Where 3 ASCs are focusing budgets, attention for 2020

Three ASC leaders discuss the big strategies for their centers next year, including the focus of their 2020 budgets and what they plan to improve.

Note: Responses were lightly edited for style and clarity.

Question: As you develop your center's budget for 2020, where do you plan to spend the most? What is changing year over year?

Brian Bizub. CEO of Raleigh (N.C.) Orthopaedic Clinic: Since the announcement by CMS allowing total knee replacements to be done in an ASC setting, the budget was adjusted in preparation [for] increased implant costs. Raleigh Orthopaedic Surgery Center has been fortunate to negotiate rates with implant vendors and suppliers that have been budget neutral, which will continue for the next three years. IT and software to ensure that we are in compliance with Leapfrog initiatives, transparency and patient satisfaction havebeen the area where the center has seen the biggest increase in costs for services and participation levels.

Mitch Schwarzbach. Administrator of Grand Valley Surgical Center (Grand Junction, Colo.): I plan to spend the most time focused on payroll and bringing it down.

Craig Filippi. Administrator of Gold Coast Surgicenter (Chicago): I don't expect significant changes from 2019, with the exception of some planned capital expenditures to upgrade certain equipment.

Q: What do you expect to do more of in 2020, and what do you plan to leave behind?

MS: We expect to do more total knee replacements next year. There is nothing we plan to leave behind.

BB: Raleigh Orthopaedic Surgery Center has seen an increase in total knee, hip and shoulder joint replacements in the center over the past two years, as well as other musculoskeletal procedures including spine, hand, foot and ankle, and sports medicine. Lower costs, fewer infections, a safer environment and patient satisfaction are driving patients to choose their surgical procedure at an ASC over a [hospital outpatient department]. The ASC continues to increase our daily cases annually because of patient choice and the reputation of Raleigh Orthopaedic Clinic and our fellowship trained surgeons in the community. The ASC removed interventional pain management injections over a year ago, so I only foresee growth in the future of musculoskeletal procedures and not regenerative medicine or orthobiologic procedures.

CF: Next year, we will likely do more complex spine cases and increase total joint cases.

Q: What aspect of ASC operations are you focused on improving the most next year?

MS: In 2020, we plan to improve our EMR and practice management solution and equipment.

CF: There are three main areas of focus for us in 2020: efficient and productive use of our block time; specific contract renegotiations with payers; and cost savings in regards to implant and supply costs.

BB: We are focused on the patient experience and safe patient care. As executive director of a single specialty ASC, my role is to ensure we have qualified teams that are well-trained and certified in orthopedics. The nursing leadership and staff in the ASC are engaged in safe patient care; efficiency; maintaining strong communication with the patients and family members prior, during and after their procedures; and promoting an environment that is patient-friendly but maintaining compliance with all regulatory requirements. Raleigh Orthopaedic Surgery Center just completed its AAAHC survey in July 2019 with a perfect score and no recommendations for improvements.

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