Sometimes progress can feel erratic, like a dance consisting of two steps forward and then a giant step back, on and on again. Just when we are beginning to see the light at the end of the tunnel with vaccines and decreasing infection and hospitalization rates, we are again faced with rapidly rising numbers fueled by the delta variant and a lower-than-expected national vaccination rate. Some communities will likely face limitations on elective surgery as businesses, practices, and local governments tighten up policies to help slow the spread of COVID. And again, we are forced to pivot, adapt, and flex.

This past 1.5 years have been challenging for everyone. We have learned to come together as a profession and as a community. We have found ways to run a tighter ship and to keep things afloat.

In this issue, we will discuss how to monitor costs per case in the ASC (page 6) and how to use that information to determine which cases to grow, including elective, noncovered procedures, such as oculoplastics/aesthetics (see page 14 for more on integrating these services into your ASC), and which cases are better performed outside of an ASC due to cost. In our August 2021 issue, we presented an overview of the expanding IOL choices now available. This issue, we will review tips on how to increase the adoption of premium IOL technologies in your practice, ultimately increasing private-pay revenues (page 10). In times of decreasing reimbursement for surgical procedures, having varied sources of income, including private pay, can help mitigate the effects of capricious changes in CMS reimbursement.

Our sense of community has been tested at times, but we have found ways of helping each other. The article “Charitable Care” explores ways of integrating volunteer work into your ophthalmic ASC, both as a location to provide for local need and in support of remote care performed by physician owners. Tips on how to manage costs and pearls on the benefits of providing charitable care can be found on page 16.

As we face the coming storms, we will continue to grow and adapt, all while anticipating a time to come with calm waters, a gentle breeze, and full sails. ■