William Tobler, MD, of The Christ Hospital Spine Surgery Center, and Michael Stroup, Vice President of Development at United Surgical Partners International gave a presentation titled "Keys to Successfully Establishing and Growing a Premier Spine Center—Why Partner With a Management Company, Why Partner With a Hospital, Challenges and Opportunities—A Case Study" at the 9th Annual Orthopedic, Spine and Pain Management-Driven ASC Conference on June 9, 2011. Dr. Tobler said the surgeons at The Christ Hospital found owning an ASC attractive because they were able to control every aspect of the center, which focuses on spine procedures. By partnering with both USPI and The Christ Hospital in Cincinnati, the surgeons at the ASC were able to maintain the majority (49 percent) of the facility while the remaining 51 percent is split between the other two entities.
Dr. Tobler recommended physicians who are forming a new spine center:
• Start slow with small cases that surgeons are confident performing
• Begin out-of-network and build relationships with payors before moving in-network
• Build physician confidence with outpatient procedures
The Christ Hospital Spine Surgery Center has always been certified for 23-hour stay cases, but surgeons didn't perform those types of cases right away. Instead, they waited until the employees were more settled and experienced to expand services and add overnight staff. The Christ Hospital Spine Surgery Center tracked its data and found that infection rates were half of what they were in the hospitals. Additional tracked data includes turnover time, cancellations, on-time starts and transfer rates. The ASC has experienced occasional transfers, mostly due to dural tears and anesthesia complications.
Dr. Tobler and Mr. Stroup cautioned ASCs against overbuilding and accepting the first contract rates offered by payors. ASCs need to have the right mix of minimally invasive surgery and interventions, and keep physicians focused on bringing cases into the surgery center. Physicians can be motivated through ownership of the ASC.
Administrators can increase efficiency at the surgery center by standardizing devices, such as the plates and screws surgeons use. Bringing the surgeons together when making decisions about which devices the ASC should use will build cohesiveness among the partners. The partners should also be aware of new technologies that may be beneficial for the ASC. Alignment with The Christ Hospital has contributed to the ASC's success and will make future partnerships easier, Dr. Tobler said.
Related Articles on Joint Ventures:
Forming a Successful 3-Way Joint Venture: Lessons From Alegent Health Back & Spine Institute
Co-Management Arrangement: Keys to Success
Trends and Key Factors Driving Successful Hospital-ASC Joint Ventures
Dr. Tobler recommended physicians who are forming a new spine center:
• Start slow with small cases that surgeons are confident performing
• Begin out-of-network and build relationships with payors before moving in-network
• Build physician confidence with outpatient procedures
The Christ Hospital Spine Surgery Center has always been certified for 23-hour stay cases, but surgeons didn't perform those types of cases right away. Instead, they waited until the employees were more settled and experienced to expand services and add overnight staff. The Christ Hospital Spine Surgery Center tracked its data and found that infection rates were half of what they were in the hospitals. Additional tracked data includes turnover time, cancellations, on-time starts and transfer rates. The ASC has experienced occasional transfers, mostly due to dural tears and anesthesia complications.
Dr. Tobler and Mr. Stroup cautioned ASCs against overbuilding and accepting the first contract rates offered by payors. ASCs need to have the right mix of minimally invasive surgery and interventions, and keep physicians focused on bringing cases into the surgery center. Physicians can be motivated through ownership of the ASC.
Administrators can increase efficiency at the surgery center by standardizing devices, such as the plates and screws surgeons use. Bringing the surgeons together when making decisions about which devices the ASC should use will build cohesiveness among the partners. The partners should also be aware of new technologies that may be beneficial for the ASC. Alignment with The Christ Hospital has contributed to the ASC's success and will make future partnerships easier, Dr. Tobler said.
Related Articles on Joint Ventures:
Forming a Successful 3-Way Joint Venture: Lessons From Alegent Health Back & Spine Institute
Co-Management Arrangement: Keys to Success
Trends and Key Factors Driving Successful Hospital-ASC Joint Ventures