Three ambulatory surgery center administrators discuss how they cut costs and increase profitability in their ASCs.
1. Collaborate with nearby facilities. Jennifer Morris, administrator of Stateline Surgery Center in Galena, Kan., says her ASC has saved money by building a relationship with nearby ASCs and hospitals. "If we are running short on supplies, we have been able to work with other ASCs and get something from their facilities," she says. Ms. Morris used to work for Four State Surgery in Joplin, and when she left, she was careful to maintain great relationships with the employees and leaders at the facility. "I gave them a 90-day notice, I trained my replacement and I did whatever I needed to do top help them out," she says. When a new surgery center opened up in Joplin, she says her ASC helped the center with supplies and broke down competitive barriers that might have prevented the centers from collaborating.
She says this relationship will help your ASC if you are short on supplies, need help with staffing or just need advice. Mr. Morris has lunch with the administrator at Four States on a regular basis. "It's nice to sit down with someone who does the same job I do and hear from someone else that it's not just you," she says. "If we're having a lot of denials, we'll call them and say, 'Hey, are you guys seeing this?' It's a good way to make sure it's not just happening to our center." This kind of communication can save your center money by alerting you to internal problems more quickly. If you realize that your center is the only one receiving a high volume of denials, for example, you can work with your billing team to improve claims submission rather than assuming the issue is beyond your control.
2. Ask job candidates specific questions about equipment and procedures. Hiring and training a new employee can be an expensive process for a surgery center, especially in the first few months, when the new hire is still getting used to working efficiently. Greg DeConciliis, administrator of Boston Out-Patient Surgical Suites, says ASC administrators can save money during the first few months of employment by hiring an experienced candidate right away. He recommends asking specific questions about facility equipment and procedures to make sure candidates really understand your specialties. "I always ask, 'What kind of equipment do you use?' or 'Can you name a certain technique?'," he says. If you ask questions with "yes" or "no" answers, you may end up hiring an agreeable staff member with no knowledge of your specialties.
He says this strategy is also important for staff members who are performing administrative tasks rather than clinical duties — especially if they work directly with surgeons on purchasing decisions. When hiring a materials manager, you should look for someone who understands the difference equipment and supplies the surgeon uses. "You want someone to be able to gel with the surgeon and understand if [a piece of equipment] is actually an appropriate substitution," he says. If your materials manager understands the procedures you perform and can be trusted to recommend a good piece of equipment, surgeons will be more likely to accept product standardization.
3. Do laundry in-house. Ms. Morris says her center also saves money by doing laundry in-house, rather than outsourcing to a more expensive company. She says surgery centers can improve the in-house laundry process by involving every staff member. "We have a staff member who does the laundry and is also a nurse tech," she says. "Circulators will also go in and fold clothes if they have 10 minutes. Nobody feels like they're too good to do anything."
4. File EOBs alphabetically and refer to them regularly. If your cases come with high costs, it is essential that your schedulers know your expected reimbursement before they schedule a case. If you book a case without understanding how the payor reimburses for the procedure, you may end up losing money unnecessarily. This problem can be avoided in a few ways: by hiring and training meticulous schedulers, by involving physicians in insurance checks and by keeping track of denials to inform future decisions. Ms. Morris' ASC takes a creative approach by filing explanation of benefits forms alphabetically in a notebook.
This means that even if your most knowledgeable office member is out of the office, someone else can pick up the notebook and determine how a case will be reimbursed. "The physician's office will call me, and I'll look up the payor and look up the code and say, 'We've done this before, and this is what happened,'" Ms. Morris says. She says this approach is especially important in an orthopedic-driven ASC, when cases can easily lose profitability if implants are not covered.
5. Don't set start and end times. Most ASCs set start and end times to let physicians know when they can begin scheduling cases. But if you want to maximize the number of cases your ASC can perform, you might consider eliminating start and end times to give physicians more flexibility. Angie Laux, administrator of Bellin Orthopedic Surgery Center in Green Bay, Wis., says hiring staff members who understand that the ASC does not enforce start and end times allows the center to flex hours more easily. "We make sure they are very flexible in the schedule they have," she says. "They know up front that they're going to need to be flexible here."
