Looking Forward

The pioneers of the ASC model would be amazed by the many advances we have made in improving outcomes, promoting patient safety and enhancing the experience of ambulatory surgery since 1970. Each year, millions of patients receive the care they need thanks to the outstanding men and women who work in ASCs, and billions of dollars are saved thanks to our efforts to lower costs.

Surgicenter of Kansas City is the oldest surgery center in Missouri. We have been providing ambulatory surgery in the Kansas City community for 42 years. The changes in the types of procedures, patient acuity and the regulatory landscape have been dramatic. The next 50 years promise to bring more change to our landscape. Politically, there is an outcry for healthcare reform. What we are seeing on the ground is less volume, more complex procedures and higher patient acuity. With the aging population and pressure to reduce costs, ASCs should be a significant part of the solution going forward.

I became a part of the ASC industry in 1976 and have been passionate about it since that time. Back in 1976, I never dreamed we would be doing total joint replacements or using robots in surgery centers, but that is where we are today. Technology is likely to drive the industry during the next 50 years as it has this first 50 years. But more important than the procedures and technology are the people. I hope we never lose that element that sets us apart. As I have said many times, it takes special people to work in ambulatory surgery. They are patient care focused and work as a team doing whatever is needed, whether it is scrubbing floors or assisting with complex surgical procedures.

The future is now! Next 50 years, full payment from the payers, so we can make a difference, it’s not just about money anymore, it’s about making patients and families accountable for their own healthcare.

I would like to see the industry continue to grow both in overall volume and, particularly, in new procedures that have traditionally been performed only in the inpatient setting.

I would like to see ASCs doing more complex procedures such as all total joints, spine and cardiac procedures. I know the industry is working on these procedures being performed in ASCs and some insurance companies are allowing it, but I would like to see these procedures listed on the approved MCR-allowable list for ASCs. I would like to see ASCs recognized as the cost-saving, safe environments they truly are as well as more data to show exactly how much ASCs could save the healthcare system.

When I pursued the concept of ambulatory surgery centers as a wide-eyed MBA-HA in 1976, with just a handful of ASCs nationally in their infancy, I viewed this extraordinary modality of care as a relevant solution to healthcare consumerism: high-quality, efficient care at a lower cost to patients and the healthcare system.

To be part of and witness the exponential growth over the past five decades, including the acceptance, support and embrace of medical communities, payers, employers, government, Main Street, Wall Street and, especially, patients, has far exceeded my expectations and has secured ASCs as a vital part of the healthcare sector. To have played a role in this achievement has been one of the most important contributions of my professional career.

If ASCs continue to prioritize the patient, deliver high-quality care and incorporate technological and administrative innovations, as they have in the past, the industry will continue to be recognized as a solution and prosper.

ASCs have been strategically evolving over the last couple of decades. Advances in technology and pharmacology have allowed a steady progression of surgical cases into the ASC space. I would expect further shifts into high-quality, lower-cost settings over the next decade as we as a nation come to terms with the evolving cost of healthcare. ASCs have the right formula for success, which involves significant physician leadership and direction, highly trained and educated staff and industry-leading patient satisfaction and outcomes. I am really looking forward to being a part of this community for years to come.

The establishment of the first surgery centers and eventual ASC boom transformed the delivery of surgical services in America. We are indebted to the pioneers of our industry: the surgeons, anesthesiologists, nurses, technicians and administrators who reengineered processes, advanced patient safety and revolutionized healthcare forever.

The ASC industry is piercing the dawn of what promises to be an era of growth and prosperity. While it is impossible to predict the prodigious technological advances to be uncloaked over the next 10 years, one surefire conclusion is scarcely debated: the 2020s will be the Roaring Twenties for the ASC industry.

The New York State Association of Ambulatory Surgery Centers joins ASCA in celebrating 50 years of high-quality, specialized surgical care in ASCs. We look forward to continued success and growth!

Each day, I am impressed by the integrity, ingenuity and positive energy of the ASC industry as a whole. Fifty years is, in reality, a very short period of time, but our industry has grown and changed so much in those years. From advocating for coverage for lap choles twenty years ago to hundreds of ASCs performing total joint replacements today, the evolution has been astonishing. The true value of the ASC industry, however, is the people who work in our facilities every day. Our scrub techs, OR nurses, back office teammates and physicians inspire me with their commitment to serving our patients and providing them the best care possible. The years ahead are going to be an exciting time to be part of the ASC world. As lower-cost sites of service in most markets, we are exceptionally well positioned to have a positive impact and help drive down healthcare costs.

I have been in the ambulatory surgery world for about 25 years now. Our center has been in business since 2006, primarily orthopedics, spine and pain management. I personally have seen tremendous growth in the acuity of cases being performed safely in an ASC. We perform same-day total joints and posterior lumbar interbody fusions of the spine. The combination of the advancement of minimally invasive techniques and regional anesthesia has allowed patients to enjoy the high-quality, personal attention received at an ASC and go home safely and well prepared. Thank you for the opportunity to include our center in this celebration.

The ASC industry has grown in volume, acuity and recognition. With around 5,800 ASCs across the country, that growth continues in 2020, amid acquisitions and mergers. The acuity of the cases we see now has greatly evolved over the last 50 years, particularly with orthopedics and spine, but other specialties will be on the growth curve, like cardiovascular, as CMS migrates more of these cases to Medicare’s ASC-approved procedure list. Recognition is one of the biggest areas of change in my opinion. Some of that comes with an increased volume of centers, but the evolution of advocacy and ASCA’s efforts to work on behalf of ASCs on the national platform accounts for the most significant change in the industry. We are generally able to be proactive rather than reactive as regulations and policy regarding the industry are discussed and modified. The legislators in our communities are better educated after being invited to visit our ASCs, hopefully making better decisions on policy. We continue to grow and advance and I am so excited to see what the next 50 years brings.