Kingsport, Tenn.-based Holston Medical Group opened MeadowView Surgery Center June 22 and completed its first cases soon thereafter.
Tammy Andrews, chief officer of ambulatory surgery centers at Holston Medical Group, and Cheryl Stanski, MD, general surgeon at Holston Medical Group, shared the thought process behind their new ASC.
Note: Responses were edited for style and content.
Question: How did MeadowView take its patients' financial concerns into mind when building the surgery center?
Dr. Cheryl Stanski: Providing high-quality care at an affordable price to the patient is always most important and top of mind for us in all of our efforts. This requires a level of efficiency without compromising quality. To do so, HMG utilizes value-based contracting to ensure that the cost to the patient remains low, while the quality of care provided is greatly improved.
Tammy Andrews: At MeadowView specifically, no expense was spared on equipment, or making the facility state of the art. We fully utilized [group purchasing organization] pricing and purchased refurbished equipment when available. Additionally, utilizing an existing building helped to avoid the need for a new build, thus offering cost savings.
Q: What sort of best practices can you share with other administrators to implement at their centers?
TA: There are many factors that go into efficiently running an ASC. During the initial stages and startup, we found it important to ensure that we prioritized capital to account for the two main variables and controllable costs, which are staffing and supplies. In addition to our GPO arrangement, we also had a distribution agreement with a large medical supply company to ensure we received the best pricing.
We also took a phased approach to hiring top qualified employees that matched our patient volumes and were very selective to hire staff that were willing to cross-train across multiple functions to ensure proper coverage and contribute to more efficient operations.
Additionally, all patients are contacted prior to surgery by a nurse to review their history and conduct the preoperative assessment.
Our front office and billing personnel also have extensive training to ensure that all insurance is verified and prior authorizations are complete prior to surgery, as well notifications for patients to inform them of their patient responsibility and establish a payment plan as soon as the case is scheduled.
Lastly, implementing a system that enables the delivery of a full continuum of care from ordering supplies to billing, scheduling and electronically charting into one administrative function eliminates double entry and ensures efficiencies are achieved.
Q: With the project starting in late 2018, how did it evolve and change over time?
TA: Much planning time was spent with our construction and architect teams prior to starting [to build out] the center. We stuck closely to the original plans approved by the state. However, we made some changes, such as removing the large windows in the operating rooms to improve monitor viewing during certain surgeries. This change also had an economic impact by reducing heat and humidity problems caused by sunlight.
CS: We are very pleased that even through the COVID-19 situation, our timeline to receive licensure was not impacted. In fact, the need for such a center became even more crucial as outpatient elective surgeries have started to pick back up and procedures at the center help patients get back on their feet quicker than when done in a hospital setting and are less costly. Also, this facility gives our patients peace of mind from being less likely to be exposed to the virus.
Q: What was the hardest hurdle you had to overcome when building the center?
TA: Our biggest challenge was using an existing space and having to accommodate construction changes to meet the updated safety codes in place, as well as being mindful of the existing tenants during the construction phases. As a result, the construction company worked after hours and on weekends, slightly increasing the cost of the project. However, we are very thankful to the crews for their help!
The one thing we did not struggle with was finding highly qualified staff to join the center — a challenge that many organizations face when building a new location. Luckily, HMG had nearly 250 applicants for one of the positions.