ASC Industry Awareness
More Electives, Procedure Migration, Cardiology Growth
ASCs are proving to be a net winner coming out of the Covid-19 pandemic. Americans’ awareness of the quality, convenience, and relative low cost of outpatient surgery centers grew rapidly throughout the past year. That awareness will continue to pay dividends as estimates pin 85% of total surgeries being outpatient-setting surgeries by 2025. To reach that percentage of the market, procedures need to continue to migrate to ASCs. Complex spine procedures, total joints, and robotic procedures continue to make their way to outpatient centers. Cardiology surgeries are moving in this direction too. Only two percent of centers include cardiology, but their number is growing, as evidenced by this new physician-owned cardiology center expansion in Ft. Myers, Florida.
Creative Conversions
Most of us did not see this coming. The events of the past year have accelerated available buildings and the potential to convert them into something newly useful. Surgery centers are taking advantage of these opportunities. Who would have thought a day care, a church, or a bar and grill would become a surgery center? Sparrow Hospital in Lansing, MI has closed its children’s day care center and is converting that space into an outpatient surgery center. Work is progressing on converting a church building in Port Huron, MI into a state of the art neurology/spine care clinic and surgery center. In Orchard Park, NY, an ophthalmology surgery center is being developed from a former restaurant. Becker’s ASC reports on twelve surgery centers adapting retail spaces to ASCs over the past year.
Healthcare Industry/Trends
Orthopaedic Construction Boom
Orthopaedic practices are experiencing a construction boom across the country. Some of the boom is due to growth of physician-owned practices and surgery centers such as this new facility in Wausau, Wisconsin. Some orthopaedic groups, like this one in Tampa Bay, Florida, are collaborating with ASC management companies to foster their growth. Hospitals have seen the evaporation of a good deal their traditional inpatient care and are constructing orthopaedic practices and ASCs, sometimes in partnership and sometimes on their own, as is the case with the expansion of this center in California’s Coachella Valley.
Insurers’ Profits Soar, Invite Inquiry
Many large and small healthcare insurers saw profits soar following a booming 2020 in which the number of elective procedures and attendant claims dropped. Even ACA insurers benefitted by overestimating costs and lowering rebates to policyholders. 2021 and 2022 are not likely to repeat these profit levels for insurers. The Blue Cross Blue Shield Association is implementing aspects of an eight-year antitrust battle that ended in a settlement with customers last September. The 2020 health insurance profit boom is causing wide anti competition concerns and inviting federal government scrutiny.
Healthcare Digital Transformation Watch
Healthcare and Big Tech
Patients are coming to expect the level of customer experience in their healthcare that they have in their regular online retail purchases. Large and small tech players used the past year as an opportunity to grow their offerings in healthcare. Digital health startups are taking off and their customers, like many of us, are a little overwhelmed. Technology partnerships in the healthcare space are multiplying. AXA and Microsoft are rolling out a new digital healthcare platform, starting in Europe. K Health, Blackstone Growth, and Anthem are launching a new digital-first healthcare model to employer and consumer markets. Best Buy Health is teaming with Apple Watch to offer new health and safety services.
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
Kaiser Just Laid off Hundreds with More Job Cuts Coming
One of Many Hospitals Dealing with Market Changes
UVA Health System to Curb Decades of Hounding Patients
Sees the Need to Take a Softer Approach to Patient Portion
Nurses Give EHR Usability an F
Electronic Health Record Systems Continue to Receive Bad Marks from Users
Advent Health Becomes Disney World’s Official Healthcare Provider
Furthers Commitment to Guest Wellness Too
Small County Career Center Provides Health Care Training
Gives Students Annual Opportunities to Explore Medicine
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