Co-founders of Nth Dimensions Bonnie Mason, MD, and J. Madume Kerina, MD, discuss the biggest challenges and opportunities for mature ambulatory surgery centers.
Dr. Mason is also the co-founder of Beyond the Exam Room and Dr. Kerina runs the TLC Outpatient Surgery and Laser Center in Lady Lake, Fla.
The primary issues facing ASCs 10 years and older include:
1. Payer consolidation which leads to lower reimbursement and less bargaining power for physician-owned ASCs.
2. Increasing hospital employment and physician-hospital joint ventures leaving fewer available physicians to participate in wholly-physician owned facilities.
3. Gathering data analytics for quality measurements and metrics as healthcare moves from volume-based to value-based care.
"In an environment where consumer pay healthcare is increasing, the primary goal is to achieve cost transparency," say Drs. Mason and Kerina. "With this in mind, a primary goal is to engage the value equation — ie, deliver higher [quality] at the same value or lower cost."
Strategic planning for surgery centers aiming for success over the next five to 10 years should include:
• Increase the volume of high revenue and high acuity cases — cases that give the highest return
• Shift from low-acuity and high volume to high quality, higher acuity cases that lower costs; this is needed in the value-based reimbursement environment
• Increase the specialty mix within your ASC
• Increase risk reimbursement strategies; risk stratification will remain important in the short- and long-term strategies
"You have to rank your payer mix," say Drs. Mason and Kerina. "You need to figure out a way to identify and rank cases and determine which cases provide the highest return."