From: Scott Becker <>
Subject: [Becker's ASC E-Weekly] Physician Non-Compete Clause Ruled OK by Court; CON Can't Be Challenged by Individual; 10 Ways to Improve Your Hospital's Orthopedics Program; How to Recruit, Retain Physicians; Safe Harbor Clarifications Q&A: One-Third Tests
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July 17, 2008
Latest News & Analysis

1. Non-Compete Agreement Imposed by Physician Group on Physician's Practice Upheld by Court. Click Here button

2. Individual Lacks Standing to Challenge Facility's Certificate of Need. Click Here button

3. CMS Continues Attempts to Address Anti-Markup Provisions With Two Alternatives. Click Here button
Note: An analysis from Scott Becker on the impact on block imaging will be posted Tuesday, July 22.

4. Somnia, a Leading Anesthesia Management Company, Has Become a Founding Sponsor of The Hospital Review. The First Issue Will Be Released Sept 1. Learn More About Somnia. Click Here button

5. U.S. News & World Report Names America's Best Hospitals. Click Here button

6. 10 Ways to Improve Your Hospital's Orthopedics Program. Click Here button

7. 10 Tips to Improve Your A/R, Written By Kyle Goldammer, Senior VP of Finance for Surgical Management Professionals. Click Here button

8. Anesthesiology Practice Sues Physician for Breach of Employment Agreement. Click Here button

9. Merging Pennsylvania Insurers Face Scrutiny on Negotiating Tactics and Leverage at Hearing. Click Here button

10. Receive a Free Copy of VMG Health's Intellimarker, an Outstanding Resource for ASCs. Please E-mail Greg Koonsman at VMG. Click Here button

11. 25 Registrations Remain for Complimentary Audio Conference for ASC Review Subscribers: ASC Transactions - Should You Sell; What is the Value and Process; Can a Merger Help. Hear Sami Abbasi, CEO of National Surgical Care; Jon O'Sullivan, principal and founder of VMG Health; and Tom Yerden, founder of TRY Health Care Solutions. Click Here button

12. 40 Registrations Remain for Complimentary Audio Conference for ASC Review Subscribers: Case Costing and Advanced Benchmarking for ASCs. Hear from Ann Geier, Vice President of Operations for ASCOA, and Susan Kizirian, COO of ASCOA. Click Here button

13. Amkai Announces New Contracts, Freedom II Upgrade Plan. Click Here button

14. Pinnacle III Announces New Corporate Position and New Director of ASC Billing. Click Here button

15. ASC Communications has added Melissa Brown as a new account manager; for information on advertising or exhibiting with ASC Communications, call (800) 417-2035 or visit our site: Click Here button

Surgical Notes --
Tips for Recruiting and Retaining Physicians in ASCs

Q: What are you doing to recruit and retain physicians for practicing at your ASC? What is your best advice for recruiting physicians to buy into your ASC?

Featured answer:

"At my facility, I was forced to get more cases from my existing owners because of the lack of available surgeons in the community. We have developed ways of acknowledging our owners and non-owners. Our physician locker room has fresh coffee, fresh fruit, snacks and their favorite reading material available to them every morning. We also go out of our way to find out certain 'little things' about each physician. For example, I have a general surgeon who loves Cheetos, so we make sure every Thursday there are Cheetos in the locker room.

"Another great example: I have an OB/GYN whom I have been trying to get to use our facility and it just seemed to be a struggle. We found out from some office staff that he loves Cherry Dum Dums. I finally got him to schedule with us and in the locker room we placed a huge bowl of Cherry Dum Dums. After his surgery he walked by my office with a Dum Dum in his mouth and in his hand. We could do no wrong. Since then he has became a consistent monthly user.

"Recruitment has been difficult. We have a small pool of surgeons to choose from. What we try to do is get physicians to use us once to get their feet wet. Once their feet are wet, we usually can retain them and eventually invite them to be owners. Also you need to have 'skin in the game.' A physician-owner needs to have his investment from his own pocket and not through "group ownership." This investment needs to be significant enough to make him feel like he has a true vested interest. At our facility we had a general surgery group own as a group. Of the five surgeons, two of them actively used the facility. We proposed to buy out the group and have them buy back individually. By doing this, two of the general surgeons bought back in and I have seen as much as a 140 percent increase in their cases they bring to the facility.

"(As for recruiting physicians to buy into the ASC), they need to know that their opinion truly counts and that they will always be heard. The return is the easy part."

-- Scott James, administrator for Yakima (Wash.) Ambulatory Surgical Center

For more selected reader answers to this question, click here.

Safe Harbor Clarifications Q&A and How Do The One-Third Tests Apply

Q: Could you clarify the Safe Harbor requirements? We have always thought that it was one-third of outpatient cases but have been informed by legal counsel that it is one-third of revenue.

-- name withheld upon request

A: There are two quantitative tests for a multispecialty center.

