FEATURE


insurance exchanges . . . and that num- ber is only going to grow,” he says. “We have seen more insurers making the decision to participate in the exchanges. That will likely put additional pricing pressure on providers, and I expect that will start with the hospitals. This may, potentially, be good for ASCs as there is going to be an opportunity for us to position ourselves as lower cost provid- ers of services of the same or superior quality to hospitals.”


As the Dust Settles


ASCs benefit as ACA changes begin to take effect BY ROBERT KURTZ


A


lmost four years after the Patient Protection and Affordable Care


Act (PPACA) became law, the initial significant uncertainty about how health care reform would affect ASCs is beginning to dissipate. The picture is becoming clearer, and the outlook is generally positive, says Stephen Rosenbaum, chief executive officer of Interventional Management Services, a physician-owned ASC management and development company in Atlanta, Georgia.


“Health care reform has essen-


tially forced everyone, including the health care consumer, to become cost conscious,” he says. “If you look at ASCs and their place in the market- place, we are positioned well. We are much less expensive than the hospital and much more highly regulated than the doctor’s office.”


One of the primary reasons consum-


ers are paying closer attention to their health care costs is that they are bearing more of the burden of these costs, says Barry Tanner, chief executive officer of Physicians Endoscopy, an ASC man- agement and development company based in Jamison, Pennsylvania. “We are seeing a dramatic increase in people that have growing and sub- stantial deductibles,” he says. “Peo- ple are more discerning in their con- sumption of health care. They are more engaged in the decision of whether to seek health care and where to go for that health care.” This consumer involvement should


serve ASCs well going forward, says Nap


Gary, ASCA past president


and chief operating officer of Regent Surgical Health in Westchester, Illinois. “There has been a reasonably healthy number of people participating in the


Effects of Cost Pressures Increasing costs for patients will likely have other effects on ASCs as well, Gary says. “I think we are going to see more significant seasonality in this business. In the short term, espe- cially earlier in calendar years, I think we are going to find a bit more hesita- tion by patients to incur elective sur- gery. ASCs have found that case vol- umes were lower in the first quarter last year than they were in previous years. That is probably going to continue to prove to be true as we go forward.” Thanks to an improving economy


over the past five years, however, ASCs should not necessarily find this concerning, he says. “I think a lot of ASCs experienced a loss of elective patients a few years ago because peo- ple were not in a situation to incur the expenses of procedures. While people may still be electing to postpone sur- gery to some degree because of the size of their deductibles, we are now in a much healthier economic environ- ment. I expect we will see pretty robust fourth quarters because people are not going to postpone their procedures indefinitely.”


ASCs might start to experience an increase in cases thanks to new kinds of procedures that they bring into their case mix for the first time, Rosenbaum says. “You are going to see the surgery center world open up to a variety of different cases that you have not seen done in an ASC before, and those will


ASC FOCUS FEBRUARY 2015 13


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