Finding a sustainable case mix is an essential part of ASC financial management and growth strategy as more procedures become approved for outpatient settings and margins become increasingly delicate.
Tara Good-Young, CEO of PDI Surgery Center in Windsor, Calif., recently joined Becker’s to discuss her organization’s approach to finding the right case mix balance.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: How does your ASC approach case mix decisions, and what factors most heavily influence which service lines you prioritize?
Ms. Good-Young: Our ASC is a single specialty, addressing catastrophic dental decay cases, which means our most predominant payer (96%) is Medi-Cal, so payer mix is not an influencing factor.
We evaluate scheduling case mix through a combination of case size and patient age considerations. Factors that most strongly influence prioritization include:
- Patient safety and clinical appropriateness: youngest children or patients with medication-dependent needs first, due to [non-profit organization] compliance constraints.
- OR time requirements and scheduling efficiency: mixing case size to prevent excess fatigue from one OR team getting only a stream of large cases.
- Alignment with organizational mission and community need.
- Availability of specialized staff and equipment: setting aside two days a month dedicated to serving patients with developmental or special healthcare needs to assure excellent provider to patient need pairing.
This balanced approach ensures that case mix decisions support both high‑quality care and sustainable operations.
Q: What challenges has your ASC faced when evaluating or shifting case mix to improve financial performance or operational outcomes?
TGY: Shifting or optimizing case mix presents several challenges in addition to our mission-driven specialty, which ties us to a single majority payer:
- Dedication to mission‑driven care, we were developed to care for high‑acuity overwhelming dental needs of underserved populations. If we shift service line/payer mix, it needs to be in response to the lack of need/demand in our primary mission.
- Staff training, equipment procurement, and new payer code/rate contracting involved when entertaining new procedures.
- Ensuring adequate referral volume to support expanded or adjusted service lines.
At the Becker's 23rd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, taking place June 18–20 in Chicago, spine surgeons, orthopedic leaders and ASC executives will come together to explore minimally invasive techniques, ASC growth strategies and innovations shaping the future of outpatient spine care. Apply for complimentary registration now.
