Medline Industries, a Mundelein, Ill-based supplier of medical, surgical and pharmaceutical products, hosted an ASC surgeon roundtable at Becker’s ASC Review 22nd Annual Meeting — The Business and Operations of ASCs.
The surgeons freely spoke about major challenges and advised each other on how to address specific complications faced in their ASCs.
Recruiting in a hospital-controlled environment
Hospitals snatch young physicians right out of residency with offerings of large sums of money. So, by aligning with hospitals ASCs gain access to a much larger network of physicians.
Yet, some ASCs successfully pull in physicians who aren't hospital employed. One gastroenterologist explained his ASC hired several fellows, exposing them to an alternative path outside of a hospital. The biggest challenge lies in getting surgeons through the door; once they're in the ASC setting, they stay.
Other markets, such as Chicago, are more difficult. ASCs may be the popular choice in just five years, pulling in more physicians as hospitals are left threatened. Trying to stick it out alone in these tumultuous times might prove most strategic.
By scouting out discontent hospital physicians, ASCs can expand their staff and increase case volume. Approaching physicians at the beginning of their careers may bolster an ASC even more, said one surgeon, as they are excited to jump full force into their futures.
Will hospital alignment hurt or help?
Aligning with hospitals may be the way of the future for ASCs. Many of the attending surgeons speak of either already being involved with hospitals or looking to partner with hospitals soon.
Based on anecdotes from surgeons hailing from various states, the geographic market determines the likelihood of a successful hospital/ASC partnership. ASCs may experience drastically different situations if partnering with an individual hospital versus a large network of hospitals.
In California, for example, hospitals are heavily investing in surgery centers and make decent partners. But if an ASC approaches an individual hospital, they may be in for a world of hurt, based on one surgeon's experience.
In Chicago, the market is cutthroat. One surgeon illustrated the intensity by explaining his ASC is six minutes away from four other surgery centers and five minutes away from three hospitals.
The art of contract negotiation
Although most ASCs enjoy autonomy, complex contracting issues steer many toward hospital support. Hospitals possess the resources to negotiate good contracts, and ASCs need those contracts to remain profitable. Often, ASC negotiations with payers result in dead-ends.
Direct contracting may prove beneficial. Going directly to employers allows ASCs to negotiate better contracts, as many of their employees use the ASC's services. Employers like high quality and low costs — exactly what ASCs offer.
Some surgeons praised their consulting companies as managing all the contracts, so the ASCs can focus on other responsibilities.
Another strategy involves working the back door, by heading straight to lobbyists who can do heavy lifting for ASC contracting issues.
Pay up for care
Patient must accept that healthcare involves payment. It's a whole new learning curve with the Affordable Care Act, as some patients don't understand they're not fully insured — upfront costs still exist.
One surgeon said his surgery center tries to ease this financial blow by setting up pre-surgery meetings with patients to clarify financial realities. The center has seen results, with the cancellation rate significantly dropping since implementing this strategy.
Also, hiring a billing team employee who interacts with patients to discuss any financial misunderstandings may properly prepare patients for inevitable bills. This will calm patients and provide for smoother processes on the procedure days.
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