Ambulatory surgery centers (ASCs) have long been a high-quality, cost-effective alternative to hospital outpatient departments for surgical care. But rapidly changing rules and regulations, coupled with patients avoiding the hospital environment during the pandemic, have driven more consumers to ASCs in recent years. This is especially true for women’s health, where upwards of 65% of cases are now performed in an outpatient setting.
As women increasingly turn to ASCs for care, health systems need to rethink what it means to offer a comprehensive women’s health program and how the outpatient setting factors into it.
The Importance of Incorporating ASCs into a Women’s Health Program
A traditional “women’s health” hospital strategy may emphasize obstetrics, with less focus on surgical cases. But despite a slight increase in 2021, birth rates have generally been declining the past few years, and OB-focused strategies may not be as impactful in the future.
A hospital with a more comprehensive perspective on women’s health may consider bariatrics, cardiac, GI, and breast in addition to gynecological surgery and obstetrics. While gynecological and other women’s surgeries are performed in the hospital setting, it is reasonable to assume they will migrate to ASCs in the near future, as technology evolves, regulations change, and payer rules are updated, potentially leaving hospital leaders wondering where those cases went.
Women’s programs throughout the country should take a more holistic and proactive approach to delivering their services and asking three important questions:
- How do we treat our patients as consumers and provide a customized experience?
- Can we offer lifelong care to women?
- How do we reduce the cost of care for our patients?
Incorporating outpatient care is one way that leading women’s health organizations are answering those questions. They are finding ways to differentiate themselves, innovate, and grow, including providing patients with a friendly and convenient site of service for surgery with a lower cost via an ASC. Figure 1 provides a vision for a comprehensive and coordinated women’s health service line capable of supporting women’s needs during various stages of their lives.
Pursuing Surgery Migration
In the average ASC, gynecological cases account for a small percentage of the case mix. This may grow as CMS regulatory and commercial payer policy changes continue to drive the approval of surgical procedures in ASCs. However, the same study showed that gynecology was behind only orthopedics and podiatry for an average ASC’s revenue per case. So, while gynecological cases make up a relatively small percentage of a typical ASC’s cases, those cases have relatively high reimbursement.
A newly developed ASC can complement a health system’s women’s health program, and organizations should act sooner than later. As the pace of case migration accelerates, a wait-and-see approach for developing an outpatient women’s surgery plan risks losing lucrative volume.
Reference
1. ASC Review article, citing HealthLeaders Media poll (Becker’s Hospital Review, Vol. 2018, No. 9, September 2018).
Edited by: Matt Maslin
Published August 4, 2022