The best opportunities for ASC growth: 3 Qs with Madison Physician Surgery Center Administrator Meredith Warf

Meredith Warf, CPA, DPT, administrator of Madison (Miss.) Physician Surgery Center and Mississippi Sports Medicine and Orthopedic Center in Madison, discusses the key payer trends and reimbursement issues for her center today.

Ms. Warf will share his expertise as a speaker at the Becker's ASC 26th Annual Meeting: The Business and Operations of ASCs, Oct. 24-26, 2019 in Chicago. To learn more and register, click here. For more information about exhibitor and sponsor opportunities, contact Maura Jodoin at 

Question: What is your ASC's strategy for patient collections?

Meredith Warf: With the global rise in patient responsibility with health plans and the increase in patients who are self-pay, this is a top priority for our center. We realize that one of the barriers of choosing to move forward with surgery is the financial burden, so we want to make this as easy as possible for the patients and their families. Our front office calls each patient as soon as possible to inform the patient of their expected amount due for surgery. Knowing that deductibles are more difficult to collect after surgery, we offer payment plans for up to six months and have recently instated a new program with BHG for patient lending.

Since we are a part of Mississippi Sports Medicine, we often work with the physician office to coordinate payment for professional and facility balances. When we began the bundled payment for joint arthroplasty several years ago, the patients were not only pleased with the lower costs but also with ease of only receiving one bill for the episode of care.

Q: How have you seen the increase in high deductible health plans impact your patients?

MW: As mentioned above, this can be a huge barrier for our patients who are electing to move forward with a total joint arthroplasty, spine surgery, or any other non-emergency orthopedic procedure. These patients usually choose to put off surgery and 'live with the pain' which, as providers, is the last thing we want patients to do. We try to ease the decision making by providing payment plans and financial options before they walk into our doors.

Q: Where is the biggest opportunity for strategic growth in the next nine to 12 months?

MW: We have been performing value-based care for arthroplasty in our ASC for four years and expect to expand that into spine and shoulder procedures in 2019. We believe this, along with data collection and improved patient outcomes, is the wave of the future in outpatient orthopedics. Moving to an episode of care model has allowed our practice to engage the patient before, during and after the procedure throughout their rehabilitation and back into their active lifestyle.

In addition, we have aligned with vendors for specialty procedures, striving to lower supply and implant costs throughout the Center. We have custom supply packs that are evaluated regularly to eliminate any waste.

Our new 60,000 square foot state-of-the-art surgery center in Flowood is nearly complete with eight operating rooms and three procedure rooms. The expected opening date is mid-June 2019. We are excited to offer the latest technology from arthroscopy towers to robotic arthroplasty surgery in our new center of excellence. As the shift for standard of patient care moves outpatient, we continue to examine cost of cases and surgery block utilization to optimize available operating room time in order to increase monthly caseload.

Research, patient satisfaction, and our experience show that outpatient surgeries are more cost effective for patients, with lower infection rates and superior outcomes. Orthopedics and spine are expected to grow 35 percent in the outpatient setting over the next 10 years. Mississippi Sports Medicine is poised to continue to lead the charge in best practices in orthopedics and orthopedic fellowship training throughout the southeast.

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The trend to outpatient surgery, risk-bearing contracts for orthopedic surgeons

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