From: Becker Scott <>
Subject: 10 Key Benchmark Statistics for ASCs; Assistant Business Office Manager Needed; 12 Days Left to Register Early for Dec. 5 Webinar!


November 8, 2007
In This Issue
10 Interesting Facts and Statistics for ASCs
Opening for Assistant Director of Business Office Operations
News and Notes: New Procedure for ENTs, Plus More
12 Days Left to Register Early: Key Thoughts on Orthopedics Webinar
Companies to Watch
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10 Interesting Facts and Statistics for ASCs

The 2007 edition of a leading benchmarking guide for ASCs, which is developed and published by VMG Health,a AAASC and Informed Healthcare Media, has been released. The guide covers financial and operational benchmarks for various specialties performed within ASCs, multi- and single-specialty ASCs and varying procedure volumes. Here are 10 statistics and observations from the 2007 Intellimarker ASC Financial and Operational Benchmarking Study.

  1. In 2005, the number of Medicare-certified ASCs grew by 467 to 4,508 (nearly 5,000 as of 2007), and 97 facilities merged or closed. The 467-facility growth was the single largest by number of ASC facilities added to the Medicare rolls.

  2. Gastroenterology and orthopedics are the two highest-volume ASC types of cases by specialty performed in ASCs. Ophthalmology and pain management follow closely behind.

  3. Healthsouth, or now what was once its ASC division, had the highest number of surgical centers as a company. USPI, an outstanding company headquartered in Dallas, has now likely closed that gap.

  4. The AAAHC, based in Skokie Ill., has been the single largest accrediting body of ASCs. It appears that the Joint Commission has made significant inroads in the ASC accreditation effort over the last two years.

  5. The median fixed assets for all centers included in the study was $2.1 million. The median net accounts receivable was $645,000.

  6. The median amount of long-term debt was a little less than $1.2 million.

  7. The median days in accounts receivable was 45 days.

  8. The specialties with the best net revenues per case included ENT, general surgery, gynecology, orthopedics, podiatry and urology. The findings are likely influenced by the size of study and the impact of lithotripsy on the urology numbers.

  9. The median amount of Medicare and Medicaid business by charges was 34 percent of a center's revenues.

  10. ENT was the fifth-highest specialty by case volume for ASCs.

Our next E-Weekly will highlight some of the data from the study focused on expenses and average supplies and wages and other expenses. For more information on this incredible resource, please call VMG Health, one of the top valuation firms in the ASC arena, at (214) 369-4888.

Opening for Assistant Director of Business Office Operations

There is an immediate opening for an assistant director of business office operations for an ambulatory surgery development and management company.

Applicant must be able to compile financial analysis and key performance indicators; train and monitor new business office managers on all facets of business office operations, including scheduling, coding, billing, collections, accounts payable and physician relations related to business office functions; provide ongoing training, and supervision and performance assessment to existing business offices; and possess strong computer and interpersonal skills.

Candidate must also be able to travel. ASC experience strongly desired. We are looking for a dynamic individual who can multitask and thrive in a fast paced environment.

Fax resume and references to (225) 753-7513 or e-mail

ortho conference
News and Notes: New Procedure for ENTs, Plus More

New procedure for ENT. One of the most interesting developments we recently became aware for ASCs is the development of a procedure for sinuses utilizing a balloon catheter. Performed by ENT surgeons, the procedures has excellent clinical support and is just moving to widespread use in ASCs. For information on this procedure, please e-mail Robert Wood at Acclarent or call him at (650) 687-5855.

GHN-Online names new executive VP. GHN-Online, a leading real-time claims management and transaction processing provider, has appointed Robert C. Marinich as executive vice president of sales. Formerly senior vice president for business development at Azima Health Services, Mr. Marinich will lead GHN healthcare banking initiatives.

"GHN is committed to serving all stakeholders in the healthcare industry's claims reimbursement model, and the strengthening our partnerships with banking, credit, and lending institutions is integral to that commitment," says Azadeh Farahmand, CEO of GHN-Online. "Bob has a wealth of healthcare banking expertise and technology know-how combined with the ability to build a team, articulate a vision, and execute for success."

Texas ASC Society names new executive director. The Texas Ambulatory Surgery Center Society (TASCS) board of directors has announced that its founder, Woodrow W. Moore, has been named executive director of the 140-facility-member advocacy organization. John M. Pike, TASCS' outgoing executive director, is leaving the organization to pursue other opportunities.

John is an outstanding leader and organizer for TASCS. During Mr. Pike's term the organization added approximately 100 facility members, now representing 42 percent of Texas's licensed ASCs. Mr. Pike also planned TASCS's transition to 501C-6 and formed Friends of Ambulatory Surgery in Texas PAC (FAST-PAC) along with the group's legislative council.

