In a session at the 9th Annual Orthopedic, Spine and Pain Management-Driven ASC Conference in Chicago on June 9, Kenny Spitler, chief development officer, Robin Fowler, MD, founder, and Stephen Rosenbaum, CEO, Interventional Management Services, shared five key steps for turning around a surgery center.
1. Evaluate operating agreement. Mr. Rosenbaum began the session by explaining that a turnaround should start with a review of key legal documents by an attorney. During this examination, provisions such as capital contributions, personal guarantees, fraud and abuse safe harbors, buy/sell provisions, non-competes and terminating events and redemptions should be revisted and updated, if necessary.
2. Add physician owners. The ownership mix and percentage of ownership available to each physician is critical to the success and longevity of an ASC partnership, said Mr. Spitler. In addition to making sure each current owner has a significant enough stake to create an incentive for high performance, additional physician partners should be recruited and syndicated.
3. Track and share information on physician productivity. Administrators should track and distribute at board meetings data on productivity by provider, including case cost, caseload charges and collections. Additionally, leaders should encourage peer pressure among physicians to perform cases more efficiently, says Dr. Fowler.
4. Renegotiate contracts. The center should evaluate and renegotiate various contracts, including contracts with commercial payors, group purchasing organizations and vendors, outsourced service providers (such as billing, coding and collections agencies) and technology and service providers, says Mr. Spitler.
5. Improve staffing. Finally, ASCs should recruit an experienced and talented administrator and strong clinical lead to empower staff and ensure appropriate coverage for case volume. A best practice in this area also involves providing incentives for productivity and patient satisfaction to all levels of staff. "Staff has to know you have their back. You can't run a great organization if you have high turnover," says Dr. Fowler.
1. Evaluate operating agreement. Mr. Rosenbaum began the session by explaining that a turnaround should start with a review of key legal documents by an attorney. During this examination, provisions such as capital contributions, personal guarantees, fraud and abuse safe harbors, buy/sell provisions, non-competes and terminating events and redemptions should be revisted and updated, if necessary.
2. Add physician owners. The ownership mix and percentage of ownership available to each physician is critical to the success and longevity of an ASC partnership, said Mr. Spitler. In addition to making sure each current owner has a significant enough stake to create an incentive for high performance, additional physician partners should be recruited and syndicated.
3. Track and share information on physician productivity. Administrators should track and distribute at board meetings data on productivity by provider, including case cost, caseload charges and collections. Additionally, leaders should encourage peer pressure among physicians to perform cases more efficiently, says Dr. Fowler.
4. Renegotiate contracts. The center should evaluate and renegotiate various contracts, including contracts with commercial payors, group purchasing organizations and vendors, outsourced service providers (such as billing, coding and collections agencies) and technology and service providers, says Mr. Spitler.
5. Improve staffing. Finally, ASCs should recruit an experienced and talented administrator and strong clinical lead to empower staff and ensure appropriate coverage for case volume. A best practice in this area also involves providing incentives for productivity and patient satisfaction to all levels of staff. "Staff has to know you have their back. You can't run a great organization if you have high turnover," says Dr. Fowler.