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As the Affordable Care Act rolls out, and businesses pass more of the cost on to employees through higher deductibles and premiums, more patients are shouldering a bigger portion of the cost for surgery. The pressure is on to get that cost down.
Ambulatory surgical centers (ASCs) position themselves as cost-effective and convenient alternatives to traditional hospitals offering cost relief to both patients and the health care system without sacrificing the quality of surgical care.
“As patients take more responsibility for their health care, they need to know that they have an opportunity to utilize ASCs and the benefits they provide,” said California Ambulatory Surgery Association Executive Director Elizabeth LaBouyer.
According to LaBouyer, the benefits include cost savings, convenience and high quality medical treatment.
“It’s such a great experience for the patient. It’s smaller. It’s not a big institution, and they see the latest technology,” she said. “They see the same quality of excellent care, nursing, equipment, the infection prevention practices. They’re very satisfied with a great outcome.”
Ambulatory surgical centers provide outpatient non-emergency procedures, allowing physicians to perform surgery and discharge patients to return home the same day.
The formula has already proven to be cost-effective with Medicare patients.
“ASCs have saved the Medicare program and its beneficiaries about $7 and a half million for the four-year period 2008 through 2011,” said LaBouyer. “If you look over the next decade ASCs will save the Medicare program an additional $32 and a half billion.”
With the influx of 4 million previously uninsured Californians as a result of the Affordable Care Act, ASCs will become an increasingly cost-effective contributor within the system, according to LaBouyer.
Physicians associated with ambulatory surgical centers also believe demand for ASC services will grow.
“The trend is to minimize the use of hospitals. In hospital intensive care units, patients go in for major types of heart surgery, brain surgery and those kinds of things. But everything else can be done in an ambulatory setting,” said Dr. Sam Romeo, president and CEO of Tower Health and Wellness Center in Turlock. “If you can do it in ambulatory surgery, you’re in, you’re efficient, with the idea being to fix you and get you home. That gets about three quarters of the cost down.”
Tower Health and Wellness Center houses the Tower Surgery Center opened in 2005. It is a multi-surgery facility where privileged physicians perform procedures across a broad spectrum of medical specialties including ear, nose and throat; gynecology; plastic surgery; dental; orthopedics; gastrointestinal; and pain management.
The 10,000-square-foot surgery center has two operating rooms in which 9,966 patients have been treated since 2009. On average, Tower Surgery Center performs 1,568 procedures a year.
The idea behind the Tower Health and Wellness Center is to maintain multiple aspects of health care provision under one roof. The goal is to keep people well and thereby reduce health care costs.
“Part of the concept is what can you do to facilitate the perception of medicine?” said Romeo. “We can no longer afford to take care of sick people if we don’t think about prevention and wellness and lifestyle.”
Stanislaus Surgical Hospital (SSH) in Modesto also offers a wide range of non-emergency surgical procedures including orthopedic, ophthalmology, pain management, neurosurgery, urology, cosmetic, and gastrointestinal.
The hospital has 23 inpatient beds, but 85 percent of procedures are performed on an outpatient basis. SSH also operates three other facilities including Precision Imaging, a pain management center and a hyperbolic oxygen program, all in Modesto.
“It’s easy for us to schedule. We can do things very timely because we control probably more things than a larger hospital that has trauma, emergency room services and things like that,” said SSH President and CEO Doug Johnson.
That efficiency, along with rising health care costs, will continue to attract more patients to ambulatory surgery centers, Johnson believes.
“There’s no question in my mind as the cost of health care becomes higher and companies make decisions on how much they are going to pay, how much they are going to participate, there’s going to be an increase cost to the patients because of that,” Johnson said.
The Stanislaus Surgical Hospital has been working with patients to deal with that trend by offering payment plans and credit to finance medical care.
Alongside cost concerns, patients value the convenience and low infection rates ASCs offer.
“If you’re staying in the hospital, there’s more likely a chance that you’re going to end up with an infection. In a surgery center, you’re not long enough here (so) the chances of infection are cut down,” said Tower Surgery Center manager Sandip Singh, noting that patients are often discharged three to four hours after arriving.
Perhaps most important to patients who have just had surgery when they get to go home. On average, time in recovery at Tower Surgical Center is only one hour and 46 minutes.
“We don’t say that patients have to go,” said Romeo. “The patients want to go.”