Healthcare reform has introduced numerous obstacles and changes for the healthcare industry, including the implementation of electronic health records, more stringent quality reporting, an influx of patients and the formation of quality-based payment models. Kelly Rodriguez, director of national sales at Provista, discusses how healthcare reform will affect ASCs and how centers can prepare for inevitable changes.
1. Make prices transparent to consumers. Ms. Rodriguez says going forward, ASCs must understand their costs and make that information available to consumers as a marketing tool. "They'll have to understand how to be competitive," she says. As consumers become more comfortable "shopping" for surgery online across a number of facilities, surgery centers can benefit if they can demonstrate lower cost than the local hospital.
Ms. Rodriguez says price transparency will be even more important as patients struggle with increasingly high deductibles and out-of-pocket costs. The move to high-deductible health plans may force consumers to delay surgery while they explore cheaper alternatives, and surgery centers could provide a more affordable option to patients looking to cut costs.
2. Talk to local hospital systems and payors about new payment models. Ms. Rodriguez says while value-based purchasing models and accountable care organizations are not necessarily designed to target ASCs, surgery center should still think about their business models to determine whether they can take part in payment models that reward quality. "The triangle will be access, cost and quality, and if any one of those three items doesn't meet or equal the other items, the triangle is not a triangle," she says. "It will be imperative for ASCs to learn how to change their fee-for-service." She says ASCs may have an advantage over hospitals in value-based purchasing plans if they can guarantee good outcomes and a set price for a certain surgery.
She says ASCs located in a region with multiple hospital systems should talk to hospital leaders about their plans for the future. Some hospital leaders are actively constructing ACOs, whereas others have chosen to opt out while the model's future is still uncertain. "It would be nice to know what hospitals are doing," she says. "You don't want to be left out if [they form ACOs]."
3. Partner with the right GPO. Ms. Rodriguez says successful ASCs should partner with the right GPO to reduce cost and provide opportunities for capital-equipment purchases. "ASCs and management companies will have to partner up with a GPO who can help them be clinically, operationally and financially savvy and efficient," she says. She says a GPO can help an ASC standardize supplies and equipment to save money, and a close relationship with a GPO representative can help the ASC find out about discounts.
She says a good GPO relationship can also help ASCs that want to install an electronic health record. "Most ASCs don't have a lot of capital to invest, but if they were to team up with a GPO, they should be able to find a solution without at a very competitive price."
4. Plan for EHR implementation. Most ASCs — especially freestanding facilities with limited capital — have trailed behind hospitals in EHR implementation, Ms. Rodriguez says. Many have survived so far with paper charts, but Ms. Rodriguez predicts that life without EHR will be increasingly difficult in the next several years. "They haven't adopted EHR as quickly as hospitals have to because of mandates, but they will be next down the line to have to adopt those practices to be successful," she says. "When hospitals become totally on EHR systems, they're going to mandate that ASCs do it as well."
She says surgery centers may also be forced to implement data collection software as the focus on transparency and quality reporting increases. "It's going to be a very data-driven environment and very transparent," she says. "In order to [work with ACOs and value-based purchasing], you have to have the infrastructure to know your costs."
5. Streamline processes to provide low costs. ASCs have an advantage in the next decade of healthcare as a low-cost, high-quality provider — but only if they can demonstrate those qualities to the local market, Ms. Rodriguez says. ASCs should be focusing now on cutting costs through staffing effectively, supply standardization, case costing and other methods so they can benchmark their costs against other facilities and demonstrate to payors, providers and patients that they provide an affordable alternative.
Related Articles on ASC Operations:
5 Reasons Why Surgeons Why Still Join Surgery Centers
100 Surgery Center Benchmarks
12 Major Issues Facing the Surgery Center Industry
1. Make prices transparent to consumers. Ms. Rodriguez says going forward, ASCs must understand their costs and make that information available to consumers as a marketing tool. "They'll have to understand how to be competitive," she says. As consumers become more comfortable "shopping" for surgery online across a number of facilities, surgery centers can benefit if they can demonstrate lower cost than the local hospital.
Ms. Rodriguez says price transparency will be even more important as patients struggle with increasingly high deductibles and out-of-pocket costs. The move to high-deductible health plans may force consumers to delay surgery while they explore cheaper alternatives, and surgery centers could provide a more affordable option to patients looking to cut costs.
2. Talk to local hospital systems and payors about new payment models. Ms. Rodriguez says while value-based purchasing models and accountable care organizations are not necessarily designed to target ASCs, surgery center should still think about their business models to determine whether they can take part in payment models that reward quality. "The triangle will be access, cost and quality, and if any one of those three items doesn't meet or equal the other items, the triangle is not a triangle," she says. "It will be imperative for ASCs to learn how to change their fee-for-service." She says ASCs may have an advantage over hospitals in value-based purchasing plans if they can guarantee good outcomes and a set price for a certain surgery.
She says ASCs located in a region with multiple hospital systems should talk to hospital leaders about their plans for the future. Some hospital leaders are actively constructing ACOs, whereas others have chosen to opt out while the model's future is still uncertain. "It would be nice to know what hospitals are doing," she says. "You don't want to be left out if [they form ACOs]."
3. Partner with the right GPO. Ms. Rodriguez says successful ASCs should partner with the right GPO to reduce cost and provide opportunities for capital-equipment purchases. "ASCs and management companies will have to partner up with a GPO who can help them be clinically, operationally and financially savvy and efficient," she says. She says a GPO can help an ASC standardize supplies and equipment to save money, and a close relationship with a GPO representative can help the ASC find out about discounts.
She says a good GPO relationship can also help ASCs that want to install an electronic health record. "Most ASCs don't have a lot of capital to invest, but if they were to team up with a GPO, they should be able to find a solution without at a very competitive price."
4. Plan for EHR implementation. Most ASCs — especially freestanding facilities with limited capital — have trailed behind hospitals in EHR implementation, Ms. Rodriguez says. Many have survived so far with paper charts, but Ms. Rodriguez predicts that life without EHR will be increasingly difficult in the next several years. "They haven't adopted EHR as quickly as hospitals have to because of mandates, but they will be next down the line to have to adopt those practices to be successful," she says. "When hospitals become totally on EHR systems, they're going to mandate that ASCs do it as well."
She says surgery centers may also be forced to implement data collection software as the focus on transparency and quality reporting increases. "It's going to be a very data-driven environment and very transparent," she says. "In order to [work with ACOs and value-based purchasing], you have to have the infrastructure to know your costs."
5. Streamline processes to provide low costs. ASCs have an advantage in the next decade of healthcare as a low-cost, high-quality provider — but only if they can demonstrate those qualities to the local market, Ms. Rodriguez says. ASCs should be focusing now on cutting costs through staffing effectively, supply standardization, case costing and other methods so they can benchmark their costs against other facilities and demonstrate to payors, providers and patients that they provide an affordable alternative.
Related Articles on ASC Operations:
5 Reasons Why Surgeons Why Still Join Surgery Centers
100 Surgery Center Benchmarks
12 Major Issues Facing the Surgery Center Industry