A growing number of health systems are forging joint venture partnerships to develop, acquire or partner with ambulatory surgery centers as more complex care continues to migrate from inpatient to outpatient settings.
Cincinnati-based Bon Secours Mercy Health System, a 48-hospital Catholic system, recently partnered with Compass Surgical Partners to develop more than 30 ASCs across multiple states.
Compass has developed more than 250 ASCs over the last three decades, and is working with Bon Secours Mercy Health to build ASCs across the health system's footprint, which includes Kentucky, Ohio, South Carolina, Virginia, Maryland, New York and Florida. The network could also expand into other states, such as North Carolina.
David Cannady, chief strategy officer of Bon Secours Mercy Health, spoke to Becker's about the importance of developing a strong ASC footprint, finding a partner with expertise in the ASC environment and shared advice for other systems looking to expand outpatient.
Editor's note: Responses were lightly edited for length and clarity.
Question: What challenges do you anticipate in developing more than 30 ASCs across multiple states, and how does the partnership with Compass Surgical address these challenges?
David Cannady: We look forward to expanding access to care through a robust ASC strategy. We are focused on ensuring we have proper pacing and prioritization of projects that allow us to scale efficiently. We are also committed to developing solid physician partnerships and securing managed care contracts. Compass brings significant experience and expertise in each of these areas, and we are already seeing the value of our partnership in accelerating our ambulatory footprint.
Q: How will the shift of more complex procedures from hospitals to ASCs affect the operational dynamics and financial sustainability of Bon Secours Mercy Health's hospitals?
DC: The shift to ASCs has been underway for some time. There are many patient benefits to having surgery at an ASC — they can provide a convenient location and a more personal experience, as well as a lower cost of care and lower infection rates.
While we want our surgery centers to thrive, it is imperative to consider the financial viability of the centers, as well as the reimbursement rates provided by payers. As a health system, we must work to expand access to care to help ensure we have new ways to align with physicians and identify continued revenue and volume sources.
Q: How does Bon Secours Mercy Health plan to integrate the new ASCs into its existing healthcare services and patient care continuum?
DC: In addition to our partnership with Compass, we are adding internal expertise to work with both our hospital operators and Compass. These teammates will help to identify service lines and procedures for which the migration to ambulatory makes clinical, operational and financial sense. We will also work with our population health and case management teams to assist patients through the care continuum following their ASC experience.
Q. What do you expect the inpatient environment will look like 10 years from now as outpatient migration accelerates?
DC: We anticipate that there will be continued demand for inpatient services. While the number of patients may decline, we expect that the average daily census will be the same or even grow. This will be attributed to a number of factors including an aging and growing population, as well as a mix of higher acuity inpatients with complex medical needs and longer lengths of stay.
Q: What advice do you have for health systems that have limited outpatient footprints or are in the early stages of their outpatient expansion?
DC: Speed to market is critical. Each system will need to weigh build, buy or partner options to find the necessary talent and systems. Health systems will also have to determine the best course of action to retain volumes in their networks while — at the same time — identifying opportunities that will increase ambulatory share and attract new physicians.