“Change is the only constant in life.” As healthcare rapidly evolves, these words of an ancient Greek philosopher continue to ring true. Regent CEO Chris Bishop recently took time to reflect on how the changing industry environment is helping ambulatory surgery centers (ASCs) thrive. He shared two trends he expects will impact the future.
Hospital as Insurers
“One trend we anticipate will continue to grow in prominence is health systems becoming payers,” Bishop says. “Five years ago, this wasn’t the case, but a lot of the major health systems have now begun to invest in, create, and acquire insurance plans. The other major trend is health systems assuming shared risk with the payers, and therefore, focused on improving value. In the future, understanding the payers in your community and particularly payers that are owned and controlled by health systems will be an important part of how ASC leaders view the market.”
Bishop says this trend especially impacts ASCs not currently aligned with a hospital, requiring that they look at the number of lives covered by the hospital’s own insurance plan and weigh potential conflicts when considering a hospital partner.
“In the past, we didn’t factor that into our decision tree when we were selecting hospital partners to join us as partners in our centers,” Bishop explains. “Now you have to be thoughtful about which health system you ask to invest because while you may invite one health system that brings covered lives that you couldn’t currently treat, you could stand to lose another contracted health system’s covered lives.”
While the word “retail” traditionally had a negative connotation in healthcare, the transition toward health savings accounts and high-deductible plans is making patients more open to the benefits of retail medicine and is prompting providers to see patients as discerning consumers who will shop around.
“Patients are asking their physicians for the most cost-effective setting,” says Bishop. “That was rare five years ago, but now that a patient could pay as much as $10,000 of their deductible, cost is a greater consideration. If a routine colonoscopy costs $3,000 at the hospital but just $1,000 at a surgery center, that’s an easy choice.”
Bishop also cites employer-owned health plans at companies like Apple, Amazon, and Walmart as a stimulus for the retail medicine trend, because they provide employees incentive to opt for a lower cost, higher quality setting for surgical procedures.
For information on trends in healthcare, contact Thomas Crossen.