ASC Industry Awareness
Helping or Hurting ASCs?
Micro trends are difficult to spot and even more challenging when it comes to determining if they spur or drag on a movement. For instance, according to one New Hampshire ASC surgeon, healthcare outcomes are inversely proportional to healthcare expenditure, but we have a hard time reigning in cost. The conundrums do not stop there. As ASCs grow, they are finding rising litigation risks rather than fewer. Growth also creates two opposing pressures for several ASCs. On one side, acquisition pressures mount and on the other, smaller, leaner, more nimble ASCs have strategic advantages in the greater ASC marketplace. Stagnating reimbursement rates, rising operating costs, and staff retention issues are all weighing on ASCs while improvements in block utilization, group purchasing, and anesthesia billing are helping.
ASC Spring Has Sprung in the Southeast
It is ASC growing season in the Southeastern US. Nine new ASCs have been recorded by Becker’s ASC since March 25. Atrium Health Wake Forest Baptist opened a new outpatient surgery center in Winston-Salem, NC. In April, The Medical University of South Carolina gained approval to build a new cancer hospital and ASC in Charleston, SC. Winter Garden Surgery Center, an affiliate of Orlando Health, opened in its namesake Winter Garden, FL with three operating rooms. In an unusual string of events, Jacksonville Orthopedic Institute closed six clinic locations due to a physician buyout. This made way for Jacksonville, FL-based Southeast Orthopedic Specialists to hire a number of clinicians locally.
Healthcare Industry/Trends
UHC Announces Leadership Transition
As CEO Andrew Witty steps down for personal reasons, UnitedHealth Group is attempting to reverse its recent fortunes by taking a page from the Starbucks, Disney, Procter & Gamble books; replacing Witty with boomerang CEO, Stephen Hemsley. Witty will remain on as senior advisor, following a tumultuous six months for upper level personnel and the short-term business outlook. With Hemsley at age 72, UHC is betting big on an old school, no-nonsense, numbers person who knows the business well because he piloted the changes to prepare it for this stage in its development. As other insurers pulled back from Medicare Advantage in 2025, UHC is paying the price for aggressive expansion, erasing $60 billion in market value early this week.
Hospital Closures Picking Up Steam
Hospital margins are moving in the right direction, having reached a one-year high, but margins are advancing slowly. Thirty-seven percent of hospitals are now losing money, compared with 40% in 2024, in what remains a very challenging financial environment. Successful hospitals tend to have a sophistication in their management of shared service costs. 16 US hospitals have closed thus far in 2025, following 25 closures in 2024 – cybersecurity issues, supply chain disruptors, and prior authorization requirements are all pressure points. The pace seems to be quickening as four hospital closures were announced in the last two weeks of April. Hospitals are really a story of the haves and have-nots. The top 20 health systems have 12,000 open jobs and the struggling systems on the other end are closing or significantly cutting jobs.
Healthcare M&A, Valuation, Revenue Cycle
Open AI Introduces Healthcare Framework. UHC Tries to Recoup from Hack.
Open AI has just introduced HealthBench, with the goal of creating a better benchmark to measure AI systems’ capabilities for health. It features 5,000 simulated medical conversations with input from over 260 physicians. As organizations grow AI capabilities, concerns and worries about potential ethics and risks ensue. AI godfather, Geoffrey Hinton, is raising concerns about superintelligence risk, that companies are placing profits over safety and are ramping up AI use too quickly before fully understanding the inherent hazards. In other disconcerting news, UHC is garnishing claims to recoup loans they issued during the Change Healthcare hack. The AMA is pushing back and is suggesting more tempered remedies.
Out-of-Network Watch
Enforcing Compliance for NSA
Americans for Fair Health Care, an advocacy group for providers in their surprise-billing challenges, issued a report of a survey of over 30,000 physicians. The survey found that 35% of the time insurers failed to make payment within the requisite 30 days and 22% of the time insurers completely failed to pay their No Surprises Act (NSA) Independent Dispute Resolutions. Due to the September 2024 bipartisan bill to increase penalties for late payment or nonpayment, many expect further federal government efforts to enforce compliance. Even with these issues, NSA can protect patients from surprise billing and from disputes over payment. In February, North Carolina fined an insurer $3.4 million.
Healthcare Digital Transformation Watch
Open AI Introduces Healthcare Framework. UHC Tries to Recoup from Hack.
Open AI has just introduced HealthBench, with the goal of creating a better benchmark to measure AI systems’ capabilities for health. It features 5,000 simulated medical conversations with input from over 260 physicians. As organizations grow AI capabilities, concerns and worries about potential ethics and risks ensue. AI godfather, Geoffrey Hinton, is raising concerns about superintelligence risk, that companies are placing profits over safety and are ramping up AI use too quickly before fully understanding the inherent hazards. In other disconcerting news, UHC is garnishing claims to recoup loans they issued during the Change Healthcare hack. The AMA is pushing back and is suggesting more tempered remedies.
Legal
Healthcare AI Regulatory Framework Still Developing
From the office of Jon Sistare, JD, Attorney at Law
The integration of AI into healthcare is set to reach new heights while the policy framework for AI continues to change. AI has the potential to transform healthcare but also comes with known and not-yet-understood risks. Organizations should spend time building a clear understanding of their AI strategy and priorities, as well as the attendant risks associated with AI in healthcare.
While there is not current, universal law governing AI, there is a patchwork of privacy, consumer protection, healthcare, and health information technology laws and regulations that pre-date AI and apply to its use. In the absence of a broad-
spectrum AI regulation, policymakers have efforts underway to address the gaps, which include the White House Blueprint for an AI Bill of Rights and voluntary commitments from leading AI companies to develop safe, secure, and trustworthy AI.
Given the rapidly changing environment, it is essential to evaluate how AI can be used to improve healthcare and efficiencies within the healthcare industry, but to also understand its impact if used adversely to a patient’s best interests.
At a Glance
CMS Proposes Closing a Medicaid Tax Loophole
To Preserve Benefits for Vulnerable Populations
Arizona Lawmakers Approve an AI Bill
To Prevent Insurers from Using It to Deny Claims
HHS and NIH to Develop Universal Flu/Coronavirus Vaccine
With the Goal of Targeting Multiple Strains
Luigi Mangione Pleads Not Guilty in Federal Court
Faces Possible Death Sentence if Convicted of UHC CEO Murder
The Cost of Hospital Closures by the Numbers
More Closures than Opening in Underserved Rural and Urban Areas
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