Grow your mature ASC — 5 key strategies

How can a mature ambulatory surgery center continue to grow in the evolving health care environment?

There are many opportunities, asserts Pinnacle III President and CEO Robert Carrera, but the first step is maximizing what you already have. Here are a few key questions to consider:

• Is your center capturing every case possible from your current physicians?
• Are physician schedulers finding it easy to get their cases on your books?
• Is everything running smoothly?
• Are current physicians happy?
• Are physicians performing cases at another ASC when they aren't at your center?

"After you've maximized your cases from within, determine what types of cases you would like to add to your current mix," says Mr. Carrera. "Higher acuity cases are being driven to the outpatient setting. Are there any opportunities with orthopedic surgeons? Could you bring in vascular procedures that can be performed in outpatient centers?"

Then comes the hard part: going after new business. The key questions to ask when forming your recruitment strategy are:

• Who is new to the area?
• Who is your hospital partner recruiting?
• Have any new physicians joined your current partners' practices?
• Is there anyone in a new specialty your current partners want to recruit?
• Is there anyone outside your ASC that is unhappy with their current ASC situation?

"Anesthesia and medical directors are good resources. They know many of the other surgeons and can look for opportunities to speak with them," says Mr. Carrera. "Many markets are so mature that most physicians are already tied into ASC ownership."

Here are five ways mature ASCs can continue to grow:

1. Focus on high acuity cases. There is a great deal of opportunity to grow case volume in higher acuity cases, which weren't traditionally considered appropriate for the outpatient setting. Total joint replacements, many spine surgeries, and new retina procedures are now being safely performed in ASCs.

2. Price transparency. ASCs that can promote their pricing as more cost effective than other providers will have an advantage in the future. "ASCs are in a unique position. We know what the costs are and can make them available to the public," states Mr. Carrera. "Brokers are out there selling transparent pricing to employers. Set up bundled and packaged pricing with physician-driven initiatives."

3. Adopt new technology, but remain cost-conscious. "New ophthalmology technology has been introduced that is helping drive volume to our centers," says Mr. Carrera. "But we have to remember costs. There are interesting opportunities to do creative things with implant costs and suppliers."

4. Practice zero-based budgeting. This concept reverses the normal working process of budgeting. Instead of having departmental managers justify incremental budget changes based on historical data, zero-based budgeting requires departments to seek approval for each line item. "You basically start from scratch, as if you were in a brand new facility," Mr. Carrera explains. "You look at what you need to spend on everything and determine which areas you can decrease or eliminate future costs."

5. Keep updated on new health care trends. There are several opportunities to become involved in health care policy at the local and national level. Join the Chamber of Commerce and state associations to stay abreast of changes and market activity.

"Ask doctors what they are hearing at the hospital or in specialty meetings and what they are doing differently in their businesses," says Mr. Carrera. "You can't manage the ASC in a vacuum. You have to look into other markets and industries to learn new approaches that may be applicable to health care as a whole."

More articles on surgery centers:
24 staffing statistics for orthopedic surgery centers
ASC M&A, real estate today: 3 key thoughts from Jon Vick
The state of ASC business today—5 key thoughts from Ann Geier

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