From COVID-19 to CMS removing 255 procedures from the ASC-payable list, ASCs are facing many obstacles in maintaining profitability.

1. Mitigating the impact of what appears to be a crisis in healthcare manpower for ASCs in terms of resiliency, availability and cost of staff.

2. The COVID-19 pandemic has only exacerbated chronic health needs, premature disability and death.

3. Financially stable, community-based ASCs have proven to be catalysts in contributing to improving the overall health, access and cost of care for communities.

4. To sustain robust ASCs in the marketplace, it is important that CMS payments to ASCs should be the same as hospital outpatient departments. Procedures that have been proven to be safely performed with high-quality outcomes in ASCs should be moved back from the inpatient-only list to the ASC- payable list in 2022.

5. ASCs, as well as healthcare systems, face workforce challenges, many of which were present prior to the pandemic and are now only exacerbated and accelerated. The reality is that if the gaps in healthcare employment and wages are not quickly addressed, with the projected higher growth in the elderly and vulnerable populations, we will face a serious inability for adequate staffing to meet the healthcare needs of our communities.