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Hello. This is Francesca Matthews with the Becker's
ASC review podcast.
I'm thrilled to be joined today by Mark
Mayo, CASC,
the administrator of Associated Surgical Center. Mark, thank
you so much for being here today.
Good morning. I'm good. Awesome. Great. So just
to start us off, could you please introduce
yourself and tell us a little bit about
your background?
I've been involved in,
surgery centers for a long time. I actually
helped a group of doctors,
create
a truly
fifty fifty joint venture
surgery center with a hospital in 1984,
and
it's still working
that way. And then I went on to
work with about 10 other surgery centers since
then. You're truly a pioneer there?
No. There were a lot of people before
me. So I I we always,
build on top of that.
I have the privilege of serving on,
two national surgery center association,
boards,
one that
merged with a group called FAFSA to become
the
ASCA,
and the other one was the board of,
the CAS credential.
I,
helped,
edit
the a a national,
ASC newsletter
and
helped develop,
a state surgery center association.
I've been involved with,
Associated Surgical Center,
since before we opened in 02/2016.
They're located in Arlington Heights, Illinois,
and have been working with them since, and
we're now focused on preparing for reaccreditation.
K. Excellent. Thank you for for the little
summary of, your breadth of experience there.
Given all of that, what are the top
three trends you're following in health care and
ASCs today?
I I think the the the the first
one is is pretty common to everybody, and
that's the
pressure
of,
revenue versus
our increase in inflationary
costs
and how do we keep up with that.
Particularly for a center like ours that's now
involved in orthopedics,
it's
a careful control of implant costs.
I think the third one would be a
better awareness.
This is a positive one, better awareness of
the value
and the
positive,
patient experience for surgery centers.
Some of that came out of the, COVID
nineteen
issues a few years ago, and surgery centers
have certainly become recognized,
as part of
a health care system
as as opposed to fighting our way in
the door.
Mhmm.
And what are you most excited about right
now?
The the the thing that excites me the
most is the possibility
for some type of cooperative networking,
that needs to be explored
among the some of the 70%
of, surgery centers that are still physician owned.
I I believe there's,
inroads that can be made,
without
those independent surgery centers selling to
hospital joint ventures or,
becoming part of a national surgery center management
company.
Yeah. And and that definitely echoes,
some things I've been hearing about just kind
of in my reporting here at Becker's. And
I think that folks in the industry are
starting to get a little bit more creative
with,
how, you know, physician owned facilities can sort
of align themselves,
in order to maintain that independence,
but, you know, kind of move forward in
the industry and adapt as well.
There's a there's a
an independent
streak,
despite
the twenty years that that
we
we always talk about a trend of
joint venturing or or affiliating with a management
company.
While those management companies have grown,
the numbers are still approximately
the same.
You know,
25%
of all surgery centers are
are point centered in in some manner,
but 75%
of those centers still remain independent physician owned.
Fueling that, I think, is gonna be,
we now have groups of younger physicians
who
went to the employment model at a hospital,
and
they're now maturing
and finding out that,
there there's,
there's some benefit
to being more independent from the hospital,
as as they they grow their practice and
and their ability to
perform surgery in an outpatient setting.
And if the hospital's not providing
that opportunity
for them in a joint venture,
some of these physicians are gonna start to
migrate back to the independent surgery centers.
Absolutely. Yeah. But, again, just definitely
falls in line with things I've been seeing
here at Becker's.
And how are you thinking about growth over
the next twelve months?
Growth over the next twelve months and over
the next few years is is, I think,
gonna be, pretty significant.
There are several factors that have come into
play.
One is the one that we just talked
about, and and that's the recognition of surgery
centers as a part of the health care
system.
Again, part of that grew out of the
experience of surgery centers being able to be
more flexible than the hospitals were during the
the COVID shutdown period.
Two, hospitals are starting to recognize that certain
cases,
if they move out of the main OR,
even at a lower reimbursement
rate, allows the hospital to
fill that, scheduling
space with, more acute cases,
either,
inpatient
added surgeries
or,
elective cases that are are are larger
orthopedic, cardiac,
neuro, cases.
