Filling a Healthcare Need: How Ambulatory Surgery Centers are Poised for Continued Growth

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By Jeff Snodgrass, President and Chief Executive Officer of AMSURG

As healthcare costs continue to rise in the U.S., addressing the drivers of unnecessary costs while improving the quality of care for patients is crucial. Ambulatory surgery centers (ASCs), which offer outpatient surgery services, are increasingly appealing options for physicians and patients. ASCs deliver outstanding patient outcomes from a growing list of surgical procedures while offering lower costs for patients and payers, including the federal government.

ASCs are tackling some of healthcare’s most significant challenges in major ways.

Reducing Costs for Patients and Payers

More than 80 percent of surgeries are now performed in an outpatient setting, according to the Ambulatory Surgery Center Association (ASCA). ASCs are highly regulated, freestanding medical facilities that offer high-quality, high-value, same-day preventive services and surgical procedures focusing on patient experience.

For patients and procedures that qualify, a procedure performed at an ASC is a viable, cost-saving option. By choosing an ASC, patients’ out-of-pocket costs may be significantly lower for some procedures, as they don’t incur the higher fees associated with a hospital setting. Instead, the patient is discharged from the facility the same day as the procedure to safely recover at home.

For example, compare three popular procedures’ costs using a national average at an ASC vs. a hospital outpatient department (HOPD) based on data:

ASCA reports that non-Medicare patients choosing ASCs for procedures create $42.2 billion in annual savings in healthcare spending. Medicare patients being cared for in an ASC setting resulted in $4 billion in annual Medicare savings.

Technology is a Driver for ASCs

New advanced technology and techniques have made outpatient surgery safer, more comfortable, and more cost-effective overall.

Physicians at ASCs have added minimally invasive, robotics-assisted joint replacement systems at some ASCs. Advantages to undergoing this procedure include a reduced risk of infection and complications and less pain after surgery, reducing the need for pain medication. Patients experience faster recovery times, translating to quicker return to their daily routine.

Tristan A. Altbuch, MD, an AMSURG partner physician, performs robotics-assisted joint replacements at The Orthopedic Surgery Center of Gainesville in Florida. He said procedures at ASCs benefit patients and their recovery.

“Ambulatory surgery centers are designed for rapid recovery,” Dr. Altbuch said. “They’re designed for patients to easily transition from the pre-operative area to the surgical suite, to the post-operative area, to home, and they are experts at it. At our facility, we have an expert team of nurses, anesthesiologists, surgical techs, and recovery room nurses to help our patients get through this process seamlessly.”

In addition, some ASCs are integrating state-of-the-art technology using Artificial Intelligence in colon cancer screenings. This tool improves the findings of a colonoscopy by assisting our doctors in identifying polyps that can lead to colon cancer. The system also provides real-time analysis to enhance the Adenoma Detection Rate.

Doctors remove precancerous polyps during the same procedure, reducing the risk of cancer development, minimizing the need for subsequent procedures, and empowering patients to receive timely interventions, leading to improved long-term survival rates.

The future is bright for ASCs as we work to address patients’ and physicians’ needs while lowering the cost curve for healthcare spending in the U.S.

Jeff Snodgrass is President and CEO of AMSURG, an independent leader in ambulatory surgery center services. The company operates a network of approximately 250 surgery centers nationwide.

 

[1] “Procedure Price Lookup for Outpatient Services.” Medicare, medicare.gov, https://www.medicare.gov/procedure-price-lookup/cost/29873. Accessed 28 June 2024.

[2] “Charted: How the cost of 6 common procedures varies by setting.” Advisory Board, 18 September 2023, https://www.advisory.com/daily-briefing/2023/09/18/procedure-costs. Accessed 28 June 2024.

[3] “Charted: How the cost of 6 common procedures varies by setting.” Advisory Board, 18 September 2023, https://www.advisory.com/daily-briefing/2023/09/18/procedure-costs. Accessed 28 June 2024.

