Rajiv Chopra, principal and CFO for The C/N Group, identifies three ways ASCs can improve processes and their overall efficiency.
1. Partner with exceptional anesthesiologists for your ASC. One of the keys to efficiency in an ASC is pre-op and post-op process. When you look at some of the more acute surgical specialties — orthopedics is one where this is critical, Mr. Chopra says — you need to maintain an efficiency mindset without compromising patient safety and comfort.
"Your anesthesia can make a difference," he says. "Once the surgery is done, how quickly are patients recovering so they can leave the facility? A lot of this ties back into anesthesia, and if you don't have an anesthesiologist with that skilled component, it can create challenges for you just from a recovery time perspective. Again, you want to maintain safety and quality without having patients clogging up your post-op recovery room.
2. Train staff to understand importance for fast turnover time. Especially for high volume procedures like cataracts and colonoscopies, you should track how quickly you can get ORs turned over, and keep trying to improve upon this time.
"Training of the staff and making sure everyone has the mindset of fast room turnover time is one of the keys to keep performing these procedures efficiently," Mr. Chopra says. "It's a learned thing — allow your nursing staff to come up with new ideas and concepts for doing things more efficiently. Remember that a physician can sometimes do 10 of these procedures at the ASC as opposed to five in the same amount of time in the hospital" because of efficient practices like fast turnover.
3. Commit more time and attention to you cash cycle. The cash cycle of an ASC has recently taken on an even higher level of importance for the organization's stability and success and is also becoming significantly more challenging, Mr. Chopra says. "What's happening is you're seeing more of a patient responsibility for co-pays, deductibles and everything in between," he says. "You've got an economic crisis — patients are going to pay their mortgage, car, cell phone, college tuition and then maybe they'll think about paying the healthcare bill. You can repo a house, you can repo a car, but you can't take a colonoscopy back."
Mr. Chopra advises ASCs to tighten up their policies in terms of front-end collections and co-pays.
ASCs must also keep a close eye on what their payors are doing that could impact the ASC's business. "The insurance companies are constantly looking at programs which benefit the patient," he says. "In some markets for colonoscopies, there is no longer a co-pay. When the rules change, how quickly can you communicate that to your front-end folks and get those routines in place so you know which patients you're supposed to collect the co-pay from, and which you're not.
"It sounds easy, but if you're in a market where youhave 100 insurance plans and each one has their own process, their own guidelines, it gets to be a little complex," he says. "There can be a breakdown in the communication by the staff upfront. They can say, 'let's just not collect any co-pays and then you'll find yourself trying to go to the patient that actually owes you after the procedure and in today's economy, that's not easy."
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