Ambulatory Surgery Centers

1. Ambulatory Surgery Centers

2. Overview • Ambulatory surgery centers (ASCs) are facilities where surgeries that do not require hospital admission are performed. • To be considered an ASC, a facility must have at least one dedicated operating room and the equipment necessary to perform surgery safely and ensure quality patient care. • ASCs are typically owned by a group of physicians and allowed to perform more than 3,000 different types of low-complication procedures. • The majority of ASC procedures involves the eyes and includes cataract removal, lens insertion, and other.

3. The Industry • In 2009, there were approximately 2,700 located across the United States in every state. Today, that number has nearly doubled to 5,200. • Most ambulatory surgery centers are licensed, certified by Medicare and accredited by one of the major health care accrediting organizations. • ASC licensing requirements are determined at the state level and require rigorous initial and ongoing evaluation and reporting. • In the United States, more than 22 million surgeries are performed each year in an ASC, of which, more than 3 million are Medicare patients.

4. Major Players • In terms of revenue, Surgical Care Affiliates (SCA) is the largest ACS in the United States operating 141 centers in 35 states with 3,700 full-time employees and 2,000 physicians. • United Surgical Partners International (USPI) operates 138 centers in United States and has partnered with more than 3,200 individual surgeons in its ownership.

5. Major Players • Ambulatory Surgical Centers of America has facilities located in 17 U.S. states and has a strong record of building ASCs from the ground up. • Symbion Healthcare, headquartered in Nashville, TN, is a leading operator of ASCs with a network of more than 70 surgical centers in 28 U.S. states.

6. Marketing and Advertising • A primary draw for patients who choose an ASC over a regular hospital is scheduling flexibility and lower procedure costs. • Patient satisfaction is a cornerstone of the ACS industry. Recent surveys indicate average patient satisfaction rates in ASCs to be at least 90%. • ASC surgeons often partner with primary physicians for patient referrals, leading to a significant source of volume for the ASC. • Physician and patient education, through lunch and learns and waiting room document, helps ASCs communicate their services and benefits over a regular hospital.

7. Growth Areas • Industry advocates are hoping to increase payments from Medicare while encourage patients to schedule procedures in an ASC rather than hospital. • As innovations in the medical field continue to occur, it is expected that the type and number of procedures performed in ASCs can increase as well. • Medical advances, such as screening tools that help to identify new patient concerns, may have an impact on ASC patient volumes. • Private equity investors are showing interest in ASCs and primarily those with a specific focus rather than general surgery centers.

8. The Future of the Industry • Government funding, on a procedureby procedure basis, can dramatically affect the success and growth of the ASC industry. • Industry experts expect there to be growth in larger physician groups as either single-specialty or multi-specialty. • With the economy continuing to struggle with its recovery, there may be a decrease in ASC patient volume and elective procedures until things stabilize.

9. Advertising Strategies • Television advertising is an effectiveway to reach American consumers not familiar with ASCs and the level of quality they provide. Television ads can give consumers an inside look into an ASC and highlight the services offered and insurance accepted. These ads should be run on local television news stations. • ASCs that specialize should partner with a specialist in their focus area for patient referrals. The ASC should advertise the partnership by placing brochures and other educational materials, including closed-caption television ads, in the specialist’s office.

10. Advertising Strategies • ASCs should sponsor health screening fairs, offering screening tests that can identify future patients. These health fairs should be advertised in local newspapers and on local television news stations during health segments. • ASCs should develop case studies and patient testimonials to include in their television advertisements. These testimonials can provide patients the peace of mind they may need to select an ASC over a regular hospital.

11. Why TV? The answer is three simple reasons!

12. 1. Your customers and potential customers use it — viewing daily for long periods of time. 2. TV’s attributes of sight, sound, motion and emotion let you best communicate your message tothese people. 3. Television works in dollars returned! Why TV?

13. Why TV? Remember,Only television can give you:The right messageTo the right peopleAt the right timeIn the right place!