As the healthcare landscape continues its shift toward outpatient care, ASCs have become a cornerstone of growth for many health systems.
AdventHealth is no exception. In East Florida, one of the fastest-growing regions in the country, the system is investing heavily in ASC development to meet rising demand, support physician partners and deliver care in more convenient, cost-effective settings.
Shyroll Morris, the senior vice president and chief strategy officer of AdventHealth East Florida Division, joined Becker’s to discuss the health system’s ASC strategy.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: How does AdventHealth’s ASC strategy fit into the broader healthcare landscape, and what trends are driving your strategy in the region?
Shyroll Morris: Over the last two years, we’ve had intentional focus and growth in the ASC space. We went from two small ASCs to now five — including one in Daytona Beach, which is a de novo build we’re really excited about.
The reason for that is, from a strategy standpoint, we recognize that ASCs are critical. They’re the cornerstone of growth strategies as healthcare continues shifting. We wanted to be proactive in our market approach to ensure we’re present where patients are, especially as procedures move from inpatient hospitals to the outpatient setting. It’s really important for us to meet that demand and provide this service to consumers.
Q: Are there any other trends driving that expansion — maybe something region-specific?
SM: For us, it’s Florida. We’re seeing rapid growth — probably four times the national rate. So capacity constraints and keeping operating rooms running are challenges. While there’s a lot of focus on building hospitals, we know we have to diversify and expand on the ASC side. That’s especially true with our growing Medicare population, and as healthcare itself transforms.
There are more procedures today that can be safely performed on an outpatient basis. For example, in our ASCs, we’re using robotics for orthopedics — we’re doing total joints in two of our ASCs already. Insurers are increasingly pushing care toward ASCs because we can offer those services more efficiently.
AdventHealth is a large national organization. We represent the East Florida division covering mostly along the northern coast of Florida — Volusia, Lake, Flagler and now we’re expanding into St. Johns County.
We have seven acute care hospitals, two freestanding ERs and a balanced portfolio of employed physicians. We also rely heavily on community physician partners. So when we grow, we grow with our community doctors, in addition to our employed providers.
From an ASC perspective, we have five ASCs. Two are GI-focused, single-specialty ASCs in Port Orange and Ormond Beach — they’re doing really well. We have a multispecialty ASC called Blue Springs in Orange City. We started as a minority owner there and are now a majority owner, again partnered with community doctors in our West Volusia market.
Our newest ASC is in Daytona Beach, in our East Volusia market. We started discussing this maybe four years ago with our community physicians. The hospital was already growing — we’re in the process of adding 100 more beds and additional ORs because it’s our tertiary center. But the physicians also wanted an ASC solution.
So we partnered with two major groups — Cardiology Associates and Florida Orthopaedic Surgeons — and built plans not just for the ASC but for a joint-venture medical office building in the same facility. That way, physicians have their clinics right next to the ASC, which was one of their key asks.
We’ve also included advanced rehab services, imaging and diagnostics — all in one building. Over the past two years, we’ve worked closely together. We have over 30 providers already credentialed and performing procedures at our Daytona Beach ASC. We’re ramping up insurance contracts and growing steadily.
It’s been an amazing partnership. The physicians are involved in everything — equipment selection, space planning, how we show up in the community. They’re invested — literally and figuratively.
Q: On a macro level, what do the next five years look like for your ASC strategy, and where do you see the biggest opportunities for growth?
SM: Florida is growing at an unprecedented pace — especially in our markets like Volusia and Flagler. A lot of people moved post-COVID, and many more are retiring here. That means a heavier Medicare mix. So our strategy is to grow alongside that. As we plan hospitals, we’re planning ASCs as part of the structure from the beginning.
Technology is also key — robotics for total joints, advanced imaging — we want to differentiate our care in the ASC setting. And we’re continuing to invest in independent physicians. We need to co-invest and grow with them rather than compete with them.
Q: Are there any specific specialties you’re targeting right now for growth?
SM: Our Daytona Beach ASC includes cardiology, general surgery, plastic surgery and ENT. Our cardiology ASC was a big investment for us, and other cardiology groups are watching closely as we run it as an ASC. There’s a lot of deregulation in cardiology — electrophysiology included — so we expect even more push into the outpatient setting. That’s why we positioned ourselves with this service line.
Orthopedics is an ideal service line for ASC growth. From a strategy perspective, we know that 60% to 70% of orthopedic procedures are shifting to ASCs. So how do we manage that? By being partners.
That’s why we’re doing total joints in our ASCs. It’s about balancing volume in the appropriate site of care. Two of our ASCs already have robots — that’s because orthopedics is such a strong fit for outpatient settings. Patients go home the same day, and the technology is there to support that.
Q: Have there been any challenges as your ASC strategy continues to expand — particularly in shifting the mindset to run ASCs so differently from hospitals?
SM: It hasn’t been too difficult for us, because we created a separate department specifically to run the ASCs apart from the hospitals. So operationally, it wasn’t hard, because we’ve run them like a joint venture partnership business from the beginning, and that’s worked really well.
The tension sometimes comes in when ASCs appear to be “pulling” cases from the hospital. But we’ve really worked together to backfill the hospital with higher acuity cases and ensure the right cases are going to the ASC. Case selection has been the key area of focus.
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