Randy Robbins, MD

really has changed we're now seeing almost a competition from the hospitals saying well we may be the better lifestyle now yes we have call but you know we're not doing as many cases because they've all been pushed to the ASC so I think that the ASCs are really at a tipping point to find out how are we going to manage the volume of growth and the volume of cases and stuff that we're seeing over the next decade because I think it's going to be immense as payers continue to put pressure on

Patients to have their stuff done in ASC and we see, you know, an increase in acuity across the board with what kind of patients we're seeing in an ASC environment.

But the problem is that increased acuity doesn't necessarily come with an increased compensation.

So it costs more to care for a sicker patient without the provision of that revenue there.

That's going to be a concern and there's going to become a squeeze that's going to be untenable at some point in time.

Absolutely.

Thank you.

I appreciate it and look forward to talking again sometime.

All right.

Thanks.