3 Challenges for Adding Spine and Retina to ASCs

While it is critical for ASCs to constantly explore growth strategies such as adding more cases and recruiting physicians, more and more ASCs are considering adding untraditional ASC specialties like spine and retina. While these may seem to fall under the umbrella of orthopedics and ophthalmology respectively, adding them is not as easy as simply expanding existing specialties.

Here are 3 major issues identified by Rajiv Chopra, principal and CFO for The C/N Group, ASCs must address when considering more complex procedures such as spine and retina.

1. The right surgeons, the right patients. It's an exciting time for ASC's in that medical technology and physician mastery of certain procedures is creating new growth opportunities. Neurosurgeons and retina specialists perform procedures with higher levels of acuity than traditional orthopedics and ophthalmology cases. As such, it is critical for an ASC to recruit physicians who are not only comfortable and capable of performing these procedures in the outpatient setting, says Mr. Chopra, but understand the regulations governing ASCs and the rules for issues such as how long a patient can stay in the center, the types of procedures appropriate for the ASC and what patients must understand about their procedure in the ASC compared to expectations they may have of the hospital environment. Additionally, surgeons tend to be selective on the types of patients they bring to the facility in the early stages of an ASC-based retina or spine program for health and safety purposes.  

2. Financial feasibility. While clinically you might be able to do retina or spine in an ASC, when you move down to the financial box — whether it's Medicare or your local payors — that may be a hindrance to adding these new specialties, says Mr. Chopra. "Just because you can do it doesn't mean you should — the reimbursements have to match up with these new services," he says. "These services will just not make sense in certain areas where you have a challenging payor market."

3. Understanding your costs. If your ASC decides to add one of these specialties, you will not be able to negotiate good contracts for them if you do not understand the costs involved with each procedure and any associated implants, which you may need to carve out, says Mr. Chopra.

Since the volume of these procedures performed at your ASC  may be lower than those seen in your traditional specialties, thus placing greater emphasis on profitability per case, you must be very careful before signing contracts, Mr. Chopra says. "If you're contracts are not structured in a way where you can make those procedures profitable,  you basically have a 'going-out-of-business' strategy where you are doing more and more procedures where you're not making money."

Learn more about The C/N Group.

Read more guidance from Rajiv Chopra:

- 5 Best Practices to Improve ASC Marketing Efforts

-
Growth of the 'One-Stop Shop' Model for Patient Care

-
Access to Physicians: 3 Major Challenges Facing ASCs

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