ASC Impending Death of Hospitals

What Do You Call a Hospital with Irrelevant ORs Other Than “Bankrupt”?

August 17, 2020

Evolutionary psychologists say that the reason we see a stick on the trail ahead of us as a snake is that it’s far better for our survival to see sticks as snakes than snakes as sticks.

This and other biases cause us to more readily focus on the relatively immediate threat as opposed to the long-term one.

So, when earlier this month CMS released its various proposed 2021 payment schedules, physicians quickly focused on what’s in it (or, rather, out of it) for them, that is, for their specialty.

But at the same time, a focus outside one’s own immediate specialty reveals other trends, ones that may have a longer term but more significant impact on your career.

As anyone who’s been reading my posts and articles (and my book, The Impending Death of Hospitals, available here for download) over the past six or so years knows that the trend of shifting procedures from the hospital setting, including from the hospital outpatient department setting, to the ASC setting is of tsunamic proportions.

In accordance with that trend, CMS’s August proposed payment pronouncements have hundreds of procedures moving to the ASC setting. For example, they propose moving more than 266 orthopedic procedures from the inpatient-only list, which means soon to be done in an ASC.

Even more revealing is that CMS is proposing to eliminate the inpatient-only list in its entirety over the next 3 years.

Shh . . . hang on for second. Can you hear that? Yes, it’s the American Hospital Association screaming.

In the long run, for those physicians performing facility-based services, such as anesthesiologists, these very strong continuing signals, in fact, stronger signals than in the past, are clear signs that unless your business model takes into account the fact that hospitals as we know them will soon no longer exist, your business might soon no longer exist.

And, on the flip side, those physicians who understand that competing with hospitals on the facility-side is becoming easier and easier, it’s time to consider ASC development.

Either way, let’s talk.

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