So they see some benefit to
allowing cases, and it it's no longer a
competitive
environment, and the ASCs are no longer accused
of cherry picking,
the easy cases to to, you know, to
take from the hospital.
There's a collaborative
atmosphere now
that recognizes
the value of of surgery centers. And, certainly,
the the numbers are showing that the shift
to
outpatient surgery
is gonna continue.
The growth of surgery centers, I'm seeing,
you know, more
individual
surgery centers being created.
So there's growth opportunity there.
The growth opportunity
per surgery center is pretty much dependent, I
think, on geography
and
the age of your medical staff.
So
succession planning is is important to,
to realize when some of your physicians might
be retiring.
And and,
are they bringing junior partners along
that
that can replace them,
in volume? And
the the other part of it is that,
we're there's more public awareness of surgery centers.
Patients have
found that that that, you know, what we
advertise is what we deliver with. We have,
quality care, low infection rates,
patient centered care that,
the patients appreciate
the the opportunity. And,
it's easier to schedule cases at a surgery
center than it is to get elective cases,
particularly
orthopedic cases where where sometimes the the orthopod
is
is telling the patient that, you know, a
hospital case is maybe two months out from
now.
So those factors are all coming to
to play now in
growth
potential for for surgery centers.
Mhmm. Mhmm. Absolutely. I like the way you
kind of illustrated that there. There are, like,
a number of these sort of larger factors
playing into,
the future of every
individual center there. Anything else to add today
here, Mark?
It it depends on, again, on on each
center.
Two two things that are that are I
I hear constantly
that are important.
Keeping up on the regulatory
environment changes,
it could be state regulation. It could be
changes in Medicare.
It could be thinking about what Medicare is
looking at. For example,
cataract surgery is the number one procedure performed
in the country,
and we all know that reimbursement
rates have, have not changed very much in
in the last five years for
for cataract surgery. At at surgery centers, we
still have the site of service differential
that's
a tremendous factor,
but
Medicare
may be leading the way to move
cataract surgery
in particular
to the office space setting. And some surgery
centers are gonna have to adjust to that,
if if that
trend
and I know it's I I know they've
been exploring it, but if that trend continues,
then then people are gonna have to start
to rethink some other line of service.
Mhmm. So that's a that's a big issue.
Absolutely. Absolutely. And and, again, just totally echoes
things I'm I'm hearing here on our end.
So
all great insights.
That's actually all I have for you today,
Mark. Oh, do you have anything else to
add? The other part the other part that
I wanted to add to that is is
not a solicitous
plug for for Becker's ASC,
but people need to be plugged into,
networks where they can exchange information.
It's Becker's. It's AORN.
It's outpatient
surgery magazine.
It's,
all sorts of resources.
So somebody in your center needs to be
allowed
and given the time to
do some of that online. It it's so
much easier now that that that we can
clearly communicate online and exchange information.
But it's not just receiving the information. It's
taking it to your governing body,
and having a discussion with the doctors there
about
what the implications are of these changes.
And, also,
making sure that staff are aware so that
they understand what they're doing and why they're
doing it is more important.
And that pays off both in in,
the attitude of staff, but certainly when you
go through accreditation,
the more the staff
are informed and know,
the better they shine
when when a surveyor comes in and asks,
well, why are you doing this? Do you
do you understand
what's behind the what's the theory behind it?
So having having somebody that's, involved,
I think, is very important, and the resources
are certainly out there.
Most of them are free. Webinars
are all over the place, and and you
have to pick and choose, but I think
it's worth the time,
to spend to do that and to educate
ourselves.
Mhmm. Mhmm. I'm I'm really glad you added
that because I think that that's sort of,
you know again, not to not to bring
it back to us, but our belief here
at Becker's is that, you know, everybody can
do better work if we're all communicating more,
if people have access to that information. And
I can only see that making an even
even bigger difference,
as, you know, the industry progresses. So thank
you for adding that. Absolutely.
Okay. You're welcome.
Yeah.
And, yeah, again, just thank you so much
for joining us.
It has been a pleasure speaking with you,
and I look forward to connecting with you
again in the future.
Francisca, thank you again for doing this, and
have a good day. Yep. You too.