5 Tips for Building a Strong Foundation for Surgery Centers
1. Hire the right administrator. Give yourself enough time and create a good culture. The best administrator for your center will be attracted to your culture and environment because it matches his or her values, says Tom Jacobs, CEO and co-founder of MedHQ. Give yourself enough time to interview several candidates and select the best one from a pool of talented professionals. "The owners should decide what the core values of the center are before the hiring process," he says. "For example, do the owners want a 'family-like' feel among the staff, or a more corporate/professional approach? Neither is the right or wrong way, they're just different approaches. Whatever the choice, those things can be taken and put into interview guides and then can be used to screen for candidates who have those values."
1. Do a physician gut check before bringing on a new partner. While it's tempting to make your decision about investing in a surgery center based on the extra revenue it could generate, surgeons must place more importance on patient care to really succeed. "It's a mistake to just think about how much money you'll be making," says Marcus Williamson, president of the spine division of Symbion Health Care. "Focus on the type of staff you are willing to acquire; focus on the referring physicians you'll attract. Conceptualize your practice."
As they spend time in the surgery center, physicians will need to monitor their outcomes in the outpatient setting. Mr. Williamson says 50 percent of their focus should be on their ability to promote their own outcomes, while the other 50 percent is on risk management. A few of the metrics to monitor for patient outcomes include:
• Surgery time
• Amount of prescription drugs patients are on before the surgery
• Blood loss during surgery
• Surgical recovery
• Return to work time
Many surgeons find benefits in bringing on a corporate partner or entity to help them cross the bridge from concept to reality. "The corporate partner should have success rates, success stories and physicians you can talk to about their experience of developing market entry strategies," says Mr. Williamson. "Tap into those resources and you'll have an easier transition."
3. Align physicians with payors and the center. Physician alignment with the payor is important because when physicians aren't aligned with the payor, they aren't aligned with the center and their procedures won't be paid. Physicians who aren't aligned with the center often have up to a 20 percent denial rate. They tend to perform surgeries without achieving prior authorization or use materials not covered in their contract.
"Surgeons must understand their contracts and perform procedures based on coverage," says Steve Arnold, MD, chief medical officer at Access MediQuip. "We want to show payors that our physicians are aligned with them and us on quality, utilization and administration."
4. Make sure surgeons are bringing all possible cases to the surgery center. If surgeons aren't bringing all their ASC-appropriate cases to the surgery center, you are losing patient volume and revenue. The success of a surgery center depends on the physician partners and credentialed physicians performing cases there, so make sure you are accommodating the special needs of each surgeon.
"If you've got a busy surgeon who is bringing only some of his eligible cases to the center and taking the remainder to the hospital, have a conversation about why that is and what you can do for him," says Catherine Sayers, director of operations at Pinnacle III. "Figure out why those cases aren't coming your way — maybe the surgeon doesn't have enough block time – and see what you can do to bring those cases into your center."
Sometimes, physicians may be taking cases to the hospital instead of the surgery center because they aren't aware of advancements in technology making those procedures appropriate in the outpatient setting.
"With careful patient selection many more complex, higher acuity cases are being done safely in the surgery centers today," says Amanda Kane, manager of business development at Blue Chip Surgical Partners. "Surgeons are bringing ACL cases to the surgery center, as well as unicompartmental knee replacements, which haven't been done in the past. Expanding the breadth of cases really helps drive ASC volume without having to recruit additional surgeons."
However, make sure the surgeon is comfortable performing these more complex cases in the surgery center.
5. Standardize daily processes. Growth in the future is dependent on the strength of your company's foundation. "You have to have very strong processes that are standardized and repeatable, which allows you to do business," says Nader Samii, CEO of National Medical Billing Services. "The key is to focus on standardized processes so quality doesn't suffer as you continue to grow."
National Medical Billing Services has grown five-fold over the past year and a half, which Mr. Samii attributes to giving a great business culture and customer-focused mindset. He says the company is constantly focused on how it can continue to grow and innovate by anticipating the market.
"We are trying to figure out how to use technology to grow our company in a scalable way," he says. "Companies need to get away from the old mindsets and use technology to their advantage."
More Articles on Surgery Centers:
5 Areas Where Problems Occur Between ASCs and Anesthesia Groups — and How to Fix Them
10 New Surgery Center Plans & Openings
22 Surgery Centers Boasting 10,000-Square-Feet or More
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