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5 Keys to ASC Strength in the Future From Hudson Valley Ambulatory Surgery Center

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Here are five keys to success for Hudson Valley Ambulatory Surgery Center (HVAS) going forward from Bradley D. Wiener, MD, medical director and managing partner of Regional Orthopaedics and Pain Management and Assistant Clinical Professor in the department of Orthopedic Surgery at NYU-Hospital for Joint Diseases.

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1. Partnership with a hospital. As reimbursements become tighter and more primary care physicians and subspecialists enter into employment agreements with the hospital, ambulatory surgery centers are scrambling to align with larger healthcare entities. HVAS has partnered with Orange Regional Medical Center since its inception, and Dr. Wiener is confident this relationship will be beneficial for both parties in the future.

"We look to a strategic partnership with the hospital to ensure that we are getting the best possible contracts we can with the insurance companies and our vendors," he says. "That's what we can do on the reimbursement side. Our partnership also allows us to be in their network of referring physicians as well."

2. Engage staff members.
The physicians of HVAS are very active members in running their facility because they have a vested interest in making sure operations are smooth and efficient. It's equally as important to engage staff members in the ASC's success.

"Our staff members are well-trained and well respected within their jobs, so we are able to run an efficient operation," says Dr. Wiener. "We try to get our staff members actively involved in oversight committees. We have staff members who are responsible for various departments, as well as meeting benchmarks for AAAHC."

Staff members are regularly sent to educational meetings and conferences to learn more about changes coming down the road for ASCs, and flexible financial incentives are given to staff members who excel.

3. Drive additional patient volume.
Surgeons in many markets are unable to sustain a one-man private practice with the new regulations and associated expenses coming forward as a result of healthcare reform. Many are choosing hospital employment so they don't have to run their own practices, as well as joining a multispecialty group which can have advantages with employment contracts.

"There is a paradigm shift going on right now in medicine," says Dr. Wiener. "Careers in medicine are becoming jobs in medicine as more surgeons are concerned about keeping regular hours and salary. However, selling out to the hospital or becoming employed takes away our ability to control our own destiny."

Instead of selling to the hospital, HVAS is looking at different strategies to drive patient volume and strategic partnerships to manage the center more cost-effectively. "We do understand we have to grow to stay profitable and we will take the necessary steps to make that happen," he says. "We want to bring in new surgeons to perform cases at the center."

4. Seek out national entity for partnership or management.
National ASC or practice management companies can provide several benefits for physicians and administrators. They can bring in expertise for years of experience in the field working with different centers, relationships with vendors and third party payors, and benchmarking information from other centers within their network.

"We are looking to possibly partner with a national entity to help with management," says Dr. Wiener. "We are actively engaging in recruitment to bring new physicians that are not affiliated with any other ASC in the region into our facility. That's where I think a national entity becomes a better salesman for the model we have because surgeons don't always want to give other surgeons their money. If someone else can point out the financial advantages of performing cases in the ASC, they will look at it in another light."

Surgeons are often skeptical about how surgery centers work if they've never been part of one. "I can tell my friends it's great, but they might not feel secure about coming onboard until they look at the numbers and see the processes in action," says Dr. Wiener. "They need to do their own investigation."

5. Make provisions for new payment models.
New payment models, such as accountable care organizations and bundled payments, are entering into healthcare markets across the country and surgery centers should be prepared.

"Bundling payments will decrease reimbursement, and I think its unfortunate that medicine is one of the few industries where we don't have control over such things," says Dr. Wiener. "We don't live in a place where we can say you have to pay a fee or there won't be a service. However, affiliating with the national entity and hospital will hopefully give your surgery center leverage with payors."

The transition to ICD-10 will also come quickly for your ASC's billing department, so make sure staff members are appropriately trained in these subjects as well.

More Articles on Surgery Centers:

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10 Strategic Initiatives for ASCs to Prepare for the Future



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