Margaret Chappell, RN, senior vice president of operations for Ambulatory Surgical Centers of America, has seen the ASC industry undergo tremendous changes throughout her career. She was a staff nurse at an ASC for several years, accumulating a wealth of knowledge in areas such as patient selection, anesthesia provider contracting, physician recruitment and retention, among several others.
Becker's ASC Review spoke with Ms. Chappell on where ASCOA, an ASC management company, is concentrating its efforts and how the company is keeping pace with the many forces at play in the industry.
Note: The following responses have been slightly edited for style and clarity.
Question: How long have you been with ASCOA and how has your role as SVP of operations evolved over the years?
Margaret Chappell: I've been with the organization for nine years and I have been in my current role for six years. We have taken on more responsibility as the landscape of the industry has changed. Now, we are working more on an individual basis with our payer contracting representatives, physician recruitment, development and marketing. We don't focus on just general operations anymore.
[In the past,] we have had a team of analysts helping with our financials. At this point, we are taking on a greater level of that responsibility. I do believe this is a result of the changes that we see everyday in the healthcare industry. Patients are better educated on their healthcare in terms of the quality of care they receive and the financial aspects of their care, and how this affects them. This [has resulted in] us becoming increasingly accountable to our patients, physicians and payers.
Q: Where is ASCOA focusing its efforts now?
MC: We are opening a surgery center in Naples, Fla., one of the ambulatory surgical centers [I oversee]. We have 14 physician-surgeon investors and we expect to have that center open in the next six weeks. ASCOA is actively pursuing purchase and development of new centers in all areas of the country.
[As an organization,] we continue to work with our centers and are actively developing centers and enhancing current relationships. ASCOA is doing recruiting for our centers and trying to provide the highest quality of healthcare at a high level of efficiency. Hospitals purchasing physician practices is a key factor that is making it increasingly difficult to recruit [physicians]. I do detect a change and some hospital-employed physicians are dissatisfied with their conditions of employment. Recruitment for us will increase if those physicians look at ASCs to work in and seek sound investments, like being an investor at an ASC.
Q: How is ASCOA keeping tabs on industry trends?
MC: We network with our physicians, their practices and other physicians in each market. All markets are different, but it is important for us to stay 'in the know' in each of those regions. We see what practices are going away because they are being bought out by hospitals and see why they chose to [pursue] that. We encourage our investors and surgeons that are performing cases in our centers to let us know what they know. I personally go out and meet with any physician in my markets that accepts an invitation to see me.
Q: What are some challenges planners face in launching a de novo ASC?
MC: There is a great deal of red tape that we have to work through in any community, no matter the region or state. One of the greatest challenges is to determine how to get through that red tape as quickly as possible.
You have to get out there and meet the people in the community who make decisions. Meet people who decide on things like building, codes and permits. Develop great relationships with your architect, construction company and licensing agency.
Q: Where do you see the ASC industry trending?
MC: I think ASCs are growing and payers are recognizing the savings they can pass on to their insured patients by using an ASC. As ASCs are being recognized as high quality, cost effective and safe sites of service by all in the healthcare industry, we are seeing more complex surgical cases daily moving into the ASC.
Margaret Chappell is among the key speakers at Becker's ASC 24th Annual Meeting: The Business and Operations of ASCs. Click here to learn more and register!