The California Ambulatory Surgery Association (CASA) held its annual conference at the Portola Hotel and Spa in Monterey, California, September 13 to 15. The event gives healthcare industry leaders the opportunity to collaborate, learn, and discuss the future of ambulatory surgery centers (ASCs). Naya Kehayes, a partner with ECG and leader of the firm’s Ambulatory Surgical Care Services practice, presented on Optimizing Operating Performance with Data Analytics.
Below are three key reflections from this year’s conference.
Growth
If there is one word to summarize the conference, it would be growth. ASCs have been a high-growth asset in the healthcare delivery system for years. There are now more than 4,000 procedures on the Medicare covered procedures list (CPL) and over 6,000 Medicare-certified ASCs across the nation. In California alone, there are 848 ASCs.
In conversations with colleagues—operators, management companies, and health system leaders—the discussion topics centered on growth:
- Case mix growth: ASCs have an evolving case mix with increasing complexity. Many are readily performing surgeries such as total joints, ACDFs, and more complex ENT procedures.
- Volume growth: Physician preference, patient preference, and hospital surgery case migration are all contributing to growing volumes being serviced in ASCs.
- Facility growth: Operators consistently talked about opportunities for physical expansion of existing spaces. In discussion with strategy and M&A leaders, there were opportunities for both acquisition and de novo ASC projects.
Margin Pressure
ASCs are not immune from the margin pressure experienced in every part of the healthcare delivery system. Many operators have had double-digit increases in cost per case measures with only small reimbursement increases—or none at all. ASC leaders at CASA discussed opportunities to streamline costs, create staffing efficiencies, and critically measure performance to ensure an efficient delivery of services. Even when discussing operating efficiencies, ASC leaders demonstrated their unwavering commitment to quality and exceptional patient care.
ECG partner Naya Kehayes presents at CASA.
Competitive Advantage
Numerous sessions at CASA centered on the concept of creating and sustaining a competitive advantage in an ASC. After the COVID-19 pandemic, ASCs have continued to pursue nimble operating strategies to retain margins; however, the operating environment has continued to present significant challenges—skyrocketing material costs, a tight labor environment, and higher-acuity patients posing throughput and care delivery challenges. Further, ASCs are now faced with paying anesthesia subsidies due to the anesthesia provider shortages, adding increased cost pressure, similar to hospitals. ASCs continue to build cultures of excellence where high-quality care can be delivered at an efficient price. Additionally, operating leaders are finding new, creative ways to deliver care (e.g., the use of LVNs, new graduate programs, using data analytics to drive efficiencies).
The well-attended CASA conference reinforced the important role of ASCs in the healthcare delivery system—an asset squarely focused on providing high-quality surgical care and reducing the financial burden on patients and the healthcare delivery system overall.
Further Reading: Surgery Migration Is Affecting Your Hospital. Do You Have an ASC Strategy?
Edited by: Matt Maslin
Published September 27, 2023