Thank you Physicians Endoscopy. We thank Physicians Endoscopy for re-upping its advertising for another year. It is an outstanding company and, as far as I can tell, the very best in the business in developing and managing endoscopy centers. Physicians Endoscopy has outstanding senior leadership in Bob Gannan, Barry Tanner, John Poisson, Karen Sablyak and Carol Stopa.

Welcome Galil Medical. We are delighted to add Galil Medical as an advertiser to the Becker's ASC Review. Galil Medical provides a solution for prostate cryoblation, which will be reimbursed in ASCs beginning Jan. 1. One of the key additions to ASCs over the next couple of years will be different types of prostate-related procedures. You can e-mail Galil or call (877) 639-2796, x. 1714, for more information.

Thank you Blue Chip Surgical. We also thank Blue Chip Surgical as a new advertiser for '08. Blue Chip is led by Jeff Leland, a terrific executive and leader who worked with Brent Lambert at ASCOA. Jeff has developed a fine company with Blue Chip, and the company is expanding rapidly. It has focused a great deal on ENT and spine and has developed an outstanding team of talented people.

Cost segregation studies. A key concept people may consider for their ASCs or related medical office building is a tax technique supported by a cost segregation study. A cost segregation study has the purpose of defining which parts of the development or fixed assets of the ASC or building can be depreciated more quickly and thus provide substantial tax savings and deferrals. For information regarding this concept, please e-mail Raymond Irving at KBKG or call him at (877) KBKG-INC, x. 513.

Welcome Orion Medical Services. We are also pleased to welcome Orion Medical Services. Orion is a national ASC development firm with specific expertise in neurosurgery, spine, ophthalmology and multi-specialty centers. To reach Orion, please call (877) 391-5390.

Update on the Jan./Feb. Becker's ASC Review. Our Jan./Feb. issue of the Becker's ASC Review will focus on 40 companies to watch in the ASC sector. It will also feature a story about adding bariatric surgery to ASCs profitably and intelligently. For information on the issue or suggestions, please e-mail Scott Becker. Advertising for the issue, which will be distributed to 20,000 people, closes on Dec. 1.

Sponsorships available for next Webinar. We have two sponsorships available for the next installment in our "Extraordinary Leaders in Healthcare" Webinar series. "Key Thoughts on the Future of Orthopedics" will be held Dec. 5. Please e-mail Jessica or call her at (312) 505-, or e-mail Ryan or call him at (212) 337- for more information.

Stark III to affect physician-hospital and physician-driven relations. The new Stark III regulations take effect Dec. 4. For a complete analysis, download the white paper, "CMS Issues Final Phase III Regulations -- Significant Impact on Physician-Hospital and Physician-Driven Relationships," authored by Scott Becker, JD, CPA, Ron Lundeen, JD, and Gretchen Heinz, JD, under Hot Topics at

Titan Health opens third N.J. ASC. Titan Health Corporation's third N.J. ASC, Millennium Surgical Center in Cherry Hill, performed its first case Oct. 22. With more than 25 physician partners and 10,750 square feet, Millennium features three OR/procedure rooms and specializes in orthopedic, spine, pain medicine and podiatric procedures. The center is licensed by the state and plans to complete the Joint Commission's accreditation process within the next few months. "We are very pleased to add Millennium to our growing list of open centers," says Marc Jang, president and CEO of Titan Health, a nationwide ASC development, acquisition and management company. "Partnerships like this demonstrate Titan's commitment to incorporating larger and more multi-specialty centers into our ASC platform."

McGuireWoods adds five lawyers to healthcare department. The McGuireWoods healthcare department has added five lawyers to its team in the last 60 days. They include Emily Tremmel, who returns to the firm after having been with the American Dental Association (Emily was at the top of her class in her program at Indiana University); Liz Campbell, a magna cum laude graduate from the University of Illinois and theUniversity of Wisconsin who joins the firm after having been recruited from the healthcare department of another leading firm; Daniel Soldato, who joins us from the Northwestern University School of Law school; Ryan Higgins, who joins us from the Duke University School of Law; and Lara Duda, who joins us from the DePaul University College of Law. For information on the McGuireWoods healthcare practice, please e-mail Scott Becker or call him at (312) 750-6016.

Ask Scott Becker. If you have an ASC-related legal or business question, e-mail Scott, and we'll publish the answer in a future E-Weekly. Please indicate when asking whether you prefer to remain anonymous.

