6 Smart Moves for Ophthalmology ASCs in 2013
1. Launch initiatives to increase patient satisfaction. Patient experience has always been important, but as insurance companies become more interested in pay for performance and patients review their experience online, a positive experience has become much more crucial.
"Patient experience is number one," says Cindy Young, administrative director at Surgery Center of Farmington (Mo.). "You want patients coming to your ASC instead of somewhere else, and patient satisfaction can make a difference. Physicians will bring cases in if their patients ask specifically for the ASC instead of performing them somewhere else."
Word-of-mouth is also an important tool for driving patient volume. Patients will tell their friends about their experience at the ASC, and the friends will be booking appointments before too long.
"Treat every patient like they are the only one," says Ms. Young. "Customer satisfaction is really key, not only in ASCs or eye surgery, but everywhere. You want to go to a place where people remember your name and went the extra mile to take care of you."
2. Train staff on a narrow focus. Jay Stallman, MD, is a partner with Georgia Retina and medical director of Georgia Retina Surgery Center. His ASC is a retina subspecialty referral practice, and surgeons only treat retina cases. While this is an unusual model, the narrow focus has allowed the physicians and staff to really refine their craft.
"Since we do just one specialty, our staff is trained to be very efficient," says Dr. Stallman. "There is a lot of uncertainty with upcoming changes in government regulation and we don't know what will happen to our reimbursement, but retinal surgery procedures have a higher per case cost than cataract surgery, so we have a lower per case profit. We have trimmed costs as low as possible and our staff has become very good at what they do."
3. Renegotiate with vendors to keep supply costs down. Ms. Young constantly renegotiates vendor contracts and buys all lenses and packs with a single company to receive a bigger rebate.
"The greatest challenge is that reimbursement from Medicare is going down and supply costs are going up," says Ms. Young. "I think we are constantly working on that, but we are mainly working with specific vendors to drive as much business as possible with them so we can reach the greatest rebate level possible."
Dr. Stallman and his partners also all use the same types of materials, which has improved efficiency and cut costs. "It's very important that everyone in the practice gets on the same page as far as establishing a degree of uniformity," says Dr. Stallman. "Each surgeon doesn't have different supplies — they can have preferences, but uniformity of instrument trays and procedures makes it easier to train the staff and simplifies the process of purchasing supplies."
4. Employ someone to float between ORs for optimized efficiency. Patient volume will be increasingly important in the future and surgery centers that increase efficiency will fit more cases in every day. When operating rooms already have a full schedule, hire someone to float between each room to help with turnover. This is Ms. Young's strategy at her surgery center.
"You want adequate staff and instrumentation so your team isn't waiting on a sterilizer to finish in order to start the next case," says Ms. Young. "I have five ophthalmologists, but I never have two here at the same time. Block time and the extra help is key to keeping things running well."
5. Promote teamwork between partners. Physician partners should work together on a successful ASC instead of placing individual success above the others. Some groups are highly competitive, but uniformity in treatment and opportunity develops a positive rapport among the physicians going forward.
"In our particular practice, our compensation model is such that we aren't competing with each other," says Dr. Stallman. "We send each other cases. If a patient comes in and I am in the clinic, I won't save that patient for myself at 7pm that night; I'll send the patient to my partner who is at the ASC that day so the patient can be taken care of promptly. I won't feel like I'm losing out financially; that's a cooperative model where we all work together and keep volume at the ASC as high as it can be."
6. Focus on case and material selection to decrease risk. Surgeons must understand the profitability of each case and whether it can be clinically performed in the ASC or not.
"Case selection is very important and we do try to be cognizant of the fact that if we have a complex case that requires an expensive device or silicon oil, we take those to the hospital because we would lose money on them at the ASC," says Dr. Stallman. "We have a very thin profit margin so we also can't bring in cases that would take two to three hours and use expensive supplies."
Supplies can make a big difference in the case and surgery centers should also minimize complication and legal risks by only using dependable materials.
"Some ASCs reuse supplies and re-sterilize disposables," says Dr. Stallman. "That can increase their profits, but also their medical legal risk. We opted not to re-sterilize disposables for that reason."
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