The panel, moderated by Scott Becker, JD, publisher of Becker’s Healthcare, featured Jason Beam, senior vice president of operations for Ambulatory Surgery Centers of America; Chad Hoare, the ASC divisional sales manager with Medline Industries; and James Stilley, vice president of operations of Visionary Enterprises/Community Health Network.
Mr. Beam said he shares data with physicians monthly on the profitability of their cases. That information includes the cases the physician performed that month, the payer of the case, the time it took to perform the surgery, the supply cost, the fixed overhead cost and what the ASC was ultimately paid. From there, physicians can see if the case was profitable or not, and can make decisions on what cases and what payers to bring into the ASC.
But to make that strategy work, accurate data is paramount. “It’s trash in, trash out,” he said, meaning if bad data goes into a system, it won’t produce accurate information. “The last thing you want to do is present bad data to your doctors.”
On that note, Mr. Stilley encouraged leaders to take ASC’s data scrutiny a very seriously. “It’s very important to not just take what your data system gives you and say, ‘This is my case cost,'” he says. Instead, he said leaders should sit with techs and materials management employees to see how accurate the cost estimates are for each physician. For instance, a case may budget for eight bags of saline, but one surgeon uses 16.
“When you really start to sit down and see that there’s so much variance, and so much garbage in and garbage out, you’re really going to have to take a look at it, have to norm it…If we don’t expense [the case] correctly, and we then rely on the report, it’s going to give us the wrong data.”
One aspect of case costing is correctly capturing the cost of supplies per case, and a big part of that is physicians’ preference cards — which Mr. Hoare said are often incorrect or out-of-date.
“Preference card management is drastically underutilized,” he said. “It’s set once and never really adjusted…If you’re not staying consistent with the preference cards, then you can’t truly come up with a case cost.”
Mr. Hoare recommended implementing one of a number of software platforms available for ASCs that allow for easy management of preference cards and can adjust the cards in the operating room during a case.
However, just implementing an easy-to-use software program isn’t going to keep preference cards up to date. “That system isn’t going to maintain your preference cards,” Mr. Stilley said. “You have to put policy in that says, ‘You’re going to go in and say you used everything on the preference card, or we didn’t.'”
