Here are three major trends that ASCs will need to keep a sharp eye on to remain successful in the coming year.
Anesthesia provider shortages
From declining anesthesia reimbursements to provider shortages, many ASCs are having to rethink the way they provide anesthesia. Payers have not adjusted their anesthesia reimbursement rates, and there are no stipends being given to ASCs to offset rising costs.
Shawna Alfano, MSN, RN, administrator and director of nursing of Walnut Creek, Calif.-based BASS Surgery Center, told Becker’s she has been relying on an anesthesia backup plan to ensure that her procedures run smoothly.
Other leaders have shifted to other models, such as employing anesthesia providers directly.
“Anesthesia has been a hot topic of discussion the last two to three years, and I don’t see that getting better anytime soon,” Andrew Lovewell, CEO of Columbia (Mo.) Orthopaedic Group, told Becker’s . “We have moved to a fully integrated model in our practice where the anesthesia staff are employed through our group practice. This created stability with insurance benefits, better contracts and a more marketable pay range.”
Rising labor costs paired with worker shortages have been a persistent issue affecting ASCs’ ability to staff their centers. In the last year, 56% of ASCs have seen an increase in volume, but 68% of facilities are still having a more difficult time recruiting experienced operating room nurses, according to a 2023 survey from ORManager. Additionally, 69% percent of facilities reported more difficulty recruiting surgical technologists.
ASC leaders are having to be more creative with staffing to compete with the deep pockets and resources of hospitals in their market.
“With strained resources, it’s important to tweak the process. Physicians and nurse practitioners are collective resources, and we strive to work at the top of our license with good communication,” Shaibal Mazumdar, MD, a gastroenterologist at Charlotte, N.C.-based Advocate Health, told Becker’s. “EMR helps along with telehealth. It is also important to innovate with newer technologies related to artificial intelligence in order to get rid of excessive added activities — to do more with less.”
ASCs have long faced obstacles to securing adequate reimbursement for their procedures, and leaders are becoming increasingly frustrated with the disparity between hospital outpatient departments and surgery centers.
For example, common medical procedures can cost as much as 58% more when they take place at HOPDs when compared to a physician office or ASC, according to an analysis by Blue Health Intelligence, the Blue Cross Blue Shield Association’s data analytics company.
Additionally, while CMS has finalized a 3.1% payment rate for ASCs, many leaders are worried that the increase will not keep up with inflation.
“Procedure reimbursements have failed to keep up with inflation and do not reflect the increased work demands of physicians,” Alyson Engle, MD, a pain medicine physician at Chicago-based Northwestern Medical Group, told Becker’s in April. “Insurance company profits soar while physician salaries decline. Less physicians will be inclined to stay in the workforce as the economics do not make sense. This trend is unsustainable for our nation’s health and will lead to lower quality care as physicians leave medicine.”