Image by Goran Horvat from PixabayAdding a new location or specialty to an ambulatory surgery center (ASC) can offer significant opportunities for growth, but it also requires careful planning and strategic execution.
ASCs often compete with large health systems and hospitals, making differentiation critical.
“You could do a market trend [survey] that cardiovascular would probably be really good in Florida, where you have a lot of older patients moving to and they don’t want to have to fly up for care,” Alyson Engle, a physician at Northwestern Medical Group, said at a recent industry conference.
Northwestern Medical Group is a multi-specialty physician group practice affiliated with Northwestern Medicine, which provides health care services across various specialties in the Chicago area.
Yet Engle said if operators don’t have the right referral mix, it might not be the best fit.
“We did use some of the data on market trends, but really we found … conversations amongst physicians, of who feels comfortable referring those good patients to your center, that was more successful and of a better use of our time,” she said.
When it comes to growth, location is everything.
Janet Carlson, executive director of ambulatory surgery centers with , said her approach to selecting new surgery center locations relies on the use of U.S. Centers for Medicare & Medicaid Services (CMS) Medicare claims data and specialized software to identify target markets.
Commonwealth Pain & Spine, based in Louisville, Kentucky, is a health care provider specializing in minimally invasive spinal surgeries. They operate multiple ASCs.
By analyzing this data, ASCs can anticipate patient demographic needs and strategically place clinics in clusters, with a surgery center centrally located among them, Carlson said.
“For example, I reside in South Carolina, and we’re seeing in the Southeast a lot of folks actually moving out of Florida and coming to the Carolinas, Georgia and Tennessee,” Carlson said. “With COVID, there’s been a shift, with people leaving the West Coast and coming to Florida, Texas. So, it’s kind of a rebound.”
There is also a cultural shift among aging populations, such as baby boomers and Gen Xers, who are unwilling to accept physical limitations as they age, Carlson said, which will likely be a tailwind for the industry.
“They’re going to want to have a solution to improve their quality of life and get back to their activities of daily living,” she said.
Patient focus
Ultimately, patients choose a surgery center for its convenience, personalized care and more attentive clinical experience, Engle said. In some larger institutions, especially in pain management, the focus is often on repeated treatments, she added.
“They’ll continue doing injection after injection, or prescribing medication after medication,” she said.
In contrast, her ASC prioritizes getting patients better with the right intervention.
“We minimize the number of injections, reduce medication dependency, and focus on helping patients return to work or everyday activities more quickly,” she said.
This patient-focused model not only improves outcomes but also strengthens payer negotiations.
“We need to use those negotiations for payer contracts also to make sure we can get better pay. We can pay our staff better and also provide patients exceptional service and get them in sooner,” Engle said.
Attracting physicians
ASCs should also take advantage of their unique advantages over hospitals, Bruce Feldman, administrator at Eastern Orange Ambulatory Surgery Center, said.
New York-based Eastern Orange Ambulatory Surgery Center is a multi-specialty ASC, specializing in areas such as gastroenterology, ophthalmology, orthopedics and anesthesiology.
“It’s all about creating an environment that’s, you know, friendly, that’s conducive, that’s quick, that’s efficient,” he said. “And that’s why ASCs were developed – to really, basically, allow physicians to get away from having to wait an hour for an OR to be turned over in a hospital, or waiting for, you know, janitorial services to come to mop the floor. It’s a much more efficient way of delivering care. But your staff are the key – that’s the most important element: staffing and physicians.”
Leveraging these benefits in marketing efforts can help to attract both patients and referring physicians, he said.
He noted that fostering this environment starts with engaged staff who feel valued.
“One of the things we recently did is we offered an incentive, because we were having some staff shortages, so we offered our staff basically a sign-on bonus, if they recruit an individual who joins the center,” he said.
ASCs can also attract entrepreneurial-minded physicians by offering more input in decision-making, Engle added.
“In the ASC space, [physicians] can kind of call their own shots,” Engle said.
However, not all physicians want an equity stake. Some high-performing physicians may prefer quarterly bonuses tied to facility fees, she said.
“There are some people that really want equity,” Engle said. “There are some that just [say], ‘Hey, I want the money that I would get from the equity as if I own shares. So just give me a bonus, and you can navigate that.’ As long as people feel like their desires are being respected, then they can be just as productive as your partner.”
