Here are five tips from ASC management companies to successfully turn around an ASC.
1. Communicate with physician offices. Rob Murphy, president and founder of Murphy Healthcare and founder of ASC Turnaround Group, says communication with physicians and their offices is an often-overlooked but critical aspect of an ASC turnaround.
"We were recently involved in a turnaround where surgical schedulers in a particular physician's office were routinely booking outpatient cases at the local hospital," he says. "The hospital had multiple empty operating rooms and was the 'path of least resistance' to book cases."
He says the ASC started communicating one-on-one with a scheduler at the physician's office and repeatedly following up about cases. After the communication was initiated, the roadblock was removed and the physician's office started booking all of its cases at the surgery center.
2. Recruit new physicians. Mr. Murphy says the turnaround process should center on syndication of new physicians to the center, which can increase case volume and bring new procedures into the center. ASC Turnaround Group uses members of its sales team to recruit new physicians to the ASC.
"They are typically on the ground running before a transaction is complete," Mr. Murphy says. "They first identify efficient, quality surgeons in the catchment area. They then build relationships and work closely with the prospective physician partners to sell the concept of joining the ASC."
He says the recruitment of new physicians should always be an ongoing process as physicians will always retire or slow down over time — new partners are always needed to replenish the lost case volume. He adds that ASC Turnaround Group focuses on certain specialties when recruiting new physicians, such as orthopedics, ENT, spine and urology.
3. Value a center's physicians. Keeping physicians happy and satisfied is the key to keeping them at the ASC. Sandra Jones, executive vice president of ASD Management, says physician satisfaction can be tied to how quickly an administrator responds to complaints or issues in the ASC. When a physician comes forward with a problem, she recommends asking questions to determine the root of the problem. For example, maybe a physician feels undervalued or financially burdened. You won't be able to fix the problem until you find out what really brought about the complaint.
Sometimes physicians will have with problems that can be fixed, and sometimes there will be no immediate solution. Ms. Jones says it's important for administrators to differentiate between the two situations and explain the difference to physicians.
"They may complain because they want a different type of instrument or a newer technology, and your resources just aren't going to allow that because of continuous cutbacks on reimbursement," she says. "It's tough to have the latest and greatest in everything."
She says part of that resource allocation is just working with physicians to help them understand that every physician has to operate for the benefit of the whole facility.
4. Add new procedures to increase volume. In order to succeed, an ASC needs to change and develop when necessary, Mr. Murphy says. This includes adding new procedures.
"Failure to constantly bring in more complex, higher-paying ASC cases puts the facility behind the curve," he says. "This would be the equivalent of running a restaurant with the same limited menu year after year." He says in order to maintain strong ongoing profits, ASCs must make sure to stay ahead of the competition by adding profitable procedures that may not be available elsewhere. "Some examples include major spine cases, joints (i.e. total hips), brachytherapy, lithotripsy, ENT navigation guided procedures and, more recently, platelet rich plasma therapy," he says.
Trey Parsons, RN, vice president of clinical operations for ASD Management, says some of these complex, higher-paying procedures include spine procedures, lap-band, implanting pacemakers for incontinence, sling procedures, minimally invasive general surgery, laparoscopic-assisted vaginal hysterectomies, partial arthroplasties on shoulders and spinal cord stimulators.
5. Benchmark against other centers. Joseph Zasa, JD, managing and founding partner of ASD Management, says it is critical for ASCs to benchmark themselves against national, regional and local standards to help ensure they run as efficiently and effectively as possible, with the highest quality possible.
"That's something you can't ignore," he says. "Margins are tighter, and with out-of-network going away, getting paid for the big stuff is gone so you have to now actually run your center."