Call for proposals. We are seeking speaking proposals from a few physician-leaders for the Orthopedics-, Spine-, and Pain Management-Driven ASC Conference, to be held in Chicago June 19 to 21. Should you have suggestions, please e-mail Scott Becker by early November.

Ortho Webinar
12 Days Left to Register Early: Key Thoughts on Orthopedics Webinar
At a Glance: "Key Thoughts on The Orthopedics Industry"

What you will learn: There are two key issues that will be the focus of the Webinar:

  1. A forecast for the next 10 years in orthopedics; and

  2. how ASCs, hospitals and medical device companies should work with orthopedic surgeons.

Who should attend: C-level hospital leadership, vice presidents and other leaders who who work in a orthopedic-physician-relations capacity, orthopedic physician leaders, ASC administrators, ASC owners, and ASC and medical device companies.

When: Wednesday, Dec. 5 at 2 p.m. CST (running time: 60 to 90 minutes)

About the speakers: John Cherf, MD, MBA, MPH, is an orthopedic surgeon at the Chicago Institute of Orthopedics, a clinical advisor for Sg2 and a thought-leader in orthopedics. Dr. Cherf founded the Midwest Orthopedic Institute, an orthopedic physicians group with full integration of diagnostic imaging, rehabilitation, ambulatory surgery and occupational medicine under one roof. He presently practices in Chicago and is once of the founding members of the Chicago Institute of Orthopedics. With more than 15 years' experience and fellowship training in sports medicine, he has served as team physician for several collegiate and professional sports teams in addition to U.S. Soccer. Dr. Cherf has published in numerous peer review journals, speaks internationally, and serves on several advisory boards for healthcare-related businesses.

Scott Becker, JD, CPA, is a partner in and co-chair of the health depatment at the national law firm of McGuireWoods in Chicago. For more information, visit his McGuireWoods profile or

Cost: $199 if registering before Nov. 19 (save $50!).

How to register: There are five easy ways.

  1. Fill out and submit the online registration form.

  2. E-mail Jessica Cole.

  3. Call us toll-free at (800) 417-2035.

  4. Download the printable registration, fill out and fax to (866) 678-5755.

  5. Download the printable registration, fill out and mail to 315 Vernon Ave., Glencoe, IL 60022.
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Companies to Watch

We are delighted to highlight the following companies in this week's E-Weekly.

National Surgical Care. National Surgical Care, a nationwide owner and operator of ambulatory surgical centers, focuses on addressing the needs and problems confronting surgery centers across the country. These challenges, which include increasing competition, complex legislative issues and a difficult managed care contracting environment, threaten both the growth and profitability of surgery centers. NSC's experienced management team offers a high degree of knowledge, skill, understanding and strategic resources for its centers. NSC specializes in the acquisition and operational enhancement of existing surgery centers and the development of new surgery centers in partnership with hospitals and physicians. Aligning with NSC allows physicians to realize some of the value they have created and gain the resources of a skilled management team. Physicians can then spend more time focusing on patient care as NSC focuses on the business. Currently, National Surgical Care operates 21 surgery centers across the country. Contact Rick Pence at 866-866-2116 at

Woodrum/Ambulatory Systems Development. The team at Woodrum/ASD is composed of healthcare professionals focused on ambulatory surgery and outpatient care. They offer a range of services that can be customized for your needs when you're looking to expand practices and revenue. The company's seasoned professionals have a proven track record in healthcare with a special focus in ASCs: feasibility, financing, structuring joint ventures, design and construction, turn-key setup, contracting with payers, certification and licensure, and marketing and management. Woodrum/ASD understands the "business of the ASC business," and is focused on helping ASCs succeed in the marketplace of today and tomorrow. E-mail Joe Zasa for more information.

MedHQ. MedHQ is the expert in all these fields, providing business office functions to hospitals, surgery centers, imaging centers and physician practices nationwide. Using state-of-the-art technology, MedHQ applies business solutions with the human touch appropriate for healthcare. By outsourcing functions of your practice to MedHQ, you can eliminate capital investments in office equipment, computer hardware and software that are required when you employ staff in-house. Based in suburban Chicago, MedHQ provides accounting, billing and collecting, human resources and credentialing services to clients in ten states. The company's services save medical facilities time and money and enable physicians to perform more cases. In short, you're able to focus on patients because MedHQ is focused on the business.

*           *           *

If you have any questions on any of the items listed in this letter, please contact me at (312) 750-6016 or by email at

Very truly yours,
Scott Becker

Scott Becker, JD, CPA
(312) 750-6016

Becker's ASC Review
is a publication of
ASC Communications, Inc.
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