ASC Growth in 2024, Overcoming Headwinds

Erik Sunset: [00:00:00] Hello, and welcome back. I’m Erik Sunset, the host of the DocBuddy journal here at DocBuddy. We deliver healthcare solutions. We’ll take the pain and cost out of broken workflows. This is episode 53 happy Valentine’s day. We are recording this show on Wednesday, February 14th, 2024. And before we get into the needs of the episode, revolves around ASC growth strategies for 2024. Some of the headwinds that you’re going to face as an ASC in this new year. One of them say, good, quick holiday themed, D two, where. To start out with which specialties have the happiest marriages as reported by Medscape.

So at the top of the list, the very happiest marriages by a specialty, start out with pulmonary medicine. Then you’ve got otolaryngology. Diabetes and endocrinology, you come in at number three. Ophthalmology for gastroenterology five. And then you get to [00:01:00] neurology cardiology, general surgery, orthopedics, plastic surgery. To round out your top 10.

And I thought there was an interesting little tidbit here in the commentary from the reports. That from year to year in this study, certain medical specialties will look better or worse. How often physicians described the marriages as very good. We’re good. In last year’s report, five specialties met or exceeded the 85% mark for happy marriages, but none reached the nines.

And this time eight specialties reached or, or exceeded 85% and three got into the nineties. So those three in the nineties, obviously top three of pulmonary medicine, otolaryngology, and then diabetes and endocrinology are your nineties scores. And the expert here shares their experience in the area is often than having. Intuitive. You would think. The specialties that are known to be extremely time-consuming. Like neurosurgery. Would have lower [00:02:00] rates of marriage satisfaction, but that has not proved to be the case. Satisfaction in a marriage involving a physician, often hinges on both partners being realistic about what they will get. The couple of grease from the start, then it’s going to be a very demanding residency or demanding lifestyle in clinical practice. Then they won’t freak out. Over bumps in the road.

But that was kind of nice for Valentine’s day. I think those are probably words the wise, no matter what profession that you or your spouse happened to be in. It’s setting clear expectations and being able to know what’s coming down the road. Probably pretty, a pretty good marriage advice, no matter what you’re doing. So, thank you very much.

The Medscape or a fun little. Valentine’s day theme detailed.

And now the core of the episode is going to revolve around ASC growth strategies for 2024. Back in [00:03:00] episode 46 of the Backwood of journal. We’ve closed out the year, asking some ASC experts, what they think. Surgery centers shouldn’t be doing to prepare for the new year. The underlying theme revolve around how technology can make the facility more efficient. And that the leaders at these facilities should be evaluating new technology. It allows facilities to do more. And be more less staff and to drive revenue. Hasn’t gotten into 2024. There’s been a lot of excitement around procedures coming off.

The inpatient only list. That’s the IPO. So procedures like total silver and total ankle arthroplasty is an owl, a reimbursable at surgery center. That’s big. So your dissenters also talking about maintaining the flow of low complexity procedures while increasing our utilization for higher complexity. We can read that as higher reimbursing cases like [00:04:00] total joints beriatrics and multiple procedure cases. But the things that I’m seeing and the things that I’m hearing, where there’s the most excitement is around building new facilities. And then adding capacity to existing one where that’s possible. So it’s obviously pretty, pretty bright, pretty rosy outlook when you’re when you’re, when you’re taking responses or taking a pulse for someone like me. There’s a lot of reading in this space. And you can go a little bit deeper just from these, these general sentiments. Here with a Becker’s spine article. The course have a link to that. In the show notes. We’re going to paraphrase it, paraphrase a few responses from folks in the industry about what growth can look like for AFCs, but this year, and then even over the next 24 months to take you to. And the 2025.

So we’ll start with Dr.

Steven Cummings, Stephen Cummings, MV. He’s an orthopedic spine surgeon at Tidewater physicians. Multi-specialty group [00:05:00] orthopedic. And he never dreamed. Of being an outpatient surgeon during his training 10 years ago. And yet since 2020. My total joint surgeries has steadily shifted to the ASC. And with more and more procedures coming off, that inpatient only list. You can probably forecast that you will be doing even more procedures at ASC. As time goes by. So that’s great.

Another reason that you really optimistic about what AFCs are doing. And we know that this is a win-win with. Because it’s good for patients. It’s good for providers and it’s even good for the payers to have more surgeries done at the ASC. So that’s great. Continue down the line, Dr. Brian Cole. Rankle MD is a managing partner, associate chair professor in the department of orthopedics at rush OPA. pH. And he thinks that over the next 12 to 24 months growth from existing ASC users will come from new allowable [00:06:00] outpatient codes, such as what recently occurred shoulder arthroplasty. This is going to have a quote, unfortunate impact on hospitals. Similar to what happened following a moment of total hip and knee arthroplasty and spine surgery to the ASC. So again, another reason to be really optimistic. And that’s obviously tongue in cheek that it’s going to have an unfortunate impact on hospitals. The unfortunate impact will be very real at the hospital as procedure shift from there. Place of service out to the ASC. But like we just said, you’re getting the same great outcome at ASC compared to the hospital. Cost the patient less. And potentially more accessible for the patients as well.

All positive.

