Step one: It’s not personal but an objective eye can perform the analysis void of any prior institutional knowledge and establish the facts. How does the center perform based on its current environment and focus? If the physical plant is antiquated, what workarounds can be deployed to defeat certain physical characteristics? What is the professional pace that the staff encounters on a daily basis and are there changes in work flow and tempo that can be deployed to assist in productivity? Leadership roles and effectiveness are evaluated, as well as informal leaders that affect performance in different ways, either positively or negatively on a daily basis. The review of available data and benchmarks are items to consider and compare to comparable center’s volume and specialty. Since what gets measured gets done, these goal posts are important to a centers success.
Step two: Physician perception of the issues at the center and the reality for change. Most physicians will have an opinion on how things should go or why certain aspects of the business do not progress. An independent party will get very direct answers to questions that are presented in a very short time frame. Discussions with physicians will also uncover the aptitude for change and flexibility. Most existing centers have core members that are locked into certain patterns, utilization, block time and resources that could be changed to enhance productivity. The key of any fluid center is the flexibility of all parties to a common goal. Recruiting potential and available physician-utilizers are a necessary step to the future of the center. Often the prior structure or initial inception of the center may have established barriers to entry by some community physicians. Often a management company infused into the center can deliver changes and opportunity for new surgeon utilization.
Step three: Line item review of expenses and how reductions could be implemented to impact total cost per case. Reviewing the purchasing processes, vendors, tier levels and vendor utilization are keys to successful purchasing. An analysis of existing inventory, antiquated inventory and consignment items are historical facts that can give insight to the past practices. Implementing creative programs on purchasing and expense control often must originate outside the center’s walls. Review of custom packs and trays, preference cards and specialty items will also give immediate data on case profitability.
Step four: Case review of the majority of procedures and the profitability of cases by physician and procedure. Often physicians are unaware of the cases that can be performed at the center and conversely others bring the kitchen sink. Each situation must be analyzed for the appropriate titration of cases and payor mix. In this phase, the analysis of managed care contracts, negotiations, appropriate payment and out-of-network payments are performed as well.
Step five: Customer service and customer satisfaction are reviewed to see how both internal and external customers view the performance of the center. When reviewing patient satisfaction and indicators, this tends to allow the reader to be objective based on feedback. Additionally, internal customers, namely physicians and employees, are reviewed to assure that needs are being met and proactively addressed.
These processes are very time consuming and could consume the resources within a surgery center very quickly. The changes are often difficult to implement when managing a center or trying to run a busy practice as a physician-owner. This list is not all encompassing but a general outline of the potential approaches for turnaround opportunity. The bottom line for successful operations is experienced leadership with a greater knowledge of the industry and a finger on the pulse of your center.
Learn more about Practice Partners in Healthcare.
Read more from the leadership team of Practice Partners in Healthcare:
– 3 Ways Health Plans are Corralling OON Surgery Centers Into Their Networks
– 2 Examples When Out-of-Network is a Surgery Center’s Only Option
