Spine’s outpatient moment is here, and as more cases fit the setting, hospitals have to find a way to make their own footprint in ASCs, Brian Cole, MD, managing partner at Midwest Orthopaedics at Rush, said.
And there’s the challenge of hospitals balancing investments between inpatient, HOPDs and ASCs. Dr. Cole pointed to strategies for expanding reach and emphasized the importance of leaning into ASCs.
“What Rush is doing is focusing on catchment, which is basically expanding the primary care network in a very cost-effective way, and that has been very helpful in terms of reach,” Dr. Cole said June 12 at Becker’s 23rd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference in Chicago.
When it comes to the outpatient setting, health systems have to figure out the best plays for positioning themselves in the ASC market. The challenge comes with revenue.
“The thing about the ASC model is that not all service lines are profitable, and not every state has a profitable ASC business line,” Dr. Cole said. “I have friends and colleagues in California who can’t keep ASCs open, so we’re probably one stroke of a pen away from not being viable in Illinois based upon where the payers feel us.”
The pressure is especially present for spine and orthopedics, specialties that have seen jumps in outpatient growth in recent years. And that growth is only expected to grow.
“Seventy percent of our spine cases have now been done in the surgery center, and about 80% of our arthroplasties are in surgery centers,” Dr. Cole said. “If the hospitals don’t play in that space, they will continue to lose facility revenue.”
The balance hospitals and health systems have to think about is keeping up the surgical side of operations and the nonsurgical options.
“I would look to lean on my facilities and reduce my cost structure,” Dr. Cole said. “I’d right size my footprint, right size from an HR perspective and bring in a lean leadership with decisionmaking ability with more defined and common roles.”
These are all things that have worked for Rush, Dr. Cole said. But he stays on his toes knowing that headwinds never stop.
“You think you get through one battle, then you get to another one, creating that other headwind, which makes the job really interesting,” Dr. Cole said. “I think they’re doing a really good job addressing the problems, and looking for solutions, and figuring out what the core talents are … It’s no different than any business, other than what I pointed out before, which is that all our costs are subject to market forces in addition to the nonfree market world when it comes to revenues, which makes it really difficult.”
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
