Richard Kube II, MD, the CEO, founder and owner of Peoria, Ill.-based Prairie Spine & Pain Institute, laid out four considerations for ASC leaders considering adding spine procedures to their centers at the 12th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference + The Future of Spine on June 14 in Chicago.
The four main considerations are as follows:
Facility readiness
A variety of concerns fall under the facility readiness umbrella. One of the most important is the length of stay parameters, which can differ state to state. Dr. Kube noted he has an overnight stay option, but "the majority that we do are sent home as outpatients."
Another technical consideration of the ASC itself is the lighting systems and equipment. Some examples of spine-specific equipment Dr. Kube gave were microscopes, which can be tens of thousands of dollars to purchase, and new OR tables.
Finally, leaders should evaluate the ASC's staff and their comfort level with spine procedures, especially if the ASC has been exclusively doing lower acuity procedures like GI cases or pain management.
Administration
This involves everything from negotiating new contracts with payers and working with implant vendors to marketing to make local physicians aware of the new service line for referrals.
Surgeons
Besides examining outcomes, ASC administrators should consider a variety of factors when choosing a surgeon to build a spine program around. Take speed, for instance. ASCs are going to "have a problem maintaining margins [if surgeons] are spending tons of time in the OR" with their spine cases, Dr. Kube said.
The surgeon's frugality should also be considered: If he or she demands top-of-the line, new equipment, he or she may not be the right surgeon to start a spine program with for smaller ASCs.
Anesthesia
Making sure the anesthesia providers are comfortable with doing spine in an outpatient is also critical to the program's success, Dr. Kube said.
The four main considerations are as follows:
Facility readiness
A variety of concerns fall under the facility readiness umbrella. One of the most important is the length of stay parameters, which can differ state to state. Dr. Kube noted he has an overnight stay option, but "the majority that we do are sent home as outpatients."
Another technical consideration of the ASC itself is the lighting systems and equipment. Some examples of spine-specific equipment Dr. Kube gave were microscopes, which can be tens of thousands of dollars to purchase, and new OR tables.
Finally, leaders should evaluate the ASC's staff and their comfort level with spine procedures, especially if the ASC has been exclusively doing lower acuity procedures like GI cases or pain management.
Administration
This involves everything from negotiating new contracts with payers and working with implant vendors to marketing to make local physicians aware of the new service line for referrals.
Surgeons
Besides examining outcomes, ASC administrators should consider a variety of factors when choosing a surgeon to build a spine program around. Take speed, for instance. ASCs are going to "have a problem maintaining margins [if surgeons] are spending tons of time in the OR" with their spine cases, Dr. Kube said.
The surgeon's frugality should also be considered: If he or she demands top-of-the line, new equipment, he or she may not be the right surgeon to start a spine program with for smaller ASCs.
Anesthesia
Making sure the anesthesia providers are comfortable with doing spine in an outpatient is also critical to the program's success, Dr. Kube said.