Eliminating Payer Leverage in Surgery Centers: Q&A With Dr. Keith Smith of Surgery Center of Oklahoma
Keith Smith, MD, board-certified anesthesiologist, is the co-founder and chief medical director of Surgery Center of Oklahoma in Oklahoma City. The Surgery Center of Oklahoma currently adheres to a price transparency policy; over hundred procedures offered at the center are posted online with their prices. Here Dr. Smith discusses how the Surgery Center of Oklahoma leadership has worked to eliminate payer leverage and how other surgery centers can work to remain independent.
Q: How has Surgery Center for Oklahoma responded to the impact of healthcare reform?
Dr. Keith Smith: Our goal here is to get rid of all of the leverage we can. We have done that from day one by not dealing with Medicare and Medicaid. We are currently trying to rid our surgery centers of all insurance carriers. When the Patient Protection and Affordable Care Act is fully enacted, it will not affect us. We have worked very hard to get rid of all payer leverage.
Q: How has the Surgery Center of Oklahoma strategy affected its patient population?
KS: We have had patients come to see us from all 50 states and Canada. Our most rapidly growing patient population is from self-funded companies. Our patients are either uninsured or have high deductibles, health savings accounts or self-funded plans. Our patient base is always increasing. We hope to witness the full implementation of ObamaCare as a nonevent.
Q: What was the motivation behind bringing price transparency to the Surgery Center of Oklahoma?
KS: I would rather come up with my own prices and determine the value of my own time, than have a faceless bureaucrat do it for me. In that model, those people ultimately decide whether or not you are independent. We have been very successful pursuing this model and I have no reason to think that any other surgery center would have a different experience.
Q: Do you foresee surgery centers facing pressure to relinquish their independence?
KS: The federal government is working very hard for consolidation. In the current model, there is more interest in control than high quality and low price healthcare. The moment our center is no longer beneficial to us, we will close it. Facilities need to come to grips with this. We cannot be forced to operate these centers. The moment we are put in a situation that is not beneficial for us, we will walk away.
Q: What advice do you have for surgery center leaders seeking to maintain their center's independence?
KS: There are all kinds of models that work, ours isn't the only one. In our market, what we are doing will make us successful as we can possibly be. That is the beauty of the free market, there is always innovation and new ideas. There will always be people to compete and mutually benefit from the competition.
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