From supply chain management to billing practices, running a financially healthy gastroenterology ASC requires vigilance on multiple fronts, leaders told Becker’s.
One source of lost revenue is avoidable procedure cancellations, particularly for colonoscopies. Benjamin Levy III, MD, a gastroenterologist at University of Chicago Medicine, pointed to inadequate prep communication as a primary culprit.
“Most gastroenterology-focused ASCs could better prevent procedure cancellations by reviewing prep instructions multiple times and in different ways: in the clinic, via paper instructions, electronically sent instructions, and pre-procedural phone calls one week and three days before the colonoscopy,” he said. “I recommend that ASCs send redundant electronic prep reminders via text, email, and MyChart/electronic health record. The colonoscopy prep instructions should be uniform.”
On the supply side, Dr. Levy said that many ASCs are not negotiating aggressively enough. He recommends revisiting contracts for snares, biopsy forceps, hemoclips and injection needles every six to twelve months, actively pricing alternative suppliers, and exploring bundle and promotional pricing.
He also advocates for a dual-vendor strategy, maintaining both a primary and secondary supplier to preserve bargaining power over time. Additionally, ASCs should closely examine out-of-network billing exposure, especially for employed anesthesiologists and CRNAs, where surprise billing risk can quietly accumulate.
Greg Schooler, COO of Cincinnati GI, has a longer list of financial pitfalls, including undiversified revenue, noncompliant budgeting, unchecked case costs and debt burden. The biggest mistake of all, he said, was illuminated during a recent AAAHC survey.
“Both surveyors commented on how happy and polite our staff were,” he said. “One added, ‘a happy staff usually means a well-run center.'”
That observation prompted him to think about staff morale as a balance sheet item. Labor is typically the largest expense in any ASC, and turnover is expensive.
At Cincinnati GI, Mr. Schooler said their reputation as a great workplace means talented CRNAs actively seek them out, often referred to by current employees, rather than the center having to compete on salary alone. The same holds true for room techs, a perpetually scarce role that competitors try to poach by overpaying market rates.
“We have an excellent group of techs that our competition is always trying to recruit,” he said. “Not tending to your human capital, investing in their training and development, creating a positive and rewarding work environment is actually a huge financial mistake and one that is often overlooked.”
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.