1 13 Thoughts on ASCs 2) Tom Price, CMS DHHS Nominee A. Orthopedic - PDF document

13 Thoughts on ASCs Click to edit Master title style Presented by: Scott Becker, JD, CPA, Partner, Publisher Beckers Healthcare, Beckers ASC and Beckers Spine 2017 Texas Ambulatory Surgery Center Annual Conference March 2, 2017 www.mcguirewoods.com www.mcguirewoods.com 13 Thoughts on ASCs Introduction 1) Thank you 2) A Changing time - - No Real Prediction on Obamacare vs. Trumpcare 3) Garden and Gun McGuireWoods LLP | 2 13 Thoughts on ASCs 1) Disruption and changes in industry giants A. USPI - Tenet B. Amsurg - Diversifying C. SCA - Optum D. Regent – ESOP, Recharged E. Surgicenter Development – Total Joints F. Nuehealth – IPAs, Physician Networks G. Physicians Endoscopy – Acquisitions, Single Specialty McGuireWoods LLP | 3 1

13 Thoughts on ASCs 2) Tom Price, CMS DHHS Nominee A. Orthopedic Surgeon ASC Owner B. Free market advocate C. Counter to 12 years to 40 years of bureaucratic negativity to entrepreneurs in healthcare at CMS 3) Big 3 Plus Pain – Resilience, Independent A. Orthopedics B. Ophthalmology C. Gastroenterology D. Pain management McGuireWoods LLP | 4 13 Thoughts on ASCs 4) Spine – big increase in outpatient, still payor challenges 5) Out of Network – tougher and tougher 6) Great growth in total joints – E.g., Surgicenter Development 7) Will doctor owned hospitals and micro hospitals make a comeback – the ACA and repeal of Stark sections 8) ASCs – 5,400 to 5,500 largely flat = + and – 100 a year McGuireWoods LLP | 5 13 Thoughts on ASCs 9) Legal A. Share sales B. Share redemptions C. Anesthesia D. Antitrust E. Out of Network F. PODs G. Non-competes McGuireWoods LLP | 6 2

13 Thoughts on ASCs 10)Bundles – movement and hiccups 11)Payor consolidation slowing; hitting hurdles 12)High deductible plans – not as deadly as expected 13)Strategy A. Know what’s working B. Double down on what works C. Abandon certain lines D. Build a terrific team E. Examine new areas i. Can you win? ii. Is it worth winning? McGuireWoods LLP | 7 Questions or Comments? 86839412 McGuireWoods LLP | 8 3