ASC Industry Awareness
ASCs on Track for Solid Growth
A plurality of ASC leaders in a recent Becker’s ASC Review survey believe they will see a greater than ten percent increase in revenue in 2021 over 2019. They largely attribute this same-center growth to the ability to expand outpatient surgical offerings due to the availability of more CMS-approved outpatient surgeries. For this reason as well as for lower infection rates and operational costs, spine surgeries are continuing their march toward ASCs. Cardiology procedures also are making a steady migration to ASCs. New centers are popping up as well. May was a very busy month for new center openings and announcements. Even Vermont is getting back in the ASC action, doubling the number of ASCs to two.
Growth Is Great but Doesn’t Eliminate All Issues
Rising tides may lift all boats, but unfortunately, they do not remove all difficulties. ASC executives are still obsessed with staffing shortages, post-Covid-19 policies and processes, robotics, and insurer behavior, among other things. High deductible plans are continuing to change ASC patient behavior, which is not all bad, because it makes for insurance-savvy patients. There are the usual ‘big” threats to physician ownership: big insurance, big hospitals, and big government. In addition, in some states there remains the smaller threat of certificate of need issuance denials.
Healthcare Industry/Trends
What Has the Pandemic Done to Healthcare?
Physician compensation was steady and even grew a little for these six specialties during 2020. Revenue is up for many medical equipment and medtech companies as elective surgeries make a comeback. Over four in ten adults went without some form of medical care by mid-pandemic. This has led to reports that hospitals in particular may have previously overused elective procedures before the pandemic. The pandemic certainly exacerbated an already growing healthcare worker shortage. Many hospitals that were feeling some pain before the pandemic are really struggling now, as seen in six hospitals that have recently laid off staff.
Why the Health Insurance Boom?
Large health insurers had an excellent financial year in 2020 as people and companies paid for benefits they would not be able to use fully. These insurers pointed to 2021 as a year of reckoning for the boom of 2020. So far, that reckoning has not taken place and 2021 is shaping up as another big boom year for big insurance. The reason is in the math. Collect normal or growing premiums while no great surge in service materializes. That equals big profits. Anthem added 1.4 million new members and so, raised profits. United Healthcare kicked off its Q1 earnings season with a 44% jump in profit with membership and their Optum division acting as the main drivers. BCBS’s growth and a state tax break will enable them to add 700 full-time jobs in Columbia, SC.
Healthcare Digital Transformation Watch
Tech and Healthcare Partnerships
Technology companies are turning their attention to healthcare, forming significant partnerships that drive new capabilities and offerings in the healthcare sector. Google has landed a deal with HCA Healthcare to develop healthcare algorithms utilizing patient records. Epic and Anthem are collaborating on a two-way data exchange to streamline prior authorizations and administrative process pain points. Microsoft and Accenture are collaborating with Kaiser Permanente to enable it to build a better cloud environment that will ultimately improve the consumer and provider experience.
Legal
Test Case for the Legality of Employer Vaccine Mandates at Houston Methodist Hospital
From the office of Jon Sistare, JD, Attorney at Law
On Saturday, federal court judge, Lynn Nettleton Hughes, dismissed a lawsuit filed by 117 staffers at Houston Methodist over the hospital system’s coronavirus vaccine requirement for employees. A small fraction of employees refused, and more than 170 employees had been suspended as a result.
The complaint, filed last month, argued that the mandate is unlawful and forces “employees to be human ‘guinea pigs’ as a condition for continued employment.”
In this ruling, the federal judge said the lawsuit’s claim that the vaccines are experimental and dangerous “is false, and it is also irrelevant.” The hospital system’s requirement does not violate state or federal law or public policy, he wrote.
“Methodist is trying to do their business of saving lives without giving them the Covid-19 virus,” Hughes wrote. “It is a choice made to keep staff, patients and their families safer. [The employees] can freely choose to accept or refuse a Covid-19 vaccine; however, if she refuses, she will simply need to work somewhere else.”
The lawsuit’s dismissal appears to be one of the first rulings over an issue that has sparked contentious debate across the country as the economy opens up and more people return to school and work. Legal experts expect further litigation as some business, hospitals and universities begin requiring vaccination.
Valerie Gutmann Koch, co-director of the University of Houston’s Health Law & Policy Institute, called the decision “another step in demonstrating the legality of these mandates, particularly in a health crisis like this.”
The inoculations are seen as key to a return to normalcy, yet most employers have shied away from mandating them, concerned about the thorny politics and previously untested legal issues. Colleges and universities, along with Houston Methodist and a handful of other health-care institutions, are the exception.
Koch said the ruling shows “employer mandates of the Covid-19 vaccine, particularly in the health care arena, are absolutely legal.”
Word to the wise – expect more employers to require the vaccines as a condition of work based upon this ruling, and less opposition to the vaccine.
At a Glance
American Rescue Plan Increases ASC Investment
Feds Recognize ASC Role in Healthcare Cost Reduction
Employers Push Hospital and ASC Quality Measures
Want Providers to Participate in the 2021 Leapfrog Surveys
Walmart to Open 4,000 Supercenters with Clinical Lab Services
Making Significant National Healthcare Move by 2029
California Anesthesiologist/Surfer Undergoes Spine Surgery
Tells the Tale from an Insider’s Perspective
Hospitals and Physicians Urge UHC to Rescind ER Policy
Policy Harms Patients through Retroactive Denials
To subscribe or unsubscribe to ASCs in Motion, simply send an email request to levans@contegollc.com.
To inquire about Contego’s expert reimbursement solutions:
Call 855.505.8346 x1245 or Email info@contegollc.com
Contego Solutions, LLC
https://contegollc.com
https://www.linkedin.com/company/contego-solutions-llc/