DOING BUSINESS

The Vital Role of Strategic Partnerships for ASCs

BY DAN BUGARIN | SEPTEMBER 2024

ASCs have become an integral part of the healthcare system, providing cost-effective, high-quality surgical care in an outpatient setting. The success of ASCs is evident in their rapid growth over the past few decades.

Funding ASC Expansion Through a Sale-Leaseback

BY JASON WINOKUR AND JON VICK | AUGUST 2024

Surgeries that have historically been done in hospitals are moving to ASCs. According to the VMG Health 2024 Healthcare M&A Report, in its third quarter 2023 investor presentation, Tenet reported that USPI same-facility ASC total joints had grown 14.2 percent year to date as of September 2023.

Rules of Engagement

BY BRIANNA THOMAS | JUNE-JULY 2024

As a member-supported organization, the Texas Ambulatory Surgery Center Society (TASCS) knows the importance of engaging with those who make our efforts possible. As we interact with potential and existing members, we build awareness and community, and establish trust and thought leadership.

Best Practices in Sterile Processing

BY ERICA SMITH | NOVEMBER-DECEMBER 2023

The sterile processing department (SPD) plays a crucial role in maintaining a clean and sanitary environment within a surgery center. Decontamination, cleaning, washing, inspecting, sterilizing and testing are just some of the tasks staff perform there.

Get Correct and Timely Payments for Implants

BY ANGELA MATTIODA | OCTOBER 2023

Implants often require a significant investment, and in an ASC, missing an implant payment can quickly turn a profitable procedure into a financial loss. For surgery centers to be able to continue to offer procedures involving expensive implants, negotiating and capturing appropriate reimbursement for those implants is critical.

Evaluate Your ASC’s Ancillary Services

BY DAREN SMITH | OCTOBER 2023

A standard for contracted services within the Medicare Conditions for Coverage (CfC) defines the expectation that an ASC will ensure that any services received through a contract with an outside vendor will be provided in a safe and effective manner.

Access Workforce Information

BY DONALD ILLICH | SEPTEMBER 2023

Established by Congress in 1986, the National Practitioner Data Bank (NPDB) is a workforce tool that prevents practitioners from moving state to state without disclosure or discovery of previous damaging performance. ASCs may use the NPDB in certain circumstances.

Leveraging Culture to Combat Labor Issues

BY RITA HERNANDEZ-FIGI | JUNE-JULY 2023

Persistent labor issues continue to pose financial and operational challenges for surgery centers. The rising costs to staff cases combined with the inability to operate at full surgical capacity is a one-two punch that is expected to cause damage throughout 2023 and beyond.

Create an Experience that Employees Prefer and Patients Want

BY ROBB WEBB | JANUARY 2023

In the early 1900s, Frederick Winslow Taylor penned the famous Principles of Scientific Management Theory. In it, he described how to optimize the way work gets done and studied the tiniest of tasks, leading to the division of labor and establishment of rigorous processes and hierarchy.

Engage Physicians Effectively

BY MICHAEL NOLAN | JUNE-JULY 2022

Successful ASCs rely on strong and efficient partnerships with physicians. As ASCs continue to expand and strengthen their role in the healthcare delivery system, it is critical that the industry continues to evolve by finding more effective and efficient ways to engage physicians.

Improve Your Payment Processes, Buy Smarter

BY DUNSTON ALMEIDA | APRIL 2022

Go into the account of your favorite online retailer and you can view detailed information about your purchases, including the date you ordered, what you spent and when orders were delivered. Go into your banking account and you should be able to see detailed information there as well, such as who you paid, what amount you paid, what you paid for and when.

Deliver Personalized Care in the Age of Machines

BY DAREN SMITH | OCTOBER 2021

A few significant developments are motivating ASCs to invest in information technology (IT) solutions. Centers that must compete with hospitals or other ASCs will want to be perceived as a leading care provider, which includes keeping current with technology.

Tips on Marketing an ASC

BY BRIANNA THOMAS | SEPTEMBER 2021

Last year, Coherent Market Insights estimated the value of the US ASC market at $54.2 billion and projected that it would see a compound annual growth rate of 5.6 percent between 2019 and 2027.

