Why ASCs should be cooperating & not competing: 5 Qs with Jeffrey Flynn, COO & administrator of Gramercy Surgery Center

Jeffrey Flynn is the administrator and COO of Gramercy Surgery Center in New York City, and serves as vice president of the New York State Association of Ambulatory Surgery Centers. Here, he shares his thoughts on value-based care, opportunities for ASC growth and more.

Note: Responses have been lightly edited for style and clarity.

Question: What initiative are you most proud of at your ASC over the last 12 to 18 months?

Jeffrey Flynn: We've integrated a center into ours in a specialty that normally would've been on its own. There was an eye center in New York that needed to close because the building is being torn down. We refitted one of our wings to accommodate their eye program, and that's increased [our volume] by 3,000 cases a year. In that same situation, because that added another specialty for us, we were able to get more contracts with the value-based medicine that we're focusing on. We do a number of cancer care programs where we team up with a number of specialties to get one lump sum, and we've accomplished two additional contracts for [those programs] for lumpectomies.

Q: What were some challenges you encountered when integrating the eye center into your ASC, and how did you move past them?

JF: A lot of people I've seen have made the mistake of forgetting steps when setting up a [new specialty]. They'll [get] the surgeon, the anesthesia and the facility, but if you don't have the radiology backup, or the pathology component, a [payer] isn't really interested in jumping into contracts unless you can provide all of those. We're all going to be in some sort of value-based medicine in the next five years anyway, so I think if [ASCs] don't start dealing with it now, they're really going to be behind the eight ball in a year or two.

Q: What do you think are the reasons some ASCs are behind in adopting value-based care?

JF: People generally live in a silo in the ASC, and they don't reach out to their community, and in a day, [ASC staff] have a million things happening. You can hear about it at a conference, but it can be difficult to get ahead of it. We made a big stride here in New York with a number of the insurance companies. They used to view us as an ancillary service and not a facility, but now the insurance companies have started viewing us as a facility, which has made a big difference because they understand the cost savings. I think [value-based care adoption] has a lot to do with knowing where to start.

Q: How do you see your ASC growing in the next year or so?

JF: Just from the standpoint of cases, a lot of it comes down to the independent practice associations, which we're making direct relationships with now. To achieve cost savings, they're trying to keep patients out of the hospital, and we're an alternative to the hospital that saves cost. The traditional [approach] was to bring in a physician as an owner and take their cases, but now we're looking to make relationships with unions and independent physician networks. It's a lot of time and effort put in, but I'm seeing the results. We started this three years ago, and in the first year and a half, nothing was happening. Now we're seeing a real benefit and seeing cases come in. I have two IPAs that make up 25 percent of my surgeries in Queens. That's where we see our business going, and that's where we're spending most of our time.

Q: How would you like to see the ASC industry change as a whole?

JF: The New York State Association of Ambulatory Surgery Centers has really tried to promote more community among ourselves. One of the things we're trying to do is see each other as colleagues and not as competition and work together more. I can reduce cost, I can do more procedures. The only way I can reduce cost is with purchasing power.

We're now in a cooperative group purchasing organization, and the more of us that join it,we're starting to see significant savings. There's a brand new surgery center which joined the association right way. When they were getting their equipment, they saved over $400,000.

We were very fragmented between upstate and downstate two years ago, and we've really made some strides. We've started doing one upstate conference and one downstate conference to get everybody together. Anytime I go to conferences and sit down with somebody I don't know, because we're in the same business, we suddenly have something in common. The conversations really need to continue outside of the conferences. We can promote the idea of calling up a colleague who may know the answer to the difficult question. With so many centers still being independent and not part of a larger management organization, a lot of people can hit a stone wall. One of the things I'd really love to see is for us to start working more with each other.

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