Those are all good things. Well, we got two more of these more we’ll move on. I don’t want to bore anybody to death, reading quotes to them. Now, but I think these are [00:07:00] important. So our next. Insight comes from Michael C Baba. CEO at Tallahassee orthopedic clinic. And if anybody’s watching on YouTube, you can see my Florida state helmet on the background.

There spent my fair share of time and Tallahassee. And even got to be a patient at the Tallahassee orthopedic clinic. So to come back to the task at hand, Michael baubles shares that the market forces continued to demand TOC. And that’s the Tallahassee orthopedic clinic. Performance more cases in the ASC. Employers and purchases per surge remain frustrated with rising cost of care. And seeking lower cost settings and hospitals are challenged with managing their top priority, which is emergent and complex patients. This place is more pressure on our ASC is to serve as a relief valve. And Michael goes on to share that there. Number one challenge is related to capacity constraints.

Good problem to have, if you were [00:08:00] the CEO of Tallahassee orthopedic clinic, right.

I just need to build to sustain your role as a relief valve. And then next, I think. Maybe one of the more interesting perspectives comes from Dr. Manoj Metta. My nose Mehta MD is the medical director at endoscopy center of the north shore. There are distinct shifts that are happening in the landscape of patient care that will drastically affect how we practice over the next year.

Physicians are being squeezed for productivity. Physician dissatisfaction as an employee. And three patients wanting one-on-one personalized care without the philosophy of volume over patient satisfaction. All these factors have created tremendous opportunity in private practice. And I hope to see a significant resurgence. Private practices as a result. These factors lead the opportunities for greater patient satisfaction, better medical care, more income, better [00:09:00] work-life balance and reduced physician burnout. It’s a win-win except for the big hospitals. So kind of a recurring theme, right?

You your greater opportunity as a physician, you get potentially better access to care as a patient with the same or better outcomes for your procedures happening at the ASC. I really the. I don’t want to call it a loser, but the not winner. When you look at the 24 month. Perspectives on ASC. As the hospitals.

All positive. If you’re interested in the ASC space.

But despite. All of the positive sentiment that we’re sharing here. Everybody sounds very bullish and I think they have a right to be. Because I’m with them. I think. There’s lotteries and people around ASC.

But there are still significant. And serious headwinds that have to be overcome. Staff. Efficiency is going to be the watchword here because it’s [00:10:00] not only tough to retain staff. It’s tough to make a hire. So if you’re an ASC leader, You really ought to be cross training employees. You gotta be reviewing your analytics to be sure.

Staffing is not only adequate, but optimized for a given day’s patient volume. You just cannot be wasting staff time. And this ties in also to the cost and availability of supplies, another big headwind, but AFCs continue to face. Really ignited by the COVID pandemic, but still feeling the supply chain. Ripple even through the 20, 24.

Some of the recommendations out there to be sure you’re doing the most with the least amount of supplies. Is it, our staff need training to be sure supplies will be needed before opening them. And your supply manager needs to be hyper-aware that lead times can be extended. Unfortunately, there’s just not a same day.

Amazon prime delivery available as an option for surgical supplies.

[00:11:00]

And another major headwind, and this is making news. This has been making news, but it’s making even more news, more noise. In the news over the last month or so. And that’s anesthesiologist.

It’s

one of the tactics that you, as an ASC can employ to be sure that you have the anesthesia coverage that you need. Is too. Get a little greedy. So you blocked times for surgeons who were consistently filling their blocks. So that anesthesiologist time isn’t wasted. And that’s an optimization that you can make. Shift that is potentially an option for you. And you often determine this with the help of an attorney, a good healthcare attorney. Is whether an all CRN model is viable for your Senate. So either all CRNs or CRNs that are able to come in and practice independently, some states you have to consult with an attorney, I guess, to determine what makes the most sense based on which state you’re in.

So [00:12:00] when you look at all the. All of the bullish. Commentary here. I mean, like the devil’s in the details, right? Staff supplies. Amos, these shortages era, anesthesiologist shortages rather. Those are all pretty critical. To being able to get the patient through, put your, you need to hit the markers that you have as a business, as an organization, right. So in closing.

I would challenge you to think about how you are using technology to help your surgery center. And we’re talking both on the growth side of the discussion. As well, as on the headwind side, the challenges that we just discussed. Technology gives you the ability to measure outcomes, both for your patients and for how your facility is operating. You have the vast majority of He’s clinging to the old ways of doing things. The high performers, the leaders, those paying attention ASC space. Are already playing the new game. And once you’re playing this new [00:13:00] game, you can’t ever go back to the old way. And you wouldn’t want to.

We see this every day with our Op Note solution. And if you’re not familiar, Op Note replaces the 100 year old technology that the majority of ASCs are still using to generate their operative reports. And that’s transcription. No matter what service level you have with your transcription vendor. There’s going to be some amount of waiting involved. Op Note is the new game.

It’s instant. It gives you the generation and approval of an operative report with images if you need them from the point of care. There’s no waiting. So how could you ever go back to the old way?

Food for thought. And on behalf of the entire doc, buddy team. I’m. Thank you for listening. Be sure you’re subscribed on apple podcasts, Spotify and YouTube. So you can always hear and watch the newest episodes of the doc body journal. [00:14:00] Until next time. I’m your host, Erik sunset. Talk to you again soon.