5 out-of-the-box ideas for ASCs to collaborate with hospitals (but stay independent)

A lot of ambulatory surgery centers pay lip service to developing cordial relationships with hospitals and physician groups in their local area, but few actually pursue them in a way that makes a difference. Gramercy Surgery Center in New York is one that does.

Gramercy Surgery Center is a multispecialty ASC in New York City's Manhattan borough — one of the toughest places to run an effective ASC. Yet, Jeffrey Flynn, COO of Gramercy Surgery Center and the newly-launched Gramercy Healthcare Management was able to partner with surrounding hospitals to show the ASC's value and prevent hospitals from blocking their expansion.

"I don't think ASCs have to be the enemy of hospitals," he says. "They can actually collaborate."

Here are five innovative ideas for collaboration without partnership, joint ventures or giving up independence.

1. Brachytherapy programs — Gramercy Surgery Center began their brachytherapy program in 2007 in collaboration with the Continuum network. The brachy cases weren't making money for the hospital, but the hospital still wanted these patients for subsequent radiation treatments.

"We found bringing the brachy cases here was ideal," says Mr. Flynn. "We understood the billing and could optimize our claims."

The center is the only free-standing Article 28 facility in New York in New York licensed to perform brachytherapy for prostate cancer treatment, and more than 300 cases have been performed there in the past five years.

2. Bring in cases that lose the hospital money — The hospital's billing department knows which cases are profitable and which aren't. Sending out the unprofitable cases to the ASC — where costs are lower and efficiency is higher — frees up the hospital ORs for the bigger, more profitable cases.

"We are starting to collaborate on cases where the reimbursement is so low that it doesn't even make sense for the hospitals to keep their lights on to do the procedure, but we can make money from it in the ASC," says Mr. Flynn. "You don't have to be taken over by the hospital or have a formal partnership, but through this collaboration we have built relationships."

3. Residency program — A local hospital started a podiatry program, but were unable to bring in enough cases for the residents to complete their hours. These cases don't generate huge reimbursement, but the hospital received government funding for the residency. So they partnered with Gramercy Surgery Center and allowed residents t olog cases as working with attending physicians at the ASC.

"If you're willing to bring one of their residency programs in, which means they can perform their cases as working attending physicians here, and they see that as a benefit, because you're covering cases that don't make money for the hospital, they won't try to block you when you expand in the future," says Mr. Flynn. "That's part of forging a lasting relationship."

4. Share equipment — There is some state-of-the-art equipment that it doesn't make sense for hospitals to purchase — they don't perform enough cases to justify the cost — but your specialty center could share the equipment to foster a relationship.

"I have the green laser, and there are two hospitals in New York that don't have it," says Mr. Flynn. "Their residents come over and train on my machine, which means their cases are performed here. I've also loaned my equipment to hospitals in the past. We build a back-and-forth relationship. That's what you need to do—think outside the box and figure out what the ASC has that the hospital needs."

5. Work with key specialists who hospital-based physicians respect — When the most respected physicians are at the ASC, hospitals take notice. Gramercy Surgery Center works with a few radiation oncologists who are prominent in the area and the hospital-based radiologists respect them. As a result, they refer their patients to those specialists.

"I have two of the most prominent radiation oncologists on staff at Gramercy and they are from two different hospital institutions, but they liked what we have here," says Mr. Flynn. "Both saw their urologists were here, and we could bring everyone together without crossing hospital lines. That helped us build community."

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