Candid Conversations: Colorectal Cancer Awareness With Jeff Snodgrass

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In this Candid Conversations episode, Jeff Snodgrass, President of AMSURG, talks about colorectal cancer (CRC) awareness and all that our teams do to save people’s lives. As a leading provider of colonoscopies (our teams provided more than 1 million colonoscopies in 2022), AMSURG helps patients prevent and detect CRC. We are uniquely positioned to continue contributing to research, education and advocacy that advances screening practices and the health of communities. Take it from us — timely colonoscopies are important in maintaining your health, and the colonoscopy process isn’t all that bad.


As we recognize Colorectal Cancer Awareness Month this March, here are some key facts to know and share with family and friends:

  • CRC is the second leading cause of cancer death in the U.S.
  • CRC is one of the most preventable cancers
  • More people are being diagnosed with CRC at a younger age
  • People at average risk for CRC should receive their first screening colonoscopy at age 45 instead of 50, which was the previous recommendation
  • Those with a family history of CRC are at a greater risk of developing CRC and should be screened earlier and more frequently
  • A colonoscopy is the most accurate and effective screening method, as a physician can remove a polyp before it becomes cancerous and can detect and sometimes remove cancerous polyps
  • The sooner CRC is detected, the more opportunity someone has to survive
  • To learn more about CRC prevention and where to receive a colonoscopy, visit StopColonCancerNow.com

About Candid Conversations
The video series features Envision teammates in endearing and curiosity-fueled interviews. We share stories about our lives and work caring for our communities. We also learn about the qualities that make us unique and find common ground on the ones that make us all human. While these videos are snapshots of our interactions, I hope they bring us closer together and inspire you to create similar meaningful moments with your teams.

Look for more videos here and engage with teammates.

White Paper: Social Determinants of Health

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Envision is committed to establishing best practices, implementing innovative approaches to care and advocating for reforms that will help attain the highest level of health for all people. As part of its efforts to improve health equity, the medical group released a new white paper examining social determinants of health and how clinicians and healthcare professionals can work together to address the social, cultural, economic and political factors that help or hinder individuals’ health.

Read the white paper here.

Envision Healthcare’s Inaugural Clinical Impact Report Details High-Quality Patient Care Initiatives

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NASHVILLE, Tenn. — Envision Healthcare, a leading national medical group, today released its 2021 Clinical Impact Report, highlighting its impact on patients’ lives and communities across the country last year. The full report is available at EnvisionHealth.com/Impact-Report.

“In 2021, we remained on the frontlines for patients, exceeding national care quality benchmarks and implementing new programs that improve patients’ access to the right care at the right time,” said Jim Rechtin, Chief Executive Officer of Envision Healthcare. “We also made strides in enhancing our Diversity, Equity and Inclusion and Clinician Wellness programs. While there is no way to measure the true impact the Envision team has had on the millions of people we serve, this inaugural report provides a snapshot of the many ways we make a difference.”

Envision’s 2021 Clinical Impact Report demonstrates how Envision is providing care when and where it’s needed most. Last year, the Envision team rose to the many unique demands for care and drove positive changes within the U.S. healthcare system. Grounded in its commitment to delivering high-quality, patient-centered care, the team continued combating the COVID-19 pandemic, responded to natural disasters and humanitarian crises and advanced innovative care approaches.

Envision remains focused on elevating the voices of clinicians and patients and championing solutions that improve the healthcare system for everyone. As the medical group moves forward in 2022, it will continue protecting the patient-clinician relationship, caring deeply for everyone and centering its actions on advancing the delivery of safe, quality care.

