10 Strategies for ASC Success in Healthcare Saturated Markets

Here are 10 strategies for ambulatory surgery center administrators to experience success in healthcare saturated markets.
1. Achieve correct reimbursement.
Many ambulatory surgery centers are signing in-network contracts with insurance companies because administrators feel it's necessary to stay viable in the market.

Dr. Hooman Melamed on surgery centers "It's become difficult for us because insurance companies are denying outpatient surgery, so it's hard to remain competitive," says Hooman Melamed, MD, an orthopedic spine surgeon at DISC Sports & Spine in Marina Del Rey, Calif. "And the rates they are willing to pay aren't conducive to performing cases in the outpatient setting. We have to take patients to the hospital where there is more of a risk for infection, less efficiency, less likely to get the one-on-one nursing, and less likely having the same experienced OR team as the surgery center."

However, contracts — whether in-network or out-of-network — shouldn't undercut surgery center costs. "ASCs must understand the out-of-network benefits to create a game plan to maximize benefits and profits," says Greg Maldonado, President of American National Medical Management. "If the ASC has correct reimbursement, it will attract new physicians and have the capital to purchase state-of-the-art equipment and form a comprehensive marketing strategy to attract patients."

2. Implement a continual improvement mindset.
New regulations and healthcare reform updates are constantly coming from state and national governmental bodies, and they impact business for healthcare providers. While regulations seem like a roadblock, they also offer opportunity for innovation.

"I don't think anyone knows what is going to happen with healthcare reform, but you want to have a strategy for success," says Dr. Melamed. "One option is partnering with other big groups in the same specialty to gain bargaining power with insurance companies. If you have a 100-surgeon orthopedic and spine group, that's very powerful. It's happening in Chicago and I think that model will move to other parts of the country."

Gregory Maldonado on surgery centersDevelop strategies such as diversifying specialties to stay on the cutting-edge of the marketplace. "If you have the mindset where you are continually trying to improve — thinking about how to attract the patient and where new patients come from — then you'll be able to survive in the changing market," says Mr. Maldonado. "I always tell sales people not to wait for the ship to come in; instead, swim to it. You have to understand where the client base is, both in terms of new physicians and patients."

3. Network with referring physicians and other professionals.
Hold a networking event between your specialty physicians and the referring primary care physicians in the community. Show off your facility and surgical skill so primary care physicians are more comfortable referring to your facility.

"You can educate them about the specialists, where the ASC is located and what separates your facility from other ASCs," says Mr. Maldonado. "When they can tell their patients that they have visited the surgery center and can assure them they'll be in good hands, these interactions dampen the fear of the unknown and help with patient retention."

This is also a great marketing tool for the specialist, and referring physicians will be able to visualize their patients at your facility after the open house. "Some primary care physicians have really great relationships with their patients, and the more at ease they can put the patient, the better their surgery will go," says Mr. Maldonado. "Then the patient can report back about the wonderful experience they had."

4. Strengthen the relationships you already have with physicians.
In most markets, ASC administrators are battling for physician retention in an increasing trend toward hospital employment. Understand your ASC's niche in the community and constantly strengthen your relationships with current physicians so they keep bringing cases.

"We are working to maintain the relationships we currently have and looking at our facility to see if there is anything we can do to accommodate those physicians," says Maria Scenna, Group Vice President with Nueterra. "Right now we are competing with some of the large hospitals employing physicians, and this new generation of physician workers, and it helps that we are able to specialize and continue to attract surgeons we already have."

When you can show them there is high quality and a slim chance of error because it's more focused and specialized, surgeons are more comfortable as well.

5. Recruit new physicians constantly and tailor your facility toward the surgeons.
To compete with hospital employment, many surgery centers are constantly on the hunt for new physicians and recruitment opportunities. Too often, new surgeons in the community or right out of fellowship think hospital employment is their only, or best, option without truly understanding the benefits of the ASC.

"We've been successful in recruiting new physicians to our facility by making it a pleasurable and smooth experience for them to perform cases here," says Ms. Scenna. "We make sure the personnel is consistent and surgeons have the tools and equipment they need to function efficiently. Their preferences are tailored to meet their needs, unlike in a hospital where general operating rooms are large and multi-purpose."

Easier patient flow and higher satisfaction will attract new physicians as well because they want good scores from their patients. "Their satisfaction will be higher because patients enjoy the boutique experience," says Ms. Scenna. "Administrators should constantly round with physicians to make sure they have everything they need."

6. Avoid relationships that don't make sense.
Healthcare reform was designed to encourage collaboration between all stakeholders in healthcare, but there are some situations where it doesn't make sense for ASCs to partner or align with other groups.

"Avoid insurance company and hospital relationships where the ASC won't benefit," says Mr. Maldonado. "If the insurance company wants to contract, do your due diligence to ensure it is not one-sided. You should always negotiate from your point of view, never from the buyer's point of view, because ultimately that relationship will be one-sided."

The same principles are important in hospital alignment or joint ventures with ASCs. Make sure those agreements and partnerships are not one-sided and benefit ASCs.

7. Identify new profit centers for ASCs.
There are several opportunities for ASCs to add new profit centers and avoid a hospital take-over, including durable medical equipment. Speak with colleagues who have already implemented revenue-adding programs, such as DME, and work with physicians to understand these opportunities.

"It's about seeing the same number of patients but increasing profits by 20 percent or more," says Mr. Maldonado. "There are a lot of potential profit centers most ASCs are missing out on. They should be constantly seeking out new ways to increase profits."

8. Control costs with vendor negotiations.
To effectively manage costs at surgery centers, administrators must negotiate supply costs down and make sure physician preference items aren't costing the ASC money. Administrators must always focus on cost-effectiveness so they can purchase new equipment and provide for surgeon needs.

"We work with vendors for pricing and stay focused on the specialties we do well," says Ms. Scenna. "To further drive costs down, we work with physician preferences and educate physicians on the supply differences so they can make the best choice for their patients. With the savings, we are able to spend more money on equipment and keep the rooms updated. We also create a pleasant atmosphere for the patients with the niceties it takes for a personalized experience."

9. Round with patients to improve satisfaction.
Whether marketing directly to patients or the physicians who could perform cases at the ASC, high patient satisfaction is crucial. Patients desire a comfortable and welcoming environment where staff members are friendly and wait times are short.

"We round with patients constantly to see whether they had a good experience," says Ms. Scenna. "We also make sure they have clear instructions for discharge and do everything possible to make it a personal experience."

10. Highlight the benefits of ASCs to the community.
Let physicians and patients know how ASCs can benefit their healthcare, from the lower infection rate to faster recoveries from less invasive surgery. Both surgeons and patients are looking for a better healthcare experience than the standard hospital.

"Surgery centers end up costing less because it's an outpatient procedure and patients don't have to return with infections or other complications. You are more likely to end up getting better nursing care and most likely the equipment in the OR is state of the art and of course the overall efficiency is much better," says Dr. Melamed. "We talk about our abilities to perform minimally invasive spine surgery as an outpatient procedure, which a lot of people don't realize is possible."

DISC's marketing campaign includes athletes who return to full sports after outpatient surgery, as well as the new equipment and procedures surgeons perform there.

More Articles on Surgery Centers:

7 Steps for ASCs Considering Majority Ownership Sale

18 Statistics on ASC Liquidity by Geographic Location

5 Exciting Trends for Surgery Center Leaders

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