Because change has become a constant in the healthcare industry, when it comes to developing a new ambulatory surgery center (ASC), it pays to understand specific trends with potential to impact efficiency and success. Stephanie Martin, vice president of operations at Regent Surgical Health, believes the shift toward hospital – physician ASC partnerships is driven by the industry’s increasingly challenging reimbursement and regulatory environment.
With ASCs, a hospital partner can help negotiate better managed care rates than they could secure on their own. “It can be a very symbiotic relationship for the hospital and the surgery center,” she explains. “Hospitals are seeing the need to leverage another site of service option for patients, where they can move patients that don’t need a high level of acute care and alleviate their schedule, so that more complex cases and patients that are sicker, can get their care more quickly and efficiently. In addition, the patients in the ASC get their needs met more quickly, without the potential of being bumped for something more critical. That’s a win-win for everybody.”
Adding an ASC management organization like Regent to the mix brings additional expertise in running the partnership more efficiently, and more cost effectively, Martin says. “Part of ensuring a successful partnership is understanding what the hospital needs in an ASC partner, what their goals are and what they’re trying to achieve. And, making sure that the mission, vision and values mesh with Regent’s values to help them accomplish their ASC goals. It’s a partnership, like a marriage. You want to make sure you’re all on the same page about what you’re hoping to achieve.”
In addition to suggesting new ASCs seek hospital–physician partnerships, Martin outlines 4 additional dos and don’ts for success:
DO: Pin Down Volume Commitments.
To avoid profitability disappointments, Martin says it is more critical today than ever before to get firm volume commitments from your new ASC’s potential physician partners. “We need to understand whether that case volume is being done today, and if so, where is it being done, and have them commit to bring those cases to the ASC,” she says. “We ask: ‘Are these cases appropriate for an ASC environment or are these patients more appropriate for the hospital? And, if the physician is still working inside the hospital, how comfortable is he or she in moving to the ACS environment? And how do we help them make that transition?’”
DON’T: Rely on a Single Specialty.
Martin says that while hospitals may see competition in the market for one particular specialty, the best answer may not be to create a single specialty ASC.
“I think a single specialty ASC is still doable,” Martin says, “but it’s a riskier and more volatile approach. I think we’ll continue to see some procedures that Medicare will say should be done in the office, and if your work is based on that particular specialty, that creates a significant hurdle to address and overcome. As a multi-specialty ASC you spread that risk. You’re more able to adapt and roll with the punches.”
DO: Drive Evidence-Based Decisions from Quality Reports.
Quality reporting and evidence-based data is increasingly important for surgery centers. “In the past, while we collected the data frequently, we didn’t do enough with it,” she says. “As quality programs increase and improve, surgery centers are doing more data reporting, analyzing the data, and making adjustments as needed. If ASCs do that well, they’ve got evidence that they can share with patients and physicians, and managed care companies as well, so that we’re not just saying we deliver great care, but we’ve got the data to prove it.”
DON’T: Overspend on EMR Technology.
While recent trends have seen hospitals jumping on the EMR bandwagon, Martin doesn’t believe EMRs have gotten to the point yet where they deliver an ROI that makes sense in the surgery center environment. “I love technology and I think it can do some wonderful things for us, but we need to be smart in surgery centers about how we do that,” she says. “We need to capture data and information but do it in a way that is so efficient that it doesn’t impede what we’re trying to accomplish. It’s very difficult when you’re doing multi-specialty to get an EMR system that’s great for each specialty, especially orthopedics or spine where they’re putting in a lot of implants and using a lot of equipment. To really have data-driven and metrics-driven results, we need to harness the technology that makes sense. Case costing, turnover time, manhours per case, those are key things that surgery centers need to be able to manage – and manage well- in order to survive and thrive in an increasingly difficult reimbursement market.”