Making a Positive Impact
From providing lifesaving care to preventing colon cancer to welcoming newborns into the world, Envision is uniquely positioned to have a positive impact on millions of people in the U.S. In 2021, Envision’s 30,000 clinical and clinical support teammates and 4,000 ambulatory surgery center physician partners cared for America through millions of visits, including:

  • 30 million patient encounters
  • 16 million emergency department visits
  • 9 million radiology reads
  • 6 million anesthesia cases
  • 900,000 colonoscopies
  • 180,000 cataract surgeries
  • 132,000 newborn deliveries supported

Caring for Communities
Throughout the COVID-19 pandemic, the medical group has helped lead the nation’s COVID-19 response, caring for patients and working to mitigate the spread of the virus. More than 500 Envision clinicians have traveled to hard-hit communities to provide lifesaving care and relief since the beginning of the pandemic. In 2021, Envision clinicians treated more than 3.4 million COVID-19 patients through emergency department and inpatient visits, including in the intensive care unit. Clinicians also administered COVID-19 tests and vaccines to first responders and community members. Envision continues to educate the public about the importance of getting vaccinated, leading by example through its commitment to having a fully vaccinated team.

Through its disaster response program and years of expertise responding to crises, Envision teams are helping community members navigate some of the nation’s most challenging times. In 2021, Envision clinicians cared for more than 5,000 Afghan refugees for five months until they were resettled and had the resources needed to begin their new lives in the U.S. Teammates also supported communities during the deep freeze in Texas, Hurricane Ida in Louisiana, the tornadoes in the Midwest and the Marshall Fire in Colorado.

Providing Safe, High-Quality, Patient-Centered Care
Through Envision’s commitment to a culture of safety, clinicians are continuously evaluating clinical protocols and developing best practices to enhance patient outcomes and satisfaction. Envision operates one of 94 Patient Safety Organizations listed by the Agency for Healthcare Research and Quality, a U.S. Department of Health and Human Services division, which helps improve the quality and safety of patient care. Through the Physicians Quality Registry, a Qualified Clinical Data Registry approved by the Centers for Medicare & Medicaid Services, Envision is one of the largest submitters of performance data to Medicare and is helping define the quality of care nationally.

Last year, Envision clinicians developed one new Merit-Based Incentive Payment System measure. Clinicians also exceeded several national quality benchmarks, including measures regarding sepsis, non-opioid pain therapy and the care of babies born weighing less than 1,500 grams.

Empowering Teammates to Thrive
Envision is focused on caring for the people who care for America. In 2021, the medical group remained steadfast in its efforts to prioritize the health of its teams through its comprehensive Clinician Wellness program, which includes free mental health services, peer-to-peer support, crisis debriefs and leadership coaching. Envision also advocated for the Dr. Lorna Breen Healthcare Provider Act – a bipartisan bill designed to help change the culture and conditions that lead to burnout and eliminate the stigma that deters healthcare professionals from seeking mental healthcare.

Last year, Envision continued advancing its Diversity, Equity and Inclusion (DEI) program, raising awareness and providing teammates with educational opportunities and resources to support DEI. As a medical group caring for communities that reflect the country’s racial, ethnic, sexual orientation and economic diversity, Envision recognizes its responsibility to create a more just and inclusive society.

To download and read the report, visit EnvisionHealth.com/Impact-Report.

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About Envision Healthcare Corporation
Envision Healthcare Corporation is a leading national medical group that delivers physician and advanced practice provider services, primarily in the areas of emergency and hospitalist medicine, anesthesiology, radiology/teleradiology, and neonatology to more than 1,800 clinical departments in healthcare facilities in 45 states and the District of Columbia. Post-acute care is delivered through an array of clinical professionals and integrated technologies which, when combined, contribute to efficient and effective population health management strategies. As a leader in ambulatory surgical care, AMSURG holds ownership in more than 250 surgery centers in 34 states and the District of Columbia, with medical specialties ranging from gastroenterology to ophthalmology and orthopedics. In total, the medical group offers a differentiated suite of clinical solutions on a national scale with a local understanding of our communities, creating value for health systems, payers, providers, and patients. For additional information, visit www.envisionhealth.com.

Envision Healthcare Shares Resources to Support Clinician Mental Health

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National Medical Group Uses Systematic Professional Well-Being Approach to Support Clinicians’ Wellness

NASHVILLE, Tenn. — Envision Healthcare, a leading national medical group, is providing best practices on how to improve the professional well-being of clinicians and mitigate burnout. To help the more than 50 percent of clinicians who experience symptoms of burnout,[1] Envision is sharing its mental health resources with the entire medical community.

