The pandemic affected ASC case volume and operations in several ways in the last year, with some centers adapting while others are struggling to stay afloat.
Here are the factors that could make or break an ASC within the next two years, according to seven administrators and physicians.
1. Case volume.
ASCs base desired payer rates and budget projections on expected volume, which drives the surgery center’s revenue. If case volume falls short of expectations, the center will miss financial goals.
2. Physician engagement.
ASCs need physicians excited and motivated to bring cases to the surgery center, whether they are owners or not.
3. Direct contracting with employers.
Employers are increasingly interested in direct contracting with surgery centers through regional and national contracts, the additional contracts will boost ASC volume.
4. COVID-19-related limitations and expenses.
The policies and guidelines for operating surgical facilities during the pandemic rapidly changed at the national and state level in the last year. It has been a challenge for ASCs to adapt to a limited case volume and increased personal protective equipment expenses.
5. Payer behavior.
Commercial payers’ policies affect the survival of independent ASCs across the U.S. an increase in the number of pending authorizations from insurance companies or more frequent denials could break the center. Success also depends on how fast the center receives reimbursement.
6. Contract negotiations.
Adequate preparation for payer negotiations will lead to more aggressive and lucrative payer contracts, which are vital for the center’s existence.
7. Cost containment.
ASC costs must remain low to meet budget expectations for net income. The center can’t spend more than it’s taking in. Financial recovery from the months when the center was closed last year and efficient resource use will make or break the center.
8. Supply availability.
When the supply chain normalizes, the center will be able to return to business operations as they were before the pandemic. But the longer price increases and back orders continue, the more he will need to reduce spending in other areas to account for the extra supply expenses.
9. Transition of cases from the inpatient to the outpatient setting.
Commercial payers are implementing price structures that provide appropriate reimbursement for several procedures to move to ASCs. The overall move of these procedures is positive, but he is concerned about high implant costs since vendors are accustomed to negotiating with hospitals, which receive higher reimbursement.
10. Staff engagement.
The staff culture and engagement affect patient and physician experience at an ASC. Having the best equipment and modern decor are meaningless if the staff isn’t taken care of.