Ambulatory, or outpatient, care can be offered in a variety of settings to meet patient needs. Ambulatory surgery centers (ASCs) have been gaining popularity among patients and physicians. The future of ambulatory care – and possibly health care – will be largely shaped by ASCs.
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The Growth of ASCs
Nearly 50 years since the first ASC was opened, thousands of ASCs are now certified by Medicare and receive reimbursements for a variety of health care procedures.
What is Ambulatory Care?
The Medicare Payment Advisory Commission defines ambulatory care as “medical services performed on an outpatient basis, without admission to a hospital or other facility.”
Statistics of ASCs
Before the creation of ASCs, patients waited for weeks or months for a surgery. ASCs’ founders wanted to address related issues like scheduling delays, limited operating room availability, and difficulties getting new equipment because of hospital policies and budgets.
ASCs have grown since the first one opened in Phoenix in 1970. In 2017, there were 5,486 Medicare-certified ASCs. The average size of an ASC is 15,262 square feet and contains four operating rooms. Additionally, certain procedures tend to be linked to ASCs. For instance, cataract surgery with IOL insert accounted for 28.1% of the ASC procedures performed in 2015.
How ASCs are Addressing Challenges & Bringing Other Benefits
ASCs – health care facilities outside of hospital settings where surgeries and other procedures can be performed – can alleviate the strain placed on hospitals’ resources.
The Problem of Increasing Wait Times
Between 2006 and 2014, visits to emergency departments (EDs) increased by 14.8%, though the U.S. population increased by only 6.9%. According to the 2016 National Hospital Ambulatory Medical Care Survey of 265 hospitals between December 12, 2015 and December 25, 2016, there were 145,591 visits to EDs.
In 2016, the average wait time for EDs across states was as high as 53 minutes. Additionally, the average wait time for a first-time appointment with a physician across 15 major cities was 24 days. What’s more, the average wait time for a cardiologist across 15 major cities was 21.1 days. Though some specialties have relatively short wait times, most areas in health care like EDs and surgery need a more expeditious solution. ASCs could be the answer needed.
Other Challenges: Patient Satisfaction, Operating Margins, and Staff Turnover
Patient satisfaction metrics pose a challenge because of their positivity. According to the 2018 HCAHPS National Survey, 73% of patients rated their hospital 9 out of 10, with 10 being best.
Additionally, 69% of patients said they “always” received help as soon as they wanted.
Operating margins can also create an issue. In 2017, the average operating margin for for-profit and nonprofit provider networks decreased by 39%. Moreover, the cost of replacing a nurse can range from $97,216 to $104,440. This could be problematic, since 2017’s average turnover concerning health care jobs was 20.6%. American health care spending also increased by 3.9% in 2017.
Benefits of ASCs
ASCs will benefit the health care industry in numerous ways. For instance, ASC procedure costs are 60% of hospital outpatient department (HOPD) procedure costs. Additionally, Medicare will save over $2.4 billion annually if 50% of eligible procedures are performed at an ASC instead of an HOPD.
Physicians can also reap benefits from ASCs. Some of these benefits can include increased control of surgical practices, proper equipment usage, and optimal facility design.
There are numerous benefits for patients that utilize ASCs, too. These can include increased access to quality care, improved patient outcomes, quality service, and increased financial efficiency and lower costs.
Trends & Careers in Ambulatory Care
Recent legislation and changes in Medicare have helped increase the popularity of ASCs. In response, health care leaders will need to create strategies to promote ASCs’ long-term growth and meet demand.
Changes and Trends
There are numerous signs that reflect positively toward the concept of ASCs. Firstly, there’s more interest among payers in ASCs due to lower surgery costs and high care quality. There’s also a growing popularity of ASC investments among non-physician investors. Additionally, there are more procedures being performed in ASCs. Finally, the implementation of the Tax Cuts and Jobs Act has decreased the corporate tax rate by 21%.
One key career opportunity linked to ASCs is the role of Chief Operations Officer (COO). Those in the role plan, direct, and coordinate operational activities in an ASC. The 2018 median pay for COOs was $104,980.
Medical and Health Services Manager, also known as Health Care Administrator, is another ASC-ready position. Those in the position are tasked with managing an ASC facility and coordinating health services. The 2018 median pay for this position was $99,730.
ASCs are showing great potential for addressing the U.S. health care system’s challenges surrounding cost, efficiency, and patient satisfaction. Health care leaders would be wise to recognize the opportunities and work with government officials to pass legislation favoring ASCs.