By: Audrie Martin, Ambulatory Surgery Center News
Colorful, friendly cartoon characters that educate children and families about upcoming medical procedures. Specialized recovery areas designed to help young patients reorient themselves after surgery. Waiting rooms that provide comfort to anxious parents.
Many families find pediatric procedures — especially those in hospitals — to be stressful and intimidating. However, it doesn’t have to be that way. Two innovative partners are using patient-centered strategies to transform this experience completely.
Dr. Dan Lieberman founded Patches Kids Care to provide safe, affordable, child-centered surgical care to communities across the U.S. Patches is explicitly built for kids, combining fellowship-trained pediatric specialists and anesthesiologists with a welcoming, child-friendly environment and family-focused care.
In September, Lieberman’s Phoenix-based Blueprint Ambulatory Surgery Concepts joined with Regent Surgical to develop and operate outpatient pediatric surgery centers under the name Patches Ambulatory Surgery Centers. The flagship location is now open in Houston, and expansion plans are already underway.
The partnership between Regent and Patches offers a comprehensive range of pediatric surgeries, including general surgery, orthopedic procedures, gastroenterology, gynecology, ophthalmology, ear, nose and throat (ENT) surgeries, urology and dental procedures.
Regent CEO Travis Messina told ASC News that a key philosophy for his company is to concentrate on two main elements: opening ASCs in markets where Regent wants to operate and building the right partnerships in those markets. It is this philosophy that led to the collaboration with Patches.
“Having the chance to partner with Dr. Lieberman, who is passionate about pediatrics and has developed a unique approach to the ASC space, and considering Houston, a market we’re interested in pursuing, meets both of those criteria as well as our standards for investing in a center,” Messina said.
Headquartered in Nashville, Tennessee, Regent Surgical collaborates with health systems and physician practices, focusing on developing, owning and managing ASCs across the U.S. The company currently operates about 30 ASCs in 13 states and partners with roughly 10 health systems.
Patches’ focus on patient and family experience stood out to Regent as something unique, Messina said. Within Regent’s mission of redefining surgical care, patient experience and quality outcomes are paramount, and he saw an alignment of philosophies that made Patches an attractive partner.
Why pediatric ASC are different
In many ways, pediatric surgical patients have specific needs and experiences that make focused ASCs essential for quality care. Messina highlighted anesthesia and recovery as two key examples.
“The recovery process for a child is different than the recovery process for an adult,” Messina said. “They don’t know what it’s like to come out of anesthesia, they’re confused, and they can’t find the right words to describe the feeling they’re experiencing. Having an experience that’s dedicated solely to children, with post-op or post-anesthesia care recovery nurses who know how to handle children and comfort them, as well as their parents, enhances the overall experience.”
Messina further explained that pediatric ASCs differ from traditional ASCs in payer mix because they have a higher proportion of Medicaid patients; however, this doesn’t change the operations of the center, but rather affects the administrative elements and how Patches contracts with payers.
The value proposition for a payer is significant for pediatric cases that could be transferred to an ASC, according to Messina. An estimated 1.6 million ambulatory surgeries for children up to age 17 in the U.S. were performed in a hospital outpatient setting in 2019, according to the Agency for Healthcare Research.
Yet relocating those ASC-eligible cases could lead to considerable savings for both payers and families.
“Pediatric procedures are generally categorized as low-net-revenue procedures per case,” Lieberman told ASC News. “That’s precisely why we need the ASCs, because they are perfect for those kinds of procedures. The overhead is much lower, and these pediatric procedures will be conducted in high-volume, high-throughput centers.”
From small beginnings to rapid growth
Lieberman developed Patches after noticing that many independent pediatric surgeons lacked proper operating spaces. Additionally, he noted that parents were upset about the cost and discomfort of their children undergoing surgery in hospital-based settings.
Surgeons wanted to take their patients to a facility that had fellowship-trained pediatric anesthesia, experienced pediatric nurses and all necessary equipment and supplies, according to Lieberman. The only place they could do that was a local children’s hospital until recently.
Due to their ability to fill these gaps, the viability of pediatric ASCs is increasing, Lieberman explained. He said in the past, there weren’t enough independent physicians to fill pediatric ASCs, but that has since changed. Now, there are eight different subspecialties of trained surgeons who are performing procedures at Patches.
“We’re able to control the architecture, design, the environment; the advantages that adults have had for 20 years by going to an ASC is what we can start delivering to children,” Lieberman said. “We’ve got a generation of young adults right now who were sick as kids and have post-traumatic stress disorder about medical care. ASCs are the right tool for this problem.”
Armed with their success, expanding and moving from Houston to other major U.S. cities is top of mind.
“We’ve established a strong model with the first Patches,” Liberman said. “We can now take our projected case volumes and code sets and analyze new markets much more quickly than we were able to do in Houston. On the site location and development side, we have a clear path to rapid expansion of the concept. We hope that, through this careful modeling that Regent has shown us and through iterative improvement over time, we can truly perfect this. We see Patches not just as one ASC in Houston, but as a model that can be replicated in many places and that can become a true center for children across the U.S.”
Beyond Patches, Regent will likely have more news to share before 2025 ends, too, Messina suggested.
“We’re excited about a strong finish to the year,” he told ASC News. “We’ll have a handful of additional announcements to talk about – additional growth, individual centers, health system partnerships, etc.”