Shelton says SSM is not interested in opening another hospital in the St. Louis market. "We really have shifted focus to the outpatient side," he says. "Hospitals of course have larger overhead. An ambulatory network can have less overhead and give us more penetration into the market. We continue to look at where we need to be in our market across the St. Louis region, whether that is placing physician offices or urgent care centers, imaging centers, rehab centers, pain care centers, any number of things that are performed on an outpatient business."
Moody's Neysmith said the top financial performers among ambulatory service centers will be those that concentrate on higher revenue treatments such as orthopedics and pain management. At the same time, growth in ambulatory service centers could be tempered by reductions in reimbursements, the shift toward bundled payments and value-based care, and the continued acquisition of surgery centers by hospitals. Even with those caveats, Neysmith says ambulatory surgery centers are well positioned to take advantage of an aging population.
"In a highly fragmented market, the larger players with economies of scale and joint ventures with physician groups and hospitals will benefit from patient referrals," he said.