Becker's ASC Review published hundreds of articles — news reports, feature stories and lists — in November. Here are 10 ASC leaders providing great best practices taken from some of the most-read articles during the month. Note: Clicking an article link will open the report in a new tab.
1. Aaron Murski of VMG Health in "Using ASC Benchmarking Data Properly: Q&A With Aaron Murski of VMG Health" — "Benchmarking data should be used to keep your ASC moving in the right direction," Mr. Murski says. "It's not necessarily about being better than everyone else. When you focus solely on that, you may forget why you're doing it and you may end up skimping in certain areas to be better than the average.
"Benchmarking is a means to understand your business better and stay on top of industry trends," he says. "If the whole industry is experiencing a trend and you aren't benchmarking, you won't know if it's just you or the peer group. Do you want to be better than average? Sure. That's the goal. But the important point that gets lost is how data can help you look at your business and the industry."
2. Amanda Kane of Blue Chip Surgical Partners in "8 Ways to Involve ASC Physicians in Physician Recruitment" — Add physician recruitment to the board meeting agenda. Ms. Kane says this is a sure-fire way to ensure that the ASC partners discuss surgeon recruitment. This is the time to talk about which physicians she should be reaching out, ask for introductions and provide physicians with information about the center to help in their conversations.
3. Josh Billstein of the ambulatory surgery center at The Polyclinic in Seattle in "8 Tricks to Save More Money at Your Surgery Center" — Compare insurance plan allowables with supply costs. Every month, Mr. Billstein's sits down and audits ASC supply costs versus the allowable charges for every insurance plan. This is reported to the governing body because when physicians understand that the ASC is receiving a finite amount of money from each insurance carrier, they tend to be more flexible in exploring alternative products, Mr. Billstein says.
"For example, we did an audit of one of our urologists for an [incontinence] case and found that the supplies were not the most cost-effective on the market," he says. "When you compare products side-by-side with the physician, you can move that data point more easily." He says the physicians enjoy comparing their supply costs with the amount of money the insurance carrier provides for a particular case.
4. Eric Woollen of Practice Partners in Healthcare in "10 Trends in ASC Payor Reimbursement & Contracting for 2012" — Data is still king in contract negotiations. Having formerly worked for United Healthcare, Mr. Woollen says the most common error he sees ASC leaders make in payor contract negotiations is failing to review and understand relevant data. He says ASC leaders should understand their case costs down to the procedure. "Every time you do an ACL repair, every time you do a meniscus repair, you need to understand what it costs," he says. Make a spreadsheet that lists the average cost of every procedure your surgery center performs by physician, then cross-reference those costs with the terms of your payor contracts.
"At a minimum, you need to understand every time an ACL comes in, what does it mean from a particular payor?" he says. "If you can't [cover the costs on a procedure], it may be time to open up the contract and talk to that particular payor." He says presenting this data to the payor at your contract negotiation can validate cost concerns in asking for higher reimbursement levels. Bring along data on quality, cost savings and patient satisfaction in your surgery center to tip the scale in your favor.
5. John D. Brock of NorthStar Surgical Center in "12 Ways to Improve ASC Physicians' Experience in 2012" — Plan free monthly, educational seminars for patients. Mr. Brock says his ASC will provide these seminars in 2012 to give physicians "the venue to educate potential patients on new and existing procedures and treatment methods for various health issues such as incontinence, migraines and joint replacement."
6. Todd Currier of Northern Wyoming Surgical Center in "12 Ways to Improve ASC Physicians' Experience in 2012" — Develop a monthly newsletter for medical staff. In 2011, Mr. Currier says Northern Wyoming Surgical Center instituted a quarterly newsletter to its medical staff. In 2012, the center will start sending the newsletter every month. "[The newsletter] illustrates the positive areas within our ASC, patient satisfaction quotes and areas that are in need for improvement — both at the facility level and physician level," he says. "I feel we need to keep our providers abreast of the changes that affect our ASC on a timely basis, not waiting too long to make changes. Areas such as on-time starts, staffing changes that may affect them, instrumentation changes/standardization issues, equipment needs/concerns will all be addressed on a monthly basis. These issues will be presented as more in a briefing format to minimize reading time. Monthly visits with individual physician can address any of the issues in more detail."
7. Joe Zasa of ASD Management in "10 Overlooked Ways to Cut Costs in an ASC" — Remove unnecessary insurance. Mr. Zasa says that while every center should have medical malpractice, general liability, director and officer insurance, business interruption insurance and hired and non-owned insurance, but more "exotic" coverage — such as terrorism insurance — isn't needed.
8. April Sackos of Meridian Surgical Partners in "8 Valuable Surgery Center Business Office Goals for 2012" — "Conduct scheduler to scheduler marketing," she writes. "With decreased volumes, it is imperative that your scheduler is meeting the needs of your physicians' schedulers. Holding an annual scheduler's luncheon, as well as making regular on-site visits, is recommended. Some common questions to ask of physicians' schedulers are as follows:
- "Is the center meeting the scheduler's expectations?
- Is the center meeting the surgeon's expectations?
- Are there payor issues?
- Is there anything the ASC could do to increase cases?"
9. Rose Eickelberger of Summit Surgical Center and Beacon West Surgical Center in "5 Strategies to Minimize Damage from Same-Day Cancellations" — Ask anesthesiologists to review patient charts a few days before the procedure to help reduce the number of same-day cancellations, Ms. Eickelberger says. They should review the charts before the day of the procedure to flag any possible concerns, such as cardiac issues, as well as develop a plan for that patient. Doing this before the day of surgery allows staff to prepare for complications in advance.
10. Mark Casner of aisthesis in "10 Ways to Evaluate Your Current Surgery Center Anesthesia Provider" — Collect information on specific clinical outcomes. Mr. Casner says surgery center leaders should collect this information, in addition to patient experience, and regurgitate that data back to providers to demonstrate where problem areas exist. The information does not have to be broken down by anesthesiologist — especially in a small ASC because anesthesia providers should be expected to act as a team to prevent adverse clinical outcomes. Mr. Casner also recommends recording any untoward events that occur in the post-anesthesia care unit and in the first 24 hours after discharge.
"We use clinical outcome data as an opportunity to educate or congratulate our providers. In the event that a provider had an excessive amount of [untoward events], such as a longer time to recover from anesthesia or too many cases of intubation, we would assess whether the anesthesia provider has a problem with their clinical skills or just a string of bad luck." Over time, you will get a sense for the most common anesthesia issues in your ASC and can work with anesthesiologists to fix those problems.