What Will Your Facility Look Like in 10 Years?

Accountant. Entrepreneur. Healthcare consultant. Soothsayer? The multifaceted Mike Guarino channeled his inner Carnac to give attendees an entertaining and informative view of what might drive the surgical industry a decade from now.

To prepare for the future, independent-minded facilities must honestly assess the current regulatory and reimbursement landscapes, said Mr. Guarino. Physician-owned ASCs and jointly-owned surgery centers under the umbrella of large hospital systems face the same challenge: Planning for success in an ever-changing healthcare environment that includes market consolidation and stagnant payments.

Physician-owned surgery center reimbursements have slipped from 86% to 56% of what hospitals earn for hosting the same procedures because ASC leaders "didn't speak up, didn't have enough people fighting," said Mr. Guarino, a board member of the Ambulatory Surgery Center Association.

He explained that the ASC industry has leveled off, making hospital-led market consolidations a growing trend. The independent physician-owner is becoming less common as more docs are opting for the relative financial security of hospital employment. He believes Accountable Care Organizations ultimately won't take shape and fee-for-service requirements will fizzle out.

So what will your facility look like 10 years from now? Ultimately, said Mr. Guarino, that's up to you. He asked surgery center leaders to back the ASC Quality and Access Act of 2011, which was introduced into Congress to close the gap between payments made to surgery centers and HOPDs for identical procedures, require CMS to implement a voluntary reporting system for quality care measures by 2013 and develop a value-based purchasing program for surgery centers by 2015.

Look for a new physician-partner each month, suggested Mr. Guarino. Consider starting an independent physician association to partner with surgeons in your marketplace. Benchmark against local surgery centers and hospitals, physician offices and your facility's past performance. Fight back against aggressive third-party payor tactics.

In the end, Mr. Guarino dared you to walk through risk and to fixate on financial goals achievable through collective reasoning. Gather data, study it, report it and, above all, act on it. Now. "The answer is inside you and your team," he said. "Either you're at the table or you're on the menu."

— Dan Cook