1. One-third of a physician-owner's practice income must come from performing outpatient surgical procedures.

2. One-third of such surgical procedures must be performed at the ASC at which one is an owner.

If an ASC is single-specialty, the rule is that the physician-owner must generate one-third of his practice income by performing outpatient surgical procedures, but there is no requirement that he perform one-third of those procedures in the ASC in which he is an owner.
ASC Communications & Ambulatory Surgery Foundation Fall Conference and Becker's ASC Review

15th Annual Improving Profits and Business and Legal Issues for ASCs
Presented by ASC Communications, Inc. & ASC Association
Sheraton Hotel and Towers, Chicago
Oct. 23 to 25

Five Great Sample Topics:

1. Assessing the Profitability of Different Specialties in ASCs -- Luke Lambert, CEO, ASCOA

2. An Administrator's Viewpoint and Success Stories -- How to Get My Doctors to Do What I Think They Should Do Without Yelling, Breaking the Law or Losing My Job -- Rob Welti, MD, Corporate Medical Director and COO, Western Region, Regent Surgical Health

3. What Do You Do When a Major Payor Cuts Your Reimbursement by 20 Percent? -- Robyn Finnegan, VP of Managed Care, and Don Jansen, VP of Marketing and Development, Prexus Health Partners

4. 3 Ways to Add Profits to an ASC -- Steve Burton, CEO, ION Healthcare; Bob Wood, VP of Strategic Planning, Acclarent

5. Succeeding Without Orthopedics -- How A Multi-Specialty ASC Can Thrive Without Orthopedics -- Steve Holst, MD, and Scott Bateman, MD, Founders, Sheridan Surgical Center

To see the entire agenda, download the conference brochure (PDF).

There are four ways to register:

1. Fill out and mail or fax the registration form in the conference brochure.
2. Call (703) 836-5904 or (800) 417-2035
3. Register online by clicking here.
4. E-mail

Don't miss the Sept./Oct. issue of the Becker's ASC Review. Here's what we have on tap:

1. 45 Things to Know About ASCs
2. CMS and Third-Party Payor Issues
3. Building and Constructing an ASC
4. ASC Real Estate: What Every ASC Should Know
5. 25 Great Physician Leaders
6. Steps to Improving Case-Costing

The Nov./Dec. issue will focus on

1. Information Technology for ASCs
2. Turning Around ASCs

*           *           *
Contact us toll-free: (800) 417-2035

Thank You to 10 Great Companies

1. Principle Valuation. Principle Valuation specializes in the valuation of hospitals, senior housing and related entities with a goal of providing the most accurate, objective and fair valuations possible. Learn more about Principle Valuation.

2. Schedule offers SCOR, a multi-purpose communication tool that works with existing scheduling systems to leverage the power of the Internet to improve your scheduling efficiency, customer service and ability to market services. Read more about

3. The C/N Group. he C/N Group is a recognized leader in the development, ownership and operation of exceptional healthcare facilities, including ASCs, medical office buildings and diagnostic imaging centers. Learn more about The C/N Group.

4. Medtegrity Medical Laundry Network. The MEDtegrity Medical Laundry Network is a $500 million commercial laundry network comprised of the largest and most successful independent and family-owned laundries in the United States. Read more about Medtegrity.

5. Marshall Erdman & Associates. As an integrated provider, Marshall Erdman & Associates offers service from facility conception to completion, including advance planning, development, design and construction. Read more about Erdman.

6. Acclarent. Acclarent is dedicated to developing innovative solutions for ENT specialists and their patients. The company's initial focus has been on achieving the goals of sinus surgery with novel, endoscopic, catheter-based tools known as Balloon Sinuplasty devices. Learn more about Acclarent

7. MarCap Corporation. Whether you are developing a new center or adding to an existing center, MarCap offers a consultative approach to financing, access to decision makers and a streamlined customer experience. Learn more about MarCap.

8. Blue Chip Surgical Center Partners. Only three years old and ten physician-led centers in operation or in the construction phase, Blue Chip has built a reputation for delivering on its commitments, quickly building trust with the partners and forging strong physician and hospital relationships. Find out more about Blue Chip Surgical Partners.

9. Eveia Health Consulting & Management Company. Founded by I. Naya Kehayes, MPH, Eveia is comprised of a team of seasoned professionals who are experts in reimbursement management, managed care contracting, and business management with a specialization in ASCs and surgical practices. Find out more about Eveia.

10. Somerset CPAs. Somerset has extensive experience in development and/or renovation of single- and multi-specialty ASCs, MOBs and single-specialty hospitals. Read more about Somerset CPAs.

Upcoming ASC Events
ASC Transactions: Successful Strategies for Mergers, Acquisitions, Divestitures and Restructuring
July 24, 2008
Audio Conference

ASC Benchmarking and Case-Costing
Aug. 6, 2006
Audio Conference

Physician/Hospital Integration Efforts
Sept. 25, 2006
Audio Conference

15th Improving Profitability, and Business, Strategic, Clinical and Legal Issues for ASCs
Oct. 23 to 25, 2008

For a complete list of upcoming events, click here
Quick Links
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