.png)
A July 2023 study by RAND highlights a significant shift in how physicians approach the use of Ambulatory Surgery Centers (ASCs) when employed by vertically integrated hospitals or health systems. The study found that physicians working in these systems were 65% less likely to use ASCs for procedures compared to their independent counterparts. This decline in ASC utilization by physicians within vertically integrated systems reflects broader economic and operational dynamics in the healthcare landscape. This article goes over the difference in hospital employment versus ASC.
Independent physicians, who have greater autonomy, often refer patients to ASCs for outpatient procedures or perform surgeries at these facilities themselves. ASCs are known for their cost-efficiency, lower patient recovery times, and ease of scheduling, making them an attractive option for both patients and independent practitioners. While some physicians within hospital systems maintain privileges to perform procedures at ASCs, the overall trend among vertically integrated physicians has been a reduction in ASC use.
The RAND study, which examined the economic effects of vertical integration in healthcare from 2013 to 2016, found that physicians whose practices became vertically integrated saw a 13% reduction in ASC utilization. They were also 9% less likely to perform any procedures in ASCs. This shift has persisted over time, with a marked preference for procedures being performed within Hospital Outpatient Departments (HOPDs), where reimbursements are often significantly higher.
What’s especially noteworthy is that despite this decline in ASC use, the number of cases performed in HOPDs did not necessarily increase. Instead, the RAND study observed that physicians raised the prices of their services by 29%, particularly affecting fee-for-service Medicare beneficiaries. Medicare reimburses ASCs at only 59% of the prevailing HOPD facility fee, making it more financially advantageous for hospitals and health systems to shift procedures to their outpatient departments rather than utilizing ASCs. This transition not only drives up healthcare costs but also undermines the benefits of ASCs in providing affordable, high-quality care.
The Critical Role of Midlevels, Physicians, and Administrators in ASCs
Given these economic dynamics, ASCs require more than just skilled surgeons and physicians to thrive—they also rely heavily on the contributions of midlevel providers and efficient administrative leadership. Nurse practitioners (NPs) and physician assistants (PAs) are essential in streamlining patient care, managing pre- and post-operative responsibilities, and enhancing the overall patient experience. With independent physicians and those with ASC privileges driving referrals, midlevel providers serve as the backbone in these settings, ensuring continuity of care and patient satisfaction.
Furthermore, the role of skilled administrators cannot be overstated. Administrators are responsible for optimizing operational efficiency, ensuring regulatory compliance, and managing costs, which are key factors in maintaining the competitive edge of ASCs. As the study reveals, economic forces are steering procedures away from ASCs to higher-cost hospital outpatient departments. To counteract this trend, ASCs must maximize efficiency and cost-effectiveness, areas where strong leadership and a well-rounded team of providers can make all the difference.
For ASCs to remain successful in an environment where vertical integration is reshaping the healthcare landscape, it’s clear that they need to foster collaboration between physicians, midlevel providers, and administrative professionals. This integrated team effort is crucial in maintaining the unique value proposition that ASCs offer: high-quality, cost-effective care in a streamlined outpatient setting.
In this shifting environment, recruitment solutions like those provided by Advanced Scope LLC can be pivotal. By recruiting highly skilled midlevel providers and ensuring that ASCs have the administrative and clinical talent they need, ASC facilities can continue to serve patients effectively and maintain their competitive advantage.
Comments