OR Manager - February 2020 - 29

AMBULATORY
SURGERY CENTERS
ASC dominance
Continued from page 27
* Besides employing surgeons, hospitals
will likely have to build gainsharing
relationships with surgeons and
proceduralists, both within the hospital
and in hospital-owned ASCs.
* Compared with what hospital leaders
are used to, working with ASC
physician-partners (both employed
and independent) will require a very
different collaborative leadership
and management style. A patientcentric,
value-focused system with
aligned incentives is at the heart of
ASC market dominance.
* Hospitals that pursue ASC expansion
will need to master several new
competencies.
Follow these steps for a strong start
when expanding into the ASC market.
1. Do careful market research to determine
whether
the local market
can support ASC expansion or HOPD
transition.
2. Choose a strong specialty focus.
The most successful ASCs perform
procedures in a few high-margin specialties,
such as orthopedics, spine
surgery, ENT, pain, etc.
3. Select partners carefully. When
purchasing an existing ASC, a resyndication
of surgeon shares may
be needed to make sure the right
specialties and surgeons are being
selected.
4. Commit to gainsharing. Profit sharing
with surgeons helps to ensure
adequate volume and active surgeon
participation in facility management.
The best way to develop experience
in this area is to pilot gainsharing arrangements
with hospital-employed
surgeons and proceduralists.
5. Do not insist on the lion's share.
Hospitals should not expect more
than a 51% ownership stake in an
ASC. In fact, most hospitals are minority
shareholders with less than
50% ownership.
www.ormanager.com
6. Focus relentlessly on process. Any
ASC expansion strategy will require
hospitals to adapt to a new environment.
Leadership teams will need to
set aside many familiar concepts and
collaborate with surgeons to create a
fast-paced organization that delivers
high-value procedural care. ✥
Thomas A. Blasco, MD, MS, is Senior
Physician Managing Director at Surgical
Directions in Chicago.
References
Centers for Medicare & Medicaid
Services. CMS Finalizes Medicare
Hospital Outpatient Prospective
Payment System and Ambulatory
Surgical Center Payment System
Changes for 2019 (CMS-1695-FC).
November 2, 2018. https://www.
cms.gov/newsroom/fact-sheets/
cms-finalizes-medicare-hospital-outpatient-prospective-payment-systemand-ambulatory-surgical-center.
Frack
B, Williamson J, Grabenstatter
K. Ambulatory surgery centers:
Becoming big business. L.E.K.
Consulting Executive Insights.
2017;XIX(25). https://www.lek.
com/sites/default/files/insights/
pdf-attachments/1925_Ambulatory_Surgery_Centers_Executive_Insights_v2.pdf.
Future
Market Insights. Ambulatory Surgical
Centers Market: Global Industry
Analysis 2012-2016 and Opportunity
Assessment 2017-2027. September
27, 2017. https://www.futuremarketinsights.com/reports/ambulatorysurgical-centre-market-092017.
Hall
M J, Schwartzman A, Zhang J, et
al. Ambulatory surgery data from
hospitals and ambulatory surgery
centers: United States, 2010. National
Health Statistics Reports. February
28, 2017. https://www.cdc.
gov/nchs/data/nhsr/nhsr102.pdf.
https://www.ascassociation.org/advancingsurgicalcare/aboutascs/industryoverview/apositivetrendinhealthcare.
Key
trends in ambulatory strategy:
When an HOPD to ASC conversion
makes sense. Panel discussion.
Becker's Hospital Review 9th Annual
Meeting, Chicago. April 11, 2018.
MedPAC. Report to the Congress:
Medicare Payment Policy. Chapter 5:
Ambulatory Surgical Center Services.
March 2018. http://www.medpac.
gov/docs/default-source/reports/
mar18_medpac_entirereport_sec.pdf.
Research and Markets. 2018 Ambulatory
surgery center (ASC) market:
Projected to increase from $36
billion in 2018, to $40 billion by
2020. Business Wire. October 11,
2018. https://www.marketwatch.
com/press-release/2018-ambulatory-surgery-center-asc-marketprojected-to-increase-from-36-billionin-2018-to-40-billion-by-2020---researchandmarketscom-2018-10-11.
Richards
R. Top outpatient surgery
center trends in health care. Optum
Health Care Conversation. Published
online February 5, 2019.
https://healthcare-conversation.
com/2019/02/05/top-outpatientsurgery-center-trends-in-health-care/.
Shapiro
F E, Punwani N, Rosenberg
N M, et al. Office-based anesthesia:
Safety and outcomes. Anesth
Analg. 2014;119(2):276-285.
The Advisory Board. The new rules of
ambulatory surgery center competition:
Three steps to build a winning
ASC strategy. January 17, 2019.
https://www.advisory.com/research/
health-care-advisory-board/research-reports/2019/the-new-rules-of-ambulatory-competition?WT.ac=Inline_HCAB_
ResRep_x_x_x_TGC_2019Jul25_Eloqua-RMKTG+Blog.
The
Leapfrog Group. The Leapfrog
Group expands ratings to outpatient
and ambulatory surgery settings.
October 16, 2018. https://www.
prnewswire.com/news-releases/
the-leapfrog-group-expands-ratingsto-outpatient-and-ambulatory-surgery-settings-300731563.html.
VMG
Health. 2017 Intellimarker MultiSpecialty
ASC Benchmarking Study.
January 11, 2018. https://vmghealth.
com/wp-content/uploads/2018/01/
VMG-Health-Intellimarker-Multi-Specialty-ASC-Study-2017.pdf.
OR
Manager | February 2020 29

http://www.medpac https://www.marketwatch https://www http://www.cms.gov/newsroom/fact-sheets/ https://healthcare-conversation https://www.lek https://www.advisory.com/research/ https://www.futuremar http://www.ketinsights.com/reports/ambulatory https://www http://www.prnewswire.com/news-releases/ https://www.cdc https://www.ascassociation.org/advanc https://vmghealth http://www.ormanager.com

OR Manager - February 2020

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