ASC Industry Awareness
ASC’s Growing Opportunities
The events of 2020 and early 2021 continue to expand growth opportunities that ASCs in some parts of the country were sensing even before the pandemic. Six ASC executives point to somewhat non-traditional ways their ASCs are returning to growth. ASC management companies are continuing to develop multispecialty and specialty centers like this total joint surgery center in Pompano Beach, FL. Orthopaedic super groups are a new rising trend that are also growing center opportunities. For deeper insight into the trend, check out this story about independent physicians joining forces to form New Jersey’s largest orthopaedic group. At least fifteen ASCs announced their opening or opened in March.
ASCs Positioned Well in 2021
All kinds of businesses and organizations took the opportunity afforded by the challenges of the pandemic to reset their activities in order to be successful on the other side. Many ASCs also made smart adjustments – for some it was shifting priorities, for others it was obtaining technology, for yet others it was changing patient relations strategies. ASCs made big gains on hospitals during the pandemic in terms of patients served and experts believe those gains will be permanent. Five spine surgeons offer their thoughts on what this position change will mean for hospitals and what hospitals can learn from ASCs. For an overview of the latest US ASC statistical data, click here.
Healthcare Industry/Trends
More Hospitals Struggling Financially, Benefit from Government Funds and Donors
Just two weeks ago, Moody’s Investors Service released a report that nonprofit hospitals’ operating margins took a significant hit during the pandemic while at the same time hospitals’ cash on hand increased. Patient volumes and profits declined. Rural hospitals, which have been hurting for years in the US, had a particularly difficult 2020 with a record high twenty closures. Large Texas system Baylor, Scott and White, reduced support staff by 1,700 to compensate for financial losses. Bon Secours Mercy Health reduced costs by closing DePaul Medical Center in Norfolk, VA. However, some hospitals report ending the fiscal year in the black due to increases in government funding and donor giving during the pandemic.
How May President Biden’s Administration Influence Healthcare?
Most notably, to date, is President Biden’s push for higher enrollment in Obamacare and over 500,000 Americans have taken him up on it, with four months remaining to do so. However, there are many other areas in healthcare where the Biden administration may influence the healthcare marketplace. The president wants to establish a new $65 billion health agency to fund the development of medical treatments. Some anticipate that the administration will move forward on increasing health care regulations evidenced by increases in FDA enforcement activity the medical device industry is likely to see. The administration has yet to weigh in on the outgoing administration’s price transparency rule. William Prentice, CEO of the Ambulatory Surgery Center Association, is expecting strong bipartisan congressional support for ASCs overall.
Healthcare Digital Transformation Watch
Telehealth Staying Power?
Telehealth certainly has limitations, but it has played a much-needed role during the pandemic and has proven generally popular with patients. However, does it have staying power beyond the pandemic? Virtual care can be a lifesaver when natural disasters strike. Digital care is keeping schools running during the pandemic and may provide a long-term solution for school-based health care. Telehealth also has the potential to expand access to care to the underserved. Even so, the question remains about telehealth’s staying power. Will laws support equitable telehealth reimbursements after the pandemic? The US House of Representatives reintroduced the Protecting Access to Post-COVID-19 Telehealth Act in January. Rather than waiting for the final federal legislation, many states are taking action to support telehealth provisions.
Legal
How Is COVID-19 Affecting PPACA Enrollment?
From the office of Jon Sistare, JD, Attorney at Law
It is valuable to grasp the impact of the pandemic on enrollment in PPACA plans (aka, Obamacare) since President Biden took office. While it has been hard to follow the trials and tribulations of Obamacare since its inception, Obamacare remains in place much as what passed as legislation in 2010. President Obama himself said it is not perfect, but it is a start. It was a heated topic in 2016, and President Trump and company tried to kill it as best they could. However, it remains intact but for the individual mandate.
Obamacare’s progresses include:
- 20 million Americans having health insurance today who would not have health insurance without it.
- Effectiveness at reducing longstanding health coverage deficits among the poor and people of color.
- Making health care more affordable for millions of Americans with ailments such as high blood pressure or lung disease who previously had been denied health coverage by insurance companies for their pre-existing conditions.
- Specifying that adult children until age 26 be covered under their parents’ plans.
- Doing away with annual and lifetime dollar limits on insurance payouts.
- Producing clear benefits in overall health and mortality reduction among Americans (according to several studies).
The goal of the individual mandate was to generate broader participation in the government insurance exchanges so more than just sick people were being insured. Broad participation was meant to ultimately reduce overall insurance costs. Whether the result of the so-called individual mandate’s demise, insurance carriers did flee the health insurance exchanges in the early years of Obamacare.
But amazingly, that trend appears to have reversed, perhaps in part because of healthy new enrollees seeking coverage during the pandemic. Regular annual enrollment is during a 45-day period at the end of each calendar year. However, President Biden re-opened the enrollment period shortly after taking office. In more than a month of the reopened period, over 528,000 people signed up through Healthcare.gov.
Constitutional challenges to the ACA have twice failed and a third also might not succeed. A majority of justices indicated during oral arguments in November that however they rule on a portion of it, the basic law will survive.
Obamacare’s failures include:
- At least 29 million Americans remain uninsured, in part because a dozen states still refuse to participate in that portion of Obamacare that provides federal funding to expand Medicaid coverage.
- In addition, the law failed to stem the nation’s rising health care costs, one of President Obama’s goals.
- Deductibles for some of the affordable plans sold on the exchanges have remained intolerably high, up to $8,150 for individuals and $16,300 for families. Surveyed enrollees say they appreciate the security of health insurance, but still avoid medical visits to reduce out-of-pocket costs.
The mantra through the Trump era was to repeal and replace Obamacare. Opponents failed on the first despite more than 60 congressional votes to repeal and never came up with a better alternative.
There are more radical options that progressives are pushing such as a single-payer, government-run insurance program. In addition, there is a Biden proposal that would allow all Americans the option of enrolling in government health care. As President Obama himself said, it is not perfect, but it is an improvement over what we had until something better comes along.
At a Glance
House Committee Weighs Telehealth Access against Cost
May Well Determine Near-Term Telehealth Future
Understanding Unhappy Patients Makes Hospitals Better
The Importance of Never and Always Events
Washington Church Raises $300,000 for Community
Wipes out $30 Million in Patients’ Medical Debts
Rising Health Costs This Year
Businesses and Individuals Will Feel the Impact
Growing Patient Satisfaction with Surveys by Text
More Than 80% of Patients Will Take Text Surveys
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