Converting an HOPD to an ASC

BY JULIE HAMBERIS, RN | AUGUST 2021

Increasing numbers of hospitals intend to expand their investments in ASCs going forward, according to a 2020 survey of senior healthcare executives conducted by Avanza Healthcare Strategies. These hospitals use a few ways to grow the number of ASCs in their portfolio.

Improve Your Revenue Cycle Performance

BY ANGELA MATTIODA | MAY 2021

To get paid, ASCs must perform a series of functions, including insurance verification, authorization, chart prep, dictation and transcription, coding, claim submission and payment posting.

The Business of Unlisted Codes

BY JESSICA EDMISTON | APRIL 2021

Surgeons often embrace new technology and highly complex or rare cases. While these challenges help surgeons excel in their field, they also can create coding and billing dilemmas.

Optimize Patient Care with Careful Provider Scheduling

BY RICH MILLER | MARCH 2021

The traditional healthcare supply chain has taken center stage because of the COVID-19 pandemic. For example, access to personal protective equipment (PPE) has become a common topic of discussion, as have questions about equitable vaccine distribution.

Tips for Increasing Patient Safety during a Pandemic

BY DAMIEN BERG | NOVEMBER-DECEMBER 2020

Surgery center operations are categorized into areas that help maintain patient and staff safety. How do we best use our resources in these categories to follow infection prevention guidelines during a pandemic?

Considering Single-Use Products

BY JESSICA RAAB | OCTOBER 2020

In this new reality impacted by the COVID-19 pandemic, healthcare facilities, including ASCs, are being asked to answer difficult questions.

Insights from GI Surgeons on Resuming Elective Procedures

BY DAN KOHL | SEPTEMBER 2020

While the COVID-19 pandemic is far from over, the ASC industry is finding innovative ways to get back to the business of handling procedures unrelated to the virus.

Keys to Case Profitability

BY ERIN PETRIE | AUGUST 2020

As the cost of delivering healthcare continues to rise, ASC reimbursement is getting tighter, necessitating even closer cost monitoring and a proactive stance on payer contracts and collection.

Maximize the Value of End-of-Month Reports

BY CARYL SERBIN | JUNE-JULY 2020

Your ASC’s end-of-month (EOM) reports serve multiple purposes. They help your accountant with tax purposes and your ASC’s governing body in understanding the center’s performance. These reports also could be used to improve the efficiency of your revenue cycle management (RCM) team and cash flow.

The National Practitioner Data Bank and Your ASC

BY DONALD ILLICH | JANUARY 2020

The National Practitioner Data Bank (NPDB) is a federally run program managed by the Health Resources and Services Administration (HRSA). It is a web-based repository of reports containing information on medical malpractice payments and certain adverse actions related to healthcare practitioners, providers and suppliers.

Prevent Perioperative Hypothermia

BY MARY LETOURNEAU, RN | NOVEMBER-DECEMBER 2019

With the ever-increasing number of complex surgeries performed in ASCs today, patients are under general or neuraxial anesthesia for longer periods of time than before. Thermoregulatory control is compromised during these surgical procedures and could potentially lead to Perioperative Hypothermia or PH.

Put Digital Marketing to Work for Your ASC

BY NADER ASHWAY | OCTOBER 2019

If you are considering a marketing program for your ASC, the amount of detail involved could easily become overwhelming. Especially when it comes to digital marketing, the technical jargon that you hear from consultants and agencies could be confusing.

Control Ancillary Services Costs

BY DAN SCHNEIDER | SEPTEMBER 2019

Most ASC administrators wear multiple hats and manage myriad tasks. One of those hats is to keep a close eye on the recurring monthly expenses that keep the lights on and the business running in their ASC.

Manage Your IOL Inventory Efficiently

BY MICHAEL B. RIVERS, MD | AUGUST 2019

Ophthalmology surgeons are experts at multitasking. On a typical day, a busy ophthalmologist manages multiple back-to-back surgeries and might perform 30 or more cataract procedures.

Put Digital Charts to Work

BY WILL CAMPBELL | JUNE-JULY 2019

ASCs spend a lot of money on the materials needed to build a paper chart. Centers shell out roughly $7 per chart, and that doesn’t include the time and labor office staff invest in assembling, retrieving, taking apart and reassembling them.

Performing TJR in the ASC Setting

BY NADER SAMII | MAY 2019

“You have to change your thinking if you desire to have a future different from your present.”

