Ambulatory surgery centers looking to contain costs sometimes need to go back to the basics. Here are four steps for ASCs to make an impact on their bottom line.
1. Run an integrated facility. Robin Fowler, MD, founder of Interventional Management Services, recommends rotating all staff members, both clinical and non-clinical, through the operating room to help coders and billers better understand what they are coding for more accurate claims. “Anytime you compartmentalize your employees, you get only bad outcomes,” he said.
Physicians should also know about the insurance portions of their practice so they can better stay within insurance guidelines and local coverage determinations. For optimal billing and collecting, ASCs need their physicians to know what is involved, he said.
2. Keep the revenue cycle on track. A fear of increased denials accompanies any significant coding changes, but that fear does not need to become a reality. "If ASC leaders do the basics correctly, a lot of denials will be avoided," says Praveen Suthrum, president and co-founder of NextServices. Basic measures to carefully execute include:
• Obtaining proper authorization
• Understanding patient benefits and eligibility
• Working for clean, accurate physician documentation
• Submitting clean claims in a timely manner
3. Manage employees effectively to control labor costs. ASCs can make the most of their staff's talent with effective, meaningful coaching and mentoring for frontline supervisors, who will set the tone for organizational culture and be the most powerful driver of retention. Developing staff professionally can also mitigate risk factors by training employees in best practices and reducing the rate of error in both patient care and workplace safety, Thomas Jacobs, president and CEO of Westchester, Ill.-based MedHQ said, generating a lot of savings potential.
"How many times have you held your breath and crossed your fingers hoping to avoid safety issues like OSHA injuries, hand washing incidents, cell phones in restricted areas, or disciplinary infractions such as harassment, hostile work environments, and sexual relations at work?" Mr. Jacobs asked the audience? Proper training of staff and regular reinforcement, especially through frontline leaders, will help best practices stick and reduce contingency costs.
"If you have a [group purchasing organization], a practice management system, and you're using preference cards with physicians, then from a supply standpoint there's not not many cost savings opportunities left," he said. "We believe employee costs are the last juice to squeeze" to save surgery centers money.
4. Benchmark cost-efficiencies and gain physician buy-in for change. Getting physicians on board early is essential to any effort to address variation in specialty care payments, said ArborMetrix Chief Scientific Officer John Birkmeyer, MD in a Becker's Hospital Review article.
Healthcare organizations seeking to get physicians behind the variation identification and reduction effort need to make sure their measures have scientific credibility so physicians will accept them, he said. Additionally, it's important to be transparent regarding how the measurement process works.
"Don't overreach," he said. "Be careful not to make inferences on which costs are preventable on a case-by-case basis."
More articles on surgery centers:
12 ASCs making the news this week
5 articles on ASC physician buy-in
What ASC administrators hired into a new center must know
1. Run an integrated facility. Robin Fowler, MD, founder of Interventional Management Services, recommends rotating all staff members, both clinical and non-clinical, through the operating room to help coders and billers better understand what they are coding for more accurate claims. “Anytime you compartmentalize your employees, you get only bad outcomes,” he said.
Physicians should also know about the insurance portions of their practice so they can better stay within insurance guidelines and local coverage determinations. For optimal billing and collecting, ASCs need their physicians to know what is involved, he said.
2. Keep the revenue cycle on track. A fear of increased denials accompanies any significant coding changes, but that fear does not need to become a reality. "If ASC leaders do the basics correctly, a lot of denials will be avoided," says Praveen Suthrum, president and co-founder of NextServices. Basic measures to carefully execute include:
• Obtaining proper authorization
• Understanding patient benefits and eligibility
• Working for clean, accurate physician documentation
• Submitting clean claims in a timely manner
3. Manage employees effectively to control labor costs. ASCs can make the most of their staff's talent with effective, meaningful coaching and mentoring for frontline supervisors, who will set the tone for organizational culture and be the most powerful driver of retention. Developing staff professionally can also mitigate risk factors by training employees in best practices and reducing the rate of error in both patient care and workplace safety, Thomas Jacobs, president and CEO of Westchester, Ill.-based MedHQ said, generating a lot of savings potential.
"How many times have you held your breath and crossed your fingers hoping to avoid safety issues like OSHA injuries, hand washing incidents, cell phones in restricted areas, or disciplinary infractions such as harassment, hostile work environments, and sexual relations at work?" Mr. Jacobs asked the audience? Proper training of staff and regular reinforcement, especially through frontline leaders, will help best practices stick and reduce contingency costs.
"If you have a [group purchasing organization], a practice management system, and you're using preference cards with physicians, then from a supply standpoint there's not not many cost savings opportunities left," he said. "We believe employee costs are the last juice to squeeze" to save surgery centers money.
4. Benchmark cost-efficiencies and gain physician buy-in for change. Getting physicians on board early is essential to any effort to address variation in specialty care payments, said ArborMetrix Chief Scientific Officer John Birkmeyer, MD in a Becker's Hospital Review article.
Healthcare organizations seeking to get physicians behind the variation identification and reduction effort need to make sure their measures have scientific credibility so physicians will accept them, he said. Additionally, it's important to be transparent regarding how the measurement process works.
"Don't overreach," he said. "Be careful not to make inferences on which costs are preventable on a case-by-case basis."
More articles on surgery centers:
12 ASCs making the news this week
5 articles on ASC physician buy-in
What ASC administrators hired into a new center must know