Combating 3 primary ASC challenges to come out on top

Successful ambulatory surgery centers will be on top of their game to ensure they withstand the transformative healthcare environment in which reimbursement is on the way down and demand for data continues to increase.

During a panel titled, "The Biggest Challenge in our ASC," industry leaders Susan Kizirian, senior manager of Seattle-based Eveia Health, a division of ECG Management Consultants, and Michael Chmell, MD, medical director of Rockford-based OrthoIllinois Surgery Center, discussed the main obstacles ASCs face and strategies to overcome them.

Reimbursement & payer negotiations
"We have seen reimbursement drop significantly," said Dr. Chmell. "It has been a struggle to maintain revenue in the face of decreased reimbursement."

To ensure maximum reimbursement, ASCs should employ payer-contracting experts. However, knowing the intricacies of payer contracting is no easy feat, said Ms. Kizirian.
She explained communicating with payers is a complicated, hierarchical process in which ASC staff members spend a significant amount of time speaking with various payer system staff members. It takes awhile to move up the chain-of-command to speak with the person who can facilitate actual change in rates for a surgery center.

"Payer contracting is a big issue for a lot of ASCs as it is becoming so complex and time consuming," she added. "Some people are gifted at payer contracting and understand how to value a contract. They know how to go to payers and talk to them and figure who in the system they should talk to."

Hiring the right people
An efficient, and ultimately a profitable ASC, has to employ staff members well-versed in the world of outpatient surgery. Not everyone is equipped to run a center in the outpatient environment, where resources may be limited compared to hospitals.

"It is hard to recruit an expert," Ms. Kizirian said. "It is becoming more difficult to recruit people for ASCs as the industry becomes more regulated. Looking for those key people to run your business is becoming increasingly complex."

To find people fully capable of operating an ASC efficiently, Ms. Kizirian said networking is crucial. Go out into the field and talk to your contacts to see if they can put you in touch with the right person. ASCs may also consider hiring a headhunter if they "have their finger on the ASC industry and their connections."

When adding physicians to your center, Dr. Chmell said finding the right physicians for your center is exceedingly important. Many younger physicians opt for the hospital setting as the hospital presents a steady income where they have someone doing their billing and insurance. When seeking physicians to add, a center should employ a physician with an entrepreneurial mindset, willing to take risk.

"In training, you don't get exposure to much being an entrepreneur," Dr. Chmell said. "I think you need someone who is willing to step out of the box and take risk; not someone who wants to take the conservation route."

Maintaining patient volume
A surgery center's patient base may vary from a hospital's in that ASCs have to be more selective on potential surgery candidates. Dr. Chmell said ASCs need to monitor every process, as even the smallest one can impact whether the surgery center will lose that case to the hospital.

"There are a lot of simple things we take for granted and pass off that can really affect us losing patients that could go to surgery centers," Dr. Chmell said.

Additionally, centers have to work with the physician investors to ensure everyone works together, resulting in a profitable center. Some centers may lose cases if physicians won't do procedures at certain times due to inconvenience. "Everyone owns the center and everyone is the boss. Even if their profitability is lost, we could lose cases that way," Dr. Chmell added.

More articles on surgery centers:
Kernersville Outpatient Surgery to face off against 3 competitors: 7 things to know
AmSurg, Envision Healthcare consider merger to form $9B+ company — 8 things to know
6 factors dictating investment and M&A activity in the ASC sector

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