← Becker’s Healthcare Podcast
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- [00:03]
A
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- [00:50]
B
Hello, this is Francesca Matthews with the Beckers ASC Review Podcast. I'm thrilled to be joined today by Mark Mayo, CASC Administrator of Associated Surgical Center. Mark, thank you so much for being here today.
- [01:03]
C
Good morning. I'm good.
- [01:05]
B
Awesome. Great. So just to start us off, could you please introduce yourself and tell us a little bit about your background?
- [01:12]
C
I've been involved in surgery centers for a long time. I actually helped a group of Doctors create a truly 5050 joint venture surgery center with a hospital in 1984 and it's still working that way. And then I went on to work with about 10 other surgery centers since then.
- [01:35]
B
Truly a pioneer there.
- [01:37]
C
No, there were a lot of people before me, so we always build on top of that. I had the privilege of serving on two National Surgery center association boards. One that merged with a group called FAFSA to become the asca, and the other one was the board of the CAST Credential. I helped edit the national ASC newsletter and helped develop a state Surgery center Association. I've been involved with Associated Surgical center since before we opened in 2016. They're located in Arlington Heights, Illinois and have been working with them since, and we're now focused on preparing for reaccreditation.
- [02:38]
B
Excellent. Thank you for that little summary of your breadth of experience there. Given all of that, what are the top three trends you're following in healthcare and ASCS today?
- [02:51]
C
I think the first one is pretty common to everybody and that's the pressure of revenue versus our increase in inflationary costs. And how do we keep up with that, particularly for a center like ours that's now involved in orthopedics, it's careful control of implant costs. I think the third one would be a better awareness. This is a positive one, better awareness of the value and the positive patient experience for surgery centers. Some of that came out of the COVID 19 issues a few years ago, and surgery centers have certainly become recognized as part of a healthcare system as opposed to Fighting our way in the door.
- [03:50]
B
And what are you most excited about right now?
- [03:55]
C
The thing that excites me the most is the possibility for some type of cooperative networking that needs to be explored among some of the 70% of surgery centers that are still physician owned. I believe there's inroads that can be made without those independent surgery centers selling to hospital joint ventures or becoming part of a national surgery center management company.
- [04:29]
B
Yeah, that definitely echoes some things I've been hearing about just kind of in my reporting here at Beckers. And I think that folks in the industry are starting to get a little bit more creative with how, you know, physician owned facilities can sort of align themselves in order to maintain that independence. But, you know, kind of move forward in the industry and adapt as well.
- [04:50]
C
There's a, there's a, an independent streak. Despite the 20 years that we always talk about a trend of joint venturing or affiliating with a management company, While those management companies have grown, the numbers are still approximately the same. You know, 20, 25% of all surgery centers are joint ventured in some manner, but 70, 75% of those centers still remain independent physician owned. Fueling that, I think is going to be, we now have groups of younger physicians who went to the employment model at a hospital, and they're now maturing and finding out that there's some benefit to being more independent from the hospital as they grow their practice and their ability to perform surgery in an outpatient setting. And if the hospital is not providing that opportunity for them in a joint venture, some of these physicians are going to start to migrate back to the independent surgery centers.
- [06:18]
B
Absolutely. Yeah. But again, just definitely falls in line with things I've been seeing here at Becker's. And how are you thinking about growth over the next 12 months?
- [06:30]
C
Growth over the next 12 months and over the next few years is, I think, going to be pretty significant. There are several factors that have come into play. One is the one that we just talked about, and that's the recognition of surgery centers as a part of the healthcare system. Again, part of that grew out of the experience of surgery centers being able to be more flexible than the hospitals were during the COVID shutdown period. Two, hospitals are starting to recognize that certain cases, if they move out of the main or even at a lower reimbursement rate, allows the hospital to fill that scheduling space with more acute cases, either inpatient added surgeries or elective cases that are larger orthopedic cardiac neuro cases. So they see some benefit to allowing cases and it's no longer a competitive environment. And the ASCs are no longer accused of cherry picking the easy cases to, you know, to take from the hospital. There's a collaborative atmosphere now that recognizes the value of surgery centers. And certainly the numbers are showing that this shift to outpatient surgery is going to continue the growth of surgery centers. I'm seeing, you know, more individual surgery centers being created. So there's growth opportunity there. The growth opportunity per surgery center is pretty much dependent, I think, on geography and the age of your medical staff. So succession planning is important to realize when some of your physicians might be retiring and are they bringing junior partners along that can replace them in volume. And the other part of it is that there's more public awareness of surgery centers. Patients have found that what we advertise is what we deliver with. We have quality care, low infection rates, patient centered care, that the patients appreciate the opportunity. And it's easier to schedule cases at a surgery center than it is to get elective cases, particularly orthopedic cases, where sometimes the orthopod is, is telling the patient that, you know, a hospital case may be two months out from now. So those factors are all coming to play now in growth potential for surgery centers.
- [09:40]
B
Absolutely. I like the way you kind of illustrated that there. There are like a number of these sort of larger factors playing into the future of every individual center there. Anything else to add today here, Mark?
- [09:52]
C
It depends again on each center. Two things I hear constantly that are important. Keeping up on the regulatory environment changes. It could be state regulation, it could be changes in Medicare. It could be thinking about what Medicare is looking at. For example, cataract surgery is the number one procedure performed in the country. And we all know that reimbursement rates have not changed very much in the last five years for cataract surgery at surgery centers. We still have the site of service differential. That's a tremendous factor. But Medicare may be leading the way to move cataract surgery in particular to the office space setting. And some surgery centers are going to have to adjust to that. If that trend, and I know they've been exploring it, but if that trend continues, then people are going to have to start to rethink some of their line of service. So that's a big issue.
- [11:08]
B
Absolutely, absolutely. And again, just totally echoes things I'm hearing here on our end. So all great insights. There's actually all I have for you today, Mark. Oh, do you have any other thing?
- [11:20]
C
The other part that I wanted to add to that is not a solicitous plug for Becker's asc, but people need to be plugged into networks where they can exchange information. It's Beckers, it's aorn, it's Outpatient Surgery Magazine. It's all sorts of resources. So somebody in your center needs to be allowed and given the time to do some of that online. It's so much easier now that we can clearly communicate online and exchange information. But it's not just receiving the information. It's taking it to your governing body. Having a discussion with the doctors there about what the implications are of these changes, and also making sure that staff are aware so that they understand what they're doing and why they're doing it is more important. And that pays off, both in the attitude of staff, but certainly when you go through accreditation, the more the staff are informed and know, the better they shine. When a surveyor comes and asks, well, why are you doing this? To understand what's behind. What's the theory behind it. So having. Having somebody that's involved, I think is very important. And the resources are certainly out there. Most of them are free. Webinars are all over the place, and you have to pick and choose. But I think it's worth the time to spend to do that and to educate ourselves.
- [13:12]
B
I'm really glad you added that, because I think that that sort of, you know, not to bring it back to us, but our belief here at Beckers is that, you know, everybody can do better work if we're all communicating more, if people have access to that information. And I can only see that making an even bigger difference, as, you know, the industry progresses. So thank you for adding that. Absolutely.
- [13:35]
C
Okay. You're welcome.
- [13:36]
B
Yeah. And, yeah, again, just thank you so much for joining us. It has been a pleasure speaking with you, and I look forward to connecting with you again in the future.
- [13:45]
C
Francesca, thank you again for doing this. Have a good day.
- [13:49]
B
Yep, you too.