Ambulatory surgery center ownership models

Abstract

Outpatient spine surgery performed in ambulatory surgery centers (ASCs) has grown dramatically over the last decade because of significant clinical and economic advantages to patients, physicians and the health care industry. Physicians benefit from the efficiencies of the outpatient setting and potential profit from ownership. There are various ownership models which differ primarily on the amount of ownership attributed to physicians, management companies and hospital systems, the key players in the space. The majority of ASCs are still solely owned by physicians, which gives physicians the benefit of maximum control but brings the challenges of management and contracting as well. Joint ventures involving various combinations of physicians, ASC management companies and hospital systems strive to find a balance between physician influence and management expertise from their partners. ASCs owned solely by hospital systems are on the rise and seek to involve physicians in a co-management role. Overall, the ASC market will continue to grow and alternative business models will arise as the key players look for the right combination to maximize efficiency and clinical success.

Keywords: Ambulatory surgery center (ASCs); economics; ownership models; physician ownership.

Figure 1

Shift towards outpatient surgery over time.

Figure 2

ASCs have increased over time. ASCs, ambulatory surgery centers.

Figure 3

Shift towards outpatient spine surgery over time.

Figure 4

Decreased cost to patient in the ASC setting. ASC, ambulatory surgery center.

Figure 5

The gap between ASC and HOPD payments has increased over time. ASC, ambulatory surgery center; HOPD, hospital outpatient department.

Figure 6

Physician ownership in ASCs makes up the majority. ASC, ambulatory surgery center.