For about 20 years, we have operated an ambulatory surgery center (ASC) as part of our practice. And during those two decades, the ASC has been the most profitable part of our business. In fact, it was almost impossible for the ASC not to be profitable if we did a reasonable amount of surgery. For a long time, it didn’t seem to matter how closely we managed expenses, everything just seemed to work. Well, things have changed and, sadly, those days are long gone.
Running a profitable ASC in 2024 is far different than it used to be. Economically, there are some good things, some bad things, and some ugly things that ASC owners need to understand. The good news is, ASCs have been able to enjoy increased reimbursement for surgical fees year over year, as opposed to the steady decline in reimbursement occurring each year on the physician side. OOSS has played a significant role in these positive fee adjustments, and continues to lobby hard on our behalf.
The bad news is that high inflation is quickly neutralizing these facility fee increases. The manager at my practice’s ASC is currently recalculating our cost per case for cataract surgery for this year. Although a few line-item costs are unchanged, most are up between 15 percent and 30 percent. With facility reimbursement increases being around 3 percent on average, you can see how those revenue and expense curves are diverging sharply.
Where things get ugly is when we look at the cost of personnel. Staffing ASC’s has always been the largest single line item for cost. Since 2019, those costs have skyrocketed. Reimbursement rates are not even close to covering these cost increases. The only way to make up this gap, it seems, is to increase volume—and that isn’t as easy as it once was.
Things are not all doom and gloom, though. Our ASC still generates a reasonable return. We just have to manage costs as carefully as possible now. No more “build it, open it, and it can’t miss.” Fortunately, you have help. OOSS is there to support ASC owners and administrators in every capacity, and this issue of The Ophthalmic ASC is loaded with good advice to help you get closer to management perfection. So, turn the page and get started. OASC