Throughout the pandemic, clinicians have dealt with similar life stressors that everyone is facing – illness and death of loved ones, child-rearing responsibilities and overall uncertainty – compounded by the trauma and fatigue of fighting a deadly disease for more than 18 months. The post-traumatic stress of the pandemic has and will continue to impact clinicians in the months and years to come.

To help clinicians navigate the many challenges they face in the U.S. healthcare system, Envision has enhanced the wellness resources it provides clinicians and efforts to reduce stigma around mental health, including:

  • Advocating for the Dr. Lorna Breen Health Care Provider Protection Act and public policy changes to promote the study of professional mental, behavioral health and burnout among healthcare professionals
  • Providing additional crisis peer support and free mental health support services to clinicians as they continue to care for critically ill COVID-19 patients
  • Enhancing its wellness program to address the psychological and emotional needs of clinicians, including peer-to-peer support, leadership training and counseling

“As a national medical group, it is a core tenet of our mission to care for and foster an environment that supports the professional well-being of clinicians; however, clinician well-being can’t solely focus on the individual – it must encompass personal, organizational, healthcare system and policy interventions,” said Stefanie Simmons, MD, FACEP, Vice President of Clinician Engagement at Envision Healthcare. “We must ensure all clinicians have the resources necessary to support their mental health and well-being. Clinicians are there when we need them most – we must be there for them.”

To further support clinician well-being, Envision supports organizational and healthcare system policy improvements, such as improving practice schedule flexibility, reforming tort laws and providing student loan relief. While individual well-being and resiliency are important, addressing professional well-being as a systemic issue that is actionable will lead to positive, lasting change.

Read the full clinician professional well-being white paper here.

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About Envision Healthcare Corporation
Envision Healthcare Corporation is a leading national medical group that delivers physician and advanced practice provider services, primarily in the areas of emergency and hospitalist medicine, anesthesiology, radiology/teleradiology, and neonatology to more than 1,800 clinical departments in healthcare facilities in 45 states and the District of Columbia. Post-acute care is delivered through an array of clinical professionals and integrated technologies which, when combined, contribute to efficient and effective population health management strategies. As a market leader in ambulatory surgical care, the medical group owns and operates 255 surgery centers in 34 states and the District of Columbia, with medical specialties ranging from gastroenterology to ophthalmology and orthopedics. In total, the medical group offers a differentiated suite of clinical solutions on a national scale with a local understanding of our communities, creating value for health systems, payers, providers, and patients. For additional information, visit www.envisionhealth.com.

[1] National Academies of Sciences, Engineering, and Medicine. 2019. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being. Washington, DC: The National Academies Press. https://doi.org/10.17226/25521

Introducing The SURG Videocast: Watch the First Episode Today

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AMSURG is excited to announce the launch of a new videocast, The Surg. Each month, we will host an ambulatory surgery center (ASC) physician partner to discuss clinical hot topics. Are there pros and cons to pre-procedure testing? What are safe turnaround times in an era of COVID-19? How should you prepare for flu season amidst COVID-19? We’ll answer those questions, and more, as we seek to be a resource for research and best practices, and a voice for our ambulatory surgery centers.

Episode 1

Envision Healthcare Chief Medical Officer and AMSURG Interim President Chan Chuang, M.D., hosts the first episode of The Surg, which you can watch here.

In the episode, Dr. Chuang and Erick Pecha, M.D., a gastroenterologist and founding physician partner with Folsom Sierra Endoscopy Center in California and president of the Gastroenterology Medical Clinic in Folsom, together tackle questions about COVID testing times, surgery center workflow, getting through state inspections, and best practices for increasing capacity while enhancing safety.

One bright spot Dr. Pecha identifies: though patients are somewhat anxious about safety, no-show rates are down from the pre-COVID era. One reason for that is the pre-procedure planning process. “Once you set up the program … and you explain to your patients that our goal is to create a sphere of safety for them that is better than their local grocery store, there has been quite easy adoption by the patients in terms of their compliance.”

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