How to tackle one of the most common types of ASC turnaround scenarios

The ambulatory surgery center business as a whole is robust and successful, but individual centers can hit road blocks. However, a struggling center does not necessarily have to close its doors.

At the Becker's 13th Annual Spine, Orthopedic & Pain Management-Driven ASC Conference + The Future of Spine, Robert Zasa, MSHHA, FACMPE, managing partner of ASD Management, discussed one of the most common types of surgery center turnaround scenarios and how to approach the situation.

A high-volume center that is struggling with operational issues is ripe for the turnaround process. Volume is only one piece of an ASC's success. Poor operations lead to wasted money and staffing issues. ASD Management has handled multiple turnarounds such as this. The first step to turning around this type of center is performing a financial and operational assessment. "We go in for three days. We get the financial information first and benchmark this against our other surgery centers with similar case mix and volume," said Mr. Zasa. "We go through payer contracts, vendor contracts and the operating agreement."

During the site visit, the ASD team will connect with all of the people who run the center. "Meet with staff, physicians and managers to understand the issues impacting the center," said Mr. Zasa. "Always interview the top five volume physicians and the lowest volume physicians." Physicians, staff members and administrators can help form a complete picture of a center's strengths and weaknesses.

Once a comprehensive picture of the center's biggest obstacles is formed, create a systematic plan to remove those obstacles. "We call it a transition plan. The plan is in writing. You can see it and touch it," said Mr. Zasa. "Look at the progress every week." Key areas to consider when putting together a turnaround plan for an operationally challenged center include:

•    Managed care contracting
•    Collections
•    Coding
•    Accounts payable and the general ledge
•    Fee schedule
•    Employees and bonus program
•    Supplies
•    Accounting
•    Regular reporting
•    Expense control
•    Bank debt
•    Legal matters
•    Equity offering

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