Remaining independent in a consolidating industry — Key thoughts from an Omaha-based ASC administrator

Maintaining independence in the competitive healthcare industry will likely continue to challenge many surgery centers and providers. Omaha-based Advanced Surgery Center has faced some difficulty in the largely hospital-dominated marketplace. In Omaha, many hospitals own ASCs and hospitals often contract with the region's leading payers, noted Maggie Summerfelt, administrator of Advanced Surgery Center.

The hospitals form unique contracts with these payers, with some contracts requiring that the insurance companies only send their employees to certain locations for procedures, which often do not include freestanding ASCs. Therefore, Advanced Surgery Center is placed under a tier system with some payers and may not be reimbursed at the same level as the hospitals.

While affiliation with a larger organization does come with perks, such as access to resources, independent surgery centers also have many benefits, including the ability toSummerfelt make decisions without navigating layers of bureaucracy.

"We are able to make decisions quickly. Our doctors can make complaints, talk to our staff and we can have it fixed by the next time they come in for a procedure," said Ms. Summerfelt. "Hospital-owned ASCs will have three meetings to accomplish something. If something needs to be changed, we can change it. We have very high physician satisfaction."

With the ability to accomplish goals quickly, the center has maintained a satisfied staff as well as patients. Since Advanced Surgery Center opened its doors in February 2006, the center has retained more than 50 percent of its staff. The center's staff members work closely with one another, with Ms. Summerfelt noting that staff members are "like a family."

The surgery center has remained viable despite hospitals' dominating presence in large part due to affiliation with ASC associations. The organizations can educate ASC personnel about the latest updates in the healthcare industry to ensure they are in line with recent regulations and standards. Oftentimes, Ms. Summerfelt explained 100 percent physician-owned centers isolate themselves and do not take an active role in regional or national ASC associations. Advanced Surgery Center is affiliated with Nebraska Association of Independent Ambulatory Centers and Ambulatory Surgery Center Association, and Ms. Summerfelt serves on ASCA's governmental affairs committee.

"You can't live in a box. You have to put yourself out there and be part of an organization that gives you information," she said. "A lot of physician-owned centers stay in their own nook and forget to stay involved, which gets them in trouble."

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