As ASCs tackle more cases and work with fewer resources than hospitals, they face a unique set of financial challenges. However, there are strategies ASC administrators can use to boost efficiency and reduce costs.
At Becker's ASC 25th Annual Meeting: The Business and Operations of ASCs in Chicago Oct. 18, Ann Geier, RN, CNO of Surgical Information Systems, and Robert Westergard, CFO of Ambulatory Surgical Centers of America, discussed four such strategies:
1. Review case costing information. Performing more cases in an ASC does not always lead to increased profits, Ms. Geier said. Case costing, where each procedure by a surgeon is reviewed based on overhead, supplies and implants compared to reimbursement by payer, can effectively manage and optimize costs. Case costing helps ASCs determine the expenses attached to each procedure performed at their facility, and administrators can use that information to find where surgeons need to adjust their practices.
"The goal with case costing is to have discussions with surgeons that can help them analyze the best practices for each procedure and see where they could be saving the facility money," Mr. Westergard said. ASC administrators can help physicians compare best practices by sitting down with them and looking at data on their case times and the materials they use. In this way, surgeons who have "money-losing" cases can figure out what's making their cases unprofitable, Mr. Westergard added.
2. Use networking to recruit new physicians. For ASCs, recruiting physicians is a difficult and constant process, Ms. Geier said. "As physicians come out of residency with large amounts of student debt, they want to be employed with a good salary, and often don't have the money to buy into an ASC, even if it's profitable," she said.
To help recruit new physicians, Ambulatory Surgical Centers of America "trials physicians and gives them the royal treatment," holding regular networking events to help them get to know the facility, Ms. Geier said.
"We found these networking opportunities much more effective for recruiting new physicians," Mr. Westergard added. "We helped increase cases all because we brought in people to talk to the doctors every month."
Additionally, Ms. Geier said holding a debriefing session with physicians after these recruiting events can help ASCs understand where to make improvements in their recruiting process. "We ask them what we could have done better and what they expected that we didn't provide to make them feel like they're a part of our team," Ms. Geier said.
3. Compress schedules. The goal of schedule compression in an ASC is to eliminate gaps in cases during the day, leading to a "patient in, patient out" routine that reduces operating room costs per minute, Mr. Westergard said.
ASCs should avoid having a typical hospital block schedule with morning and afternoon blocks because no surgeons are generating revenue during the middle lunchtime block, Ms. Geier added. "This is where ASCs can get creative with scheduling," she said. "For example, if a physician never uses an entire four-hour block, you can give that physician a four-hour block every other week. Or, if it's a physician that does longer cases but doesn't need a lot of days in the OR [operating room], you can give them one day a month to load up on OR cases."
4. Optimize materials management. Although supplies are among the largest expenses for an ASC, these costs are controllable, Ms. Geier said. To ensure facilities aren't spending too much on supplies, ASCs need a materials manager who is detail-oriented.
"One person should be assigned to enter data on materials," Ms. Geier said. "This should not be assigned to multiple people because it can lead to miscommunications when different staff members enter data into two different places."
The materials manager should also be responsible for ensuring vendor prices are correct and tracking significant increases in supply prices. ASCs can also review surgery schedules one week before the procedures and plan for the supplies providers will need, Ms. Geier said.
"For example, when looking at shoulder cases, the materials manager can look ahead and see how many cases are booked, and if they know that physician usually books a few more cases at the last minute, the facility can have extra supplies on hand," Ms. Geier said. "Taking these steps can help your facility get ahead of the game."