Developing an Outpatient Spine Business Model for ASCs

At the 19th Annual Ambulatory Surgery Centers Conference in Chicago on Oct. 25, Karen Reiter, COO, and Robert Bray, Jr., MD, founder and CEO of DISC Sports and Spine Center in Marina del Rey, Calif., discussed the business model for outpatient spine surgery and where minimally invasive surgery will lead.

Dr. Bray and Ms. Reiter discussed how DISC evolved into a multidisciplinary orthopedic and spine practice and built the model of more than just a surgery center. DISC offers a full spectrum of conservative and surgical care for patients.

The business model revolves around doing a lower volume of more high acuity cases, providing a higher level of service for a restricted time and producing lower costs for patients with better outcomes. You center has to become complex enough, Dr. Bray said, because that's where outpatient spine surgery is headed.

"We try to create a non-hospital environment," he said. "Our patient center is the focus. We have private overnight rooms, and our operating rooms are very complex. Don't mistake minimally invasive for minimal procedures. They include maximum technology. You need a big operating room that is well equipped."

To combat physicians taking salaried hospital jobs, DISC created a similarly stable structure with the benefits of being a standalone surgery center. Its model includes physician contracting, human resources, marketing, business development, computerized technology and more.

"We are not hospital-owned, but we have the structure," he said. "It let us become big enough to negotiate with payors. We are taking the ASC and creating a business structure model around it which allowed it to become a bigger entity and take higher acuity cases."

His tips for developing a similar model include:
•    Build for the future and plan for growth
•    Do not plan for the get-rich-quick model, but for long-term sustainability
•    Emphasize safety, quality, infection control and cost-efficiency
•    Be flexible
•    Do not carry a large amount of debt
•    Choose good patients, but don't be desperate. Be willing to say no to cases

More Articles on Orthopedic and Spine:
Total Joint Procedures to ASC Settings: Key Steps in Making the Transition
7 Steps to Add a Podiatry Residency Program to an ASC
10 Tactics for Managing Orthopedic Technology




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