—Germany Kent, print and television journalist, author, actor

Leverage Technology to Improve Business Office Efficiency

BY RANDY BISHOP | APRIL 2019

If you have worked in the ASC industry long enough, you have likely heard a phrase along the lines of “case volume is the lifeblood of an ASC.” While cases are vital to an ASC’s success—after all, without cases, there are no billable services—cases on their own will not make or break a surgery center.

Closing the Loop

BY ARNOLD G. LEVY, MD | MARCH 2019

The overarching goals of population health are to improve the overall well-being of a designated population while lowering costs. "Burden and Costs of Gastrointestinal Disease in the U.S.,” an October 2018 column in NEJM Journal Watch, estimates direct and indirect spending on GI diseases in the US to be $136 billion per year, with many procedures and surgeries costing patients hundreds or even thousands of dollars.

Improve Patient Engagement with Two-Way Texting

BY BRANDON DANIELL | FEBRUARY 2019

Communicating with patients can be challenging. Traditional methods can be expensive and time consuming and are becoming less effective every day. The mobile phone has changed the way the world shops, socializes and, most importantly, communicates.

Childhood Dental Disease Affects Millions

BY HAZEL WHITEOAK | JANUARY 2019

Dental disease, our nation’s number 1 preventable childhood disease, endangers the overall health of millions. It is a silent epidemic that disproportionately affects poor children leading to a lifetime of health problems.

Quote Costs Up Front to Boost Patient Satisfaction

BY SCOTT PALMER | SEPTEMBER 2018

Patients are increasingly shopping for the health care services they need and becoming more aware of the cost of that care, especially for their portion of the cost. As low-cost, high-quality providers, ASCs should encourage this trend.

Key Trends in ASC Valuations

BY TAMI M. BOLDER | JUNE-JULY 2018

Since Medicare approved payments to ASCs in 1982, the number of ASCs has grown substantially. Further, as the number of procedures that can be performed in an outpatient setting has grown, the utilization of outpatient surgery centers has increased in recent years from 50.5 percent of total surgeries in 1990 to 65.9 percent of total surgeries in 2014, according to VMG Health’s “Multispecialty ASC Study Intellimarker 2017.”

Is Staff Hours Per Case a Reliable Labor Metric?

BY ARNE BROCK-UTNE, MD | MAY 2018

I was driven to write this because managers/administrators get blamed for high and inconsistent staff hours per case (SH/C), when the reason for this outcome might be completely out of their control. When managers are pushed to lower SH/C they might inadvertently lower their staffing assignments to a point below what is acceptable for safe clinical care. When that happens, you will have problems ranging from sub-par patient and physician experiences— resulting in poor online reviews and lost cases—to bad clinical outcomes.

Code Properly to Prevent Lost Revenue

BY ANGELA MATTIODA | APRIL 2018

An ASC’s coding staff plays a key role in avoiding claims denials. By ensuring accurate coding and data entry, an ASC is more likely to receive correct, complete payment for services rendered. Any number of coding-related issues might cause a loss of revenue. Understanding these issues and how to effectively respond when they arise will help keep cash flowing in and denials away.

OR Utilization

BY ARNE BROCK-UTNE, MD | JANUARY 2018

Everyone wants their ASC to be busy, their operating rooms (OR) full and their profits rolling in. What is the definition of “full” and can a center be “too full” or “too busy?”

When we talk about how busy a center is, we are talking about OR utilization. How well are you using your fixed capacity (ORs) to drive your revenue (cases)?

Not Too Late to Succeed Under MIPS

BY JULIE C. SERVOSS, MD | NOVEMBER-DECEMBER 2017

Almost a full year has passed since the Centers for Medicare & Medicaid Services (CMS) deemed 2017 as the transitional year for independent physicians to comply with the Medicare Access and CHIP Reauthorization Act (MACRA). MACRA has two available tracks: Alternative Payment Models (APMs) and a Merit-Based Incentive Payment System (MIPS).

Attain Compliant Revenue Cycle Management

BY CARYL SERBIN | OCTOBER 2017

Obtaining the full reimbursement you deserve while remaining compliant with federal, state and managed care regulations is imperative to keeping your doors open and achieving year-over-year growth. Several areas in your revenue cycle that affect compensation also are potential areas for noncompliance.

