Independent surgery centers are in danger. That's the message Michael Guarino, a board member of the Ambulatory Surgery Center Association, says he'll relay to the nation's lawmakers on Sept. 9 when he testifies before the congressional Ways and Means Health Subcommittee.
"Mine will be a cautionary tale," says Mr. Guarino, an accountant by trade who owns, manages and advises surgery centers. "I am going to show them how changes in reimbursement are forcing independent surgery centers to look at other options, such as partnering with or selling to hospitals."
You'll be able to watch his testimony live, which is scheduled to begin at 9:30 a.m. Eastern time, via the House Ways and Means Committee's website.
Mr. Guarino will focus on consolidation in the U.S. healthcare marketplace and on the longstanding and widening disparity between what surgery centers and hospital outpatient departments are paid for performing the same procedures. (At present, ASC payments average only 57% of what HOPDs earn for the same procedures, down from 86% in 2004.)
Both of these factors, he says, have had unintended consequences - a slowdown of the migration of cases from HOPD settings to ASCs, and a slow but steady conversion of ASCs to hospital outpatient departments. "Is this the right move?" he asks. "Is hospital ownership helping or hurting the system?"
Hospital systems are trying to become monopolies, he says, using accountable care organizations (ACOs) as a means of excluding ASCs and employing more and more physicians. "There will be winners and losers in the next 5 years when it comes to healthcare players," he says.
Mr. Guarino is scheduled to discuss many of these issues live at Outpatient Surgery Magazine's OR Excellence conference next month in San Diego. There's still time to register for that education and networking opportunity.
Dan O'Connor
