by legislative action. Ironic, to say the least.
John Lewin, MD. Administrator for Hawaii's State Health Planning and Development Agency: We are most concerned by the ever-increasing marketplace presence of investor-owned companies in the insurance, hospital, ASC and physician group services markets that could drive up costs, reduce physician autonomy and independent patient advocacy, and increase profit-taking versus reinvestment in community and population health.
Bonnie Greenblatt. Director of Ambulatory Surgical Services at the Michigan Institute of Urology (Utica): Trends most concerning right now:
- Healthcare workforce shortages. There is a shortage of new nurses, physicians and allied health personnel. But this is exacerbated by burnout, high turnover, and elevated pay scale requirements.
- Data privacy and security. With the increasing data leaks and hijacking of data, cybersecurity is of the utmost importance.
- Rising healthcare costs. Staffing and overhead costs have increased exponentially in every field. But, none more than healthcare. With insurance companies decreasing reimbursement, the cost of providing healthcare is far exceeding the net. Something will need to change in order to maintain the quality of care that we expect.
John Savage, DNP, APRN. Owner of MedTrack ASC Consulting (Franklin, Tenn.): The increased costs of staffing, supplies and medication has eroded "bread and butter" case margins which traditionally have enabled less profitable cases to be performed. In addition to politically supporting increased ASC reimbursement, this is an ideal time to incorporate Lean methodology to identify and remedy wastes in your ASC. Lean is a simple, common sense, no-cost management tool that actually works the very first time it is engaged.
Lean defines waste as: waiting time, excessive transportation, excess production, defects, excess inventory, unnecessary processing, and unclear directions. Lean is based on the ability of workers that are closest to the job to recognize this waste, improve processes, solve problems by standardization. When best demonstrated processes are determined they become the ASC’s standard for any process from which there should be no variation. The end results are cost savings, happier investors, patients, staff and providers.
Elaina Turner, RN. Administrator of Commonwealth Pain and Spine (New Albany, Ind.): Topping the most concerning trend in healthcare list would have to be decreases related to third party payers in the ASC space. Hospitals are paid at a much higher rate than the ASC for the exact same procedure. However, many times the patient has a better experience and very similar, if not better, outcome than in the hospital environment. ASCs allow for convenience, efficiency and hands on personal care that is sometimes lost in larger health systems and hospitals. Margins are already tight for many ASCs and decreasing rates while cost continue to soar may push some smaller, private ASCs to the breaking point.