Performing Hand and Upper Extremity Procedures in an ASC

BY JENNIFER PETERSON AND GLENN BUTERBAUGH, MD | JUNE-JULY 2017

Through the years, the surgical arena has changed dramatically. Surgical procedures—particularly hand and upper extremity procedures—that had been performed in hospitals only have now come to call ASCs their home. These procedures have paved the way for more complicated cases to switch venues as well.

Surgery Center Coding and Your Bottom Line

BY JESSICA EDMISTON AND LORI SAMII | APRIL 2017

The quality of an ASC’s coding can make the difference between a struggling center and a successful center. Incorrect coding and billing practices might mean a facility is not being paid for all of the procedures it performs.

Ban the Breaches

BY JIM TUFTS | NOVEMBER-DECEMBER 2016

Health care organizations worldwide are up against an evolving problem: information technology (IT) security risk. With a wealth of digitized personal information, these organizations are enticing targets for malicious hackers. With so many endpoints in use, it is easy to see the scope of the danger.

The Growth of Clinical Data Registries

BY ERIK MICHALESKO | OCTOBER 2016

Data has been gaining traction as one of the most integral aspects of the modern world. Businesses use it to make tough financial decisions, web sites analyze it to present relevant content and political parties utilize it to target specific demographics. Currently, one of the best ways to collect health care data is with a clinical data registry. Quality initiatives and government provisions have spurred their growth, proliferating the number of registries in the US. The information contained in them can benefit the health care field hugely, and the points below are what ASCs should know about registries.

Grow Your ASC

BY ANDY WHITENER | SEPTEMBER 2016

It is no secret that growing an ASC can be a challenge. Every ASC administrator is faced with the same goals: optimizing capacity and continuously growing the center’s volume. The multispecialty center—four operating rooms and two procedure rooms—that I manage was no exception. In 2010, the center was barely performing 100 cases each month, and we were competing in a very tight market. Within a five-mile radius of our center, there were no fewer than 17 single-specialty surgery centers.

Communication Mistakes Could Prove Costly

BY JHO OUTLAW | AUGUST 2016

Poor communication between the revenue cycle team and key ASC stakeholders, such as physicians, can result in coding errors, delayed dictation and inaccurate documentation. This, in turn, negatively impacts revenue in an ASC. With improved communication, many of these mistakes can be remedied.

Improving Outcomes

BY STEPHEN PUNZAK, MD | JUNE-JULY 2016

The potential for improved outcomes greatly increases as patients become more involved in their own care. As health care providers look for new ways to engage patients, patient engagement technology is becoming increasingly popular. While many people are excited about this technology, it is interesting to note that these systems are still in their infancy and have yet to be truly defined. In fact, even the term “patient engagement” can mean very different things to different people.

Lowering the Cost of Spine and Orthopedic Implants

BY TIM BURNEY | APRIL 2016

Implant costs make for one of the largest expenses—if not the largest expense— in an ASC with a spine and/or orthopedic focus. Because of their complexity and the quantities required, managing spine and orthopedic implants presents a unique challenge for ASCs. For those same reasons, they also offer ASCs a great opportunity for cost savings.

Increasing Productivity in a Complex, High-Volume Environment

BY TINA ELLIOTT | FEBRUARY 2016

Many recent studies demonstrate that ASCs provide cost savings for Medicare, insurers and patients alike. A few of the most noteworthy include one released by the US Department of Health and Human Services (HHS) Office of the Inspector General (OIG) in April 2014, one by researchers at the University of California-Berkeley released in late 2013 and another by two health economists published in Health Affairs in May 2014.

What’s My Center Worth?

BY M. DEREK LONG | JANUARY 2016

ASC transactions continue to be a hot trend in the health care mergersand- acquisition arena for several strategic reasons. While an organization’s motivation for buying or selling interests in an ASC will vary, common catalysts remain the same: i) a hospital’s desire to purchase an ownership interest in a local ASC, ii) a large, for-profit organization’s desire to purchase a majority interest in an ASC as part of its strategic plan, iii) a large, for-profit organization’s desire to purchase a minority interest in an ASC as part of its strategic plan, and iv) a physician’s desire to sell a minority interest due to retirement or relocation.

Doing Business

DOING BUSINESS