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Attendees mingle during Powder River Surgery Center’s open house. PHOTO CREDIT: CASEY STARR

Wyoming ASC Hosts Open House

Lawmakers and local healthcare community celebrate National ASC Month

INTERVIEWED BY MAIA KUNKEL | OCTOBER 2022

Powder River Surgery Center in Gillette, Wyoming, opened its doors for an open house event recently, as part of National ASC Month. Out of the 20 surgery centers in the state, Powder River was the only ASC to host an open house in Wyoming. Administrator Linda Bedwell organized the event to bring together elected officials, private payers and center staff to discuss the state of healthcare in Wyoming and the issues facing ASCs across the state. Below is an excerpt from an interview with Bedwell.

Q: Why did you decide to host an open house?

Linda Bedwell (LB): After navigating the last three years of uncertainty and emerging on the other side with even more uncertainty, I found myself very concerned about the future of healthcare in Wyoming and our nation for all providers. While it is an election year, I have not seen/read one [local] candidate address or even mention healthcare on their platforms.

The population in Gillette is 33,000 and the total state population is the lowest in the country, at 570,000, despite being the 10th largest in surface area. After talking to many community members, I learned many are not aware of the surgical specialties available in Gillette and assume they need to leave the state to get “quality surgical care.” We may be small in number here in Wyoming but we have outstanding surgical healthcare here.

Q: Tell me about the event.

LB: Preparation started in the spring in collaboration with ASCA. ASCA assisted with getting the event on state and federal officials’ calendars as well as providing critical data to include for discussion. We looked at this as an opportunity to bring several components of healthcare together in an informal setting to have the opportunity to collaborate and learn about each other, and discuss what everyone is doing to address healthcare issues. The invitation list included elected officials and their staff [at the local, state and federal levels], primary care physicians, our surgeons [at Powder River Surgery Center], insurance carriers, our joint venture hospital leadership, Wyoming Hospital Association officials and supply chain professionals.

Q: Why is it important to advocate for ASCs?

LB: Despite the huge cost savings for surgical procedures that ASCs provide, our voices [as individual ASCs] can feel like they have little impact. Without ASCA’s advocacy on the Outpatient Surgery Quality and Access Act of 2021 and access to legislators directly, I am not sure where we would be.

Q: What are the biggest issues facing ASCs in Wyoming today?

LB: ASCs’ Medicare reimbursement is dependent on the hospital wage index reporting in a local region. In the case of Wyoming, the entire state is one region based on sparse population and the low number of hospital beds—1,478 licensed inpatient beds—in the state.

Although there is an annual inflation factor for ASCs, which seems to have a minimal impact historically, the wage index adjustment accounts for geographic differences in labor costs. Hospital reimbursement for 2022–2024 is based on reporting from 2019.

Q: What do you see coming down the pipeline for ASCs in the next five years?

LB: In Wyoming, the Centers for Medicare & Medicaid Services steers reimbursement for most government plans based on their published rates. Although we are for-profit, we are dependent on commercial insurances to make up the difference. But as we watch the number of government cases outweigh the commercial volume, combined with low population and low volume, it creates a worrisome quandary.

We are all here to serve our communities and want to do the right thing. Big insurance is big business, but when they increase their fee schedules this is passed to the patient in higher premiums and deductibles. In our small community, we are seeing independent primary care providers deferring patients with government plans to our hospital-employed physicians, driving a bigger percentage of these patients to an already struggling healthcare system.

ASCA members interested in hosting their members of Congress can complete the Facility Tour Interest Form or visit ASCA’s facility tour webpage for more information.

Write Maia Kunkel with questions.