Joy Taylor, JD, COO of Polaris Spine & Neurosurgery Center in Atlanta, discusses the big challenges and strategic opportunities for her center today.
Ms. Taylor will share her expertise as a speaker at the Becker's ASC 26th Annual Meeting: The Business and Operations of ASCs, Oct. 24-26, 2019 in Chicago. To learn more and register, click here. For more information about exhibitor and sponsor opportunities, contact Maura Jodoin at mjodoin@beckershealthcare.com.
Question: What is the biggest challenge for your spine center today?
Joy Taylor: I would say that we actually have two primary challenges: the payer environment and costs. We are experiencing what has been described by so many well-established centers as increasing scrutiny of out-of-network claims and payments. Further, as insurance plan design has shifted more of the burden to patient consumers, we find ourselves in the position of having to provide more financial counseling to patients, to ensure they are informed of and comfortable with the costs of their care, and then collecting on their expected balances.
As for costs, to provide an exceptional environment for care, we have to have an impeccable facility, which does not come at a low cost. Nor can we provide top-notch care without top-notch staff, and plenty of them, all of which adds to our costs and erodes the bottom line, while being central to our model. We are always looking for staffing innovations and ways to streamline workflow, adding an EHR to our surgery center at the end of 2018.
Q: Where do you hope to grow for the next nine months?
JT: West! We are opening a new vanguard office just to the west of our metro area, as we work to establish our second full center in the background that we hope will come online in 18 to 24 months. While it is only 10 miles away, the segmentation of the Atlanta market is such that this will represent a significant additional catchment area.
We are also continuing to expand our lumbar fusion business with the help of the robotic technology we brought online mid-2018.
We are also in negotiations with additional payers, to capture more volume.
Q: How do you approach budgeting for and selecting new technology for your center?
JT: That's a great question! As a physician-owned center, we try to share cost data continually so that there's awareness of how choices impact the bottom line. We also work hard to model out how technology acquisition will impact cash flow and profits to the good, as well as to the bad. After that, administration works with the stakeholders to try to make the best decisions for the center's future.
Q: What are your biggest payer challenges today?
JT: I would say that the increased hostility toward out-of-network claims and payments is the single biggest challenge with payers at this point. However, the incremental but not insignificant burden presented by the increased denials for an expanding range of reasons (lack of medical necessity, included in services provided, etc.) is a close second.