The re-election of George W. Bush as president of the U.S. will have little impact on the ambulatory surgery center industry, according to leaders of an industry association.
Ditto if Sen. John Kerry (D-Mass.) had won a sojourn in the White House.
"I don't think it's going to make much difference," said Jack Egnatinsky, M.D., president of the Federated Ambulatory Surgery Association, a not-for-profit association based in Alexandria, Va.
"We have a (Medicare reimbursement) cap that we're trying to get overturned," Egnatinsky said, and there was no clear picture before the election what position either Bush or Kerry had on that key issue for ASC owners, most of whom are physicians. The Medicare Modernization Act took reimbursements for ASCs back to 2003 levels, where they are to remain frozen through 2009.
In addition, said Kathy Bryant, executive director of FASA, "The projections for the budget deficit are just horrendous. That's why it might not make much difference if the Democrats or the Republicans were in there. There wouldn't be much money either way."
In a recent interview, Egnatinsky and Bryant spoke about key ASC industry issues and the outlook for 2005. Neither said they foresee any increase in political pressure brought to bear on ASCs by acute-care hospitals similar to that visited on physician-owned specialty hospitals.
The same Medicare legislation that froze ASC reimbursements banned Medicare payments for 18 months to any new specialty hospital, and the American Hospital Association is plainly in favor of extending the moratorium indefinitely.
One problem the ASC industry faces is differentiating itself from specialty hospitals. Another is making the case for ambulatory centers, which, despite their numbers -- estimated to be at more than 3,000 and growing -- suffer from a much lower profile than that of their hospital neighbors.
"They kind of think of us all together, even though we've been around for 30 years and a lot of the new ones are joint ventures between hospitals and physicians," Egnatinsky said. "We're really a totally different entity."
The problem of differentiation also arises "in virtually every state," Bryant said, pointing to New Jersey last summer slapping a 3.5% tax on ASC gross revenues in legislation to boost payments to hospitals for charity care. Legislators are looking to amend the law to exempt charity work from the tax, because the lawmakers learned the physician owners of ASCs do a lot of charity work, Bryant said.
Of the Nov. 5 announcement by Nashville-based Symbion of the purchase of two ASCs in Alabama to add to three the company purchased in September, Egnatinsky said in general, consolidation of the industry is growing steadily if not rapidly.
"That's because we have more companies and they're becoming more aggressive in approaching physicians as well as building their own," Egnatinsky said. But with continued growth in the number of ASCs over all, "the percentage of those that are corporate-owned vs. physician-owned has stayed flat."