Acute

Future
Trends in
Event

Prevention

Screening Diagnosis Monitoring

Treatment

Healthcare:
Plus

Chronic
Disease

Impact on ASCs

Ogan Gurel, MD MPhil

Aesis Research Group, LLC
gurel@aesisgroup.com

12th Annual Ambulatory Surgery Center Conference

Chicago, IL
October 21st, 2005
 Outline

 Change
 The Future of Healthcare
 Imperatives for ASCs
 Competitive forces cause
change
• Entry of hospitals

• Relaxation of CON

• Aging of the population

•Emphasis of baby-boomers
on convenience and
• Growing influence of device seamlessness
companies
• Consumer-directed health
• Relative physician/surgeon plans
shortages
• Growing influence of
• Physician work-life balance Federal government
issues
• Emphasis on quality
measures

• BBA II?

• Emerging technologies

• Convergence of
diagnosis and treatment
Source: Porter, Michael, On Competition, 1995
 Change can be
incremental or disruptive

Source: Christensen, Clayton et al, Seeing What’s Next, 2004

 Outline

 Change
 The Future of Healthcare
 Imperatives for ASCs
The hospital as center of
care

Acute
Event

Diagnosis Treatment

Chronic
Disease
 Care is now decentralized
and fragmented
Acute
Event

Prevention

Screening Diagnosis Monitoring

Treatment
Plus

Chronic
Disease
The future will demand more
integration and coordination

Acute Prevention
Event

Sub-
Screening Diagnosis
Diagnosis

Treatment
Monitoring
Plus
Chronic
Disease
 Buyer driven forces

• Aging of the population

•Emphasis of baby-boomers
on convenience and
seamlessness

• Consumer-directed health
plans

• Growing influence of
Federal government

• Emphasis on quality
measures

• BBA II?

Source: Porter, Michael, On Competition, 1995

 Growth of Over-65 Age Group
Accelerates After 2010
Forecasted Percent Change The Baby Boomers
US, 2004-2014 US, 2004-2014
Millions

Total 10.7%
45-64
86

65-UP 22.4%
76

66
45-64 19.7%
56
65 +
46
18-44 6.3%

36
2004 2006 2008 2010 2012 2014
00-17 3.0% Year

Source: Sg2 Analysis, 2004

 Supplier-driven forces

• Growing influence of device

companies

• Relative physician/surgeon
shortages

• Physician work-life balance

issues
 Potential entrants
• Entry of hospitals

• Relaxation of CON

Source: Porter, Michael, On Competition, 1995

 Substitutes

• Emerging technologies

• Convergence of
diagnosis and treatment
Source: Porter, Michael, On Competition, 1995
Key disruptive technologies
Carotid stenting
CV Less invasive intervention
Non-invasive angiography
Targeted therapies
Cancer MIS advances
& General Virtual colonoscopy
Surgery HIFU
Image-guided surgery
Carotid stenting
Image-guided surery
Neuro/Ortho Robotic surgery
MIS advances (hip,knee,spine)
 Outline

 Change
 The Future of Healthcare
 Imperatives for ASCs
 Imperatives for ASCs
In order to meet the changes in the future ASCs …
 Must provide coordinated, seamless care
 Must address increasingly complex conditions and must address more
than just the medical / surgical problem
 Must consider alliances to help address these challenges
 Must measure quality
 Must “ride the IT wave” or be rendered irrelevant
 Must increasingly consider the integration of imaging (and diagnosis) to
their operations
 Must be increasingly aware that the federal government (Medicare, etc.)
are not just “bystanders” in the process. Regulation and compliance
are critical
 Must keep costs down – reimbursements will not be increasing and may
very well decrease (though without compromising quality)
 Must keep physicians happy … which is not always about money
 Must be flexible enough to accommodate technology changes. “One-
trick” ASCs have a limited future
Æsis Research Group
Ogan Gurel, MD MPhil
Providing forward-looking information, intelligence and
research services to healthcare investment decision-makers
Facilitating hospital-clinician relationships to help implement
and move forward strategic, operational and facilities initiatives

11 S. LaSalle Street, 5th Floor, Chicago, IL 60603

T (312) 423-2764 | F (773) 409-5897 | M (312) 543-9019

gurel@aesisgroup.com