Andy Poole, CEO of Monticello Community Surgery Center in Charlottesville, Va., discusses how his center is beginning to engage in value-based care.
Mr. Poole will speak at the Becker's ASC 25th Annual Meeting: The Business and Operations of ASCs, October 18-20, 2018 in Chicago. Click here to learn more and register.
Question: What is the biggest issue your ASC is facing today? What strategies to you use to overcome it?
Andy Poole: We are an independent ASC and we're in a market where there's consolidation among big healthcare systems. Primary care physicians are increasingly joining health systems and steering their cases to system-employed specialists, which makes it difficult for us to increase market share. As a result, we are engaging in more collaboration with neighboring hospitals that see us as a great way to gain a presence in low-cost, high-quality centers.
The group we work most closely with is an academic hospital [in Charlottesville, Va.], which is experiencing capacity issues. Since they are an academic center, they have an inherently high cost structure. We are able to offer a lower cost of care for patients paying more out-of-pocket for elective procedures, or for their shared savings contracts. When the health system is ready, they can increase their outpatient market presence in a more competitive way after working with us. That's a positive start, and for us it's about expanding services and growing physicians while maintaining relationships with the surgeons who already perform cases at our center.
We are also working on direct contracting with large self-funded employers to set up our own value-based contracts with those groups so we won't have to rely as much on referrals from primary care physicians. This is still developing for us, but we are very excited about the potential here.
Q: How is value-based care affecting your ASC or your plans for the future?
AP: We are one of the centers that truly believes and embraces transparent pricing. Many of any of our prices are online, available on our website. We also offer self-funded employers bundled surgical pricing through direct contracts. It's not currently a huge volume of what we do, but we anticipate growth. More and more it is the individual, or the self funded business that is paying for care. They are both looking for ways to save money while receiving the best care possible. Posting or pricing, and quality metrics, will continue to increase.
As mentioned previously, our partnership with the hospitals that have high-cost structures and less efficient operations make us attractive. But you have to have the right circumstances to develop a beneficial partnership. As health systems become more strategic about the site of services and increase their risk-based contracts, they will need to have lower-cost centers available.
Q: Over the next two to three years, what is the biggest opportunity for growth for your ASC?
AP: Obviously, joints and spine offer a huge opportunity for ASC’s, and that's what our center is focused on as well. For us, we've got a relationship with a spine group and certainly as you see more procedures pushed out of the hospital, we anticipate additional spine cases coming our way. We are still in the planning phases for total joints right now.
We also see the increased demand for both price and quality transparency as a source of growth opportunity. Patients with high deductibles and companies funding plans will want to know there their health care dollars go, and I believe will be more savvy shoppers for care. Our goal is to make it easy for those patients to find us and have the best service offerings available for them.