Related Articles About ASC Cost-Cutting:
6 Areas of Focus for Starpoint Health to Keep Costs Low for Its Surgery Centers
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10 Proven Surgery Centers Cost-Cutting Measures
1. Collaborate with nearby facilities. Jennifer Morris, administrator of Stateline Surgery Center in Galena, Kan., says her ASC has saved money by building a relationship with nearby ASCs and hospitals. "If we are running short on supplies, we have been able to work with other ASCs and get something from their facilities," she says. Ms. Morris used to work for Four State Surgery in Joplin, and when she left, she was careful to maintain great relationships with the employees and leaders at the facility. "I gave them a 90-day notice, I trained my replacement and I did whatever I needed to do top help them out," she says. When a new surgery center opened up in Joplin, she says her ASC helped the center with supplies and broke down competitive barriers that might have prevented the centers from collaborating.
She says this relationship will help your ASC if you are short on supplies, need help with staffing or just need advice. Mr. Morris has lunch with the administrator at Four States on a regular basis. "It's nice to sit down with someone who does the same job I do and hear from someone else that it's not just you," she says. "If we're having a lot of denials, we'll call them and say, 'Hey, are you guys seeing this?' It's a good way to make sure it's not just happening to our center." This kind of communication can save your center money by alerting you to internal problems more quickly. If you realize that your center is the only one receiving a high volume of denials, for example, you can work with your billing team to improve claims submission rather than assuming the issue is beyond your control.
2. Ask job candidates specific questions about equipment and procedures. Hiring and training a new employee can be an expensive process for a surgery center, especially in the first few months, when the new hire is still getting used to working efficiently. Greg DeConciliis, administrator of Boston Out-Patient Surgical Suites, says ASC administrators can save money during the first few months of employment by hiring an experienced candidate right away. He recommends asking specific questions about facility equipment and procedures to make sure candidates really understand your specialties. "I always ask, 'What kind of equipment do you use?' or 'Can you name a certain technique?'," he says. If you ask questions with "yes" or "no" answers, you may end up hiring an agreeable staff member with no knowledge of your specialties.
He says this strategy is also important for staff members who are performing administrative tasks rather than clinical duties — especially if they work directly with surgeons on purchasing decisions. When hiring a materials manager, you should look for someone who understands the difference equipment and supplies the surgeon uses. "You want someone to be able to gel with the surgeon and understand if [a piece of equipment] is actually an appropriate substitution," he says. If your materials manager understands the procedures you perform and can be trusted to recommend a good piece of equipment, surgeons will be more likely to accept product standardization.
3. Do laundry in-house. Ms. Morris says her center also saves money by doing laundry in-house, rather than outsourcing to a more expensive company. She says surgery centers can improve the in-house laundry process by involving every staff member. "We have a staff member who does the laundry and is also a nurse tech," she says. "Circulators will also go in and fold clothes if they have 10 minutes. Nobody feels like they're too good to do anything."
4. File EOBs alphabetically and refer to them regularly. If your cases come with high costs, it is essential that your schedulers know your expected reimbursement before they schedule a case. If you book a case without understanding how the payor reimburses for the procedure, you may end up losing money unnecessarily. This problem can be avoided in a few ways: by hiring and training meticulous schedulers, by involving physicians in insurance checks and by keeping track of denials to inform future decisions. Ms. Morris' ASC takes a creative approach by filing explanation of benefits forms alphabetically in a notebook.
This means that even if your most knowledgeable office member is out of the office, someone else can pick up the notebook and determine how a case will be reimbursed. "The physician's office will call me, and I'll look up the payor and look up the code and say, 'We've done this before, and this is what happened,'" Ms. Morris says. She says this approach is especially important in an orthopedic-driven ASC, when cases can easily lose profitability if implants are not covered.
5. Don't set start and end times. Most ASCs set start and end times to let physicians know when they can begin scheduling cases. But if you want to maximize the number of cases your ASC can perform, you might consider eliminating start and end times to give physicians more flexibility. Angie Laux, administrator of Bellin Orthopedic Surgery Center in Green Bay, Wis., says hiring staff members who understand that the ASC does not enforce start and end times allows the center to flex hours more easily. "We make sure they are very flexible in the schedule they have," she says. "They know up front that they're going to need to be flexible here."
Related Articles About ASC Cost-Cutting:
6 Areas of Focus for Starpoint Health to Keep Costs Low for Its Surgery Centers
4 Ways to Profit on GI in an Ambulatory Surgery Center
10 Proven Surgery Centers Cost-Cutting Measures
5 Creative Ways to Cut Costs in an Ambulatory Surgery Center