Mike Lipomi, president and CEO of Surgical Management Professionals, says benchmarking reports can give ASCs an idea of where their salary costs are and how they stack up against nationwide averages. Reed Martin, COO of Surgical Management Professionals, says centers should track cash balance, operating room schedule and staffing schedule on a daily basis; case volume, charges, collections, quality statistics/agenda and employee and physician satisfaction on a weekly basis; net income, cash flow statement, accounts receivable days, accounts payable balance and cases and charges by physicians on a monthly basis; and distributions, supply costs with physical inventory correction and block utilization on a quarterly basis.
Related Articles on ASC Turnarounds:
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1. Communicate with physician offices. Rob Murphy, president and founder of Murphy Healthcare and founder of ASC Turnaround Group, says communication with physicians and their offices is an often-overlooked but critical aspect of an ASC turnaround.
"We were recently involved in a turnaround where surgical schedulers in a particular physician's office were routinely booking outpatient cases at the local hospital," he says. "The hospital had multiple empty operating rooms and was the 'path of least resistance' to book cases."
He says the ASC started communicating one-on-one with a scheduler at the physician's office and repeatedly following up about cases. After the communication was initiated, the roadblock was removed and the physician's office started booking all of its cases at the surgery center.
2. Recruit new physicians. Mr. Murphy says the turnaround process should center on syndication of new physicians to the center, which can increase case volume and bring new procedures into the center. ASC Turnaround Group uses members of its sales team to recruit new physicians to the ASC.
"They are typically on the ground running before a transaction is complete," Mr. Murphy says. "They first identify efficient, quality surgeons in the catchment area. They then build relationships and work closely with the prospective physician partners to sell the concept of joining the ASC."
He says the recruitment of new physicians should always be an ongoing process as physicians will always retire or slow down over time — new partners are always needed to replenish the lost case volume. He adds that ASC Turnaround Group focuses on certain specialties when recruiting new physicians, such as orthopedics, ENT, spine and urology.
3. Value a center's physicians. Keeping physicians happy and satisfied is the key to keeping them at the ASC. Sandra Jones, executive vice president of ASD Management, says physician satisfaction can be tied to how quickly an administrator responds to complaints or issues in the ASC. When a physician comes forward with a problem, she recommends asking questions to determine the root of the problem. For example, maybe a physician feels undervalued or financially burdened. You won't be able to fix the problem until you find out what really brought about the complaint.
Sometimes physicians will have with problems that can be fixed, and sometimes there will be no immediate solution. Ms. Jones says it's important for administrators to differentiate between the two situations and explain the difference to physicians.
"They may complain because they want a different type of instrument or a newer technology, and your resources just aren't going to allow that because of continuous cutbacks on reimbursement," she says. "It's tough to have the latest and greatest in everything."
She says part of that resource allocation is just working with physicians to help them understand that every physician has to operate for the benefit of the whole facility.
4. Add new procedures to increase volume. In order to succeed, an ASC needs to change and develop when necessary, Mr. Murphy says. This includes adding new procedures.
"Failure to constantly bring in more complex, higher-paying ASC cases puts the facility behind the curve," he says. "This would be the equivalent of running a restaurant with the same limited menu year after year." He says in order to maintain strong ongoing profits, ASCs must make sure to stay ahead of the competition by adding profitable procedures that may not be available elsewhere. "Some examples include major spine cases, joints (i.e. total hips), brachytherapy, lithotripsy, ENT navigation guided procedures and, more recently, platelet rich plasma therapy," he says.
Trey Parsons, RN, vice president of clinical operations for ASD Management, says some of these complex, higher-paying procedures include spine procedures, lap-band, implanting pacemakers for incontinence, sling procedures, minimally invasive general surgery, laparoscopic-assisted vaginal hysterectomies, partial arthroplasties on shoulders and spinal cord stimulators.
5. Benchmark against other centers. Joseph Zasa, JD, managing and founding partner of ASD Management, says it is critical for ASCs to benchmark themselves against national, regional and local standards to help ensure they run as efficiently and effectively as possible, with the highest quality possible.
"That's something you can't ignore," he says. "Margins are tighter, and with out-of-network going away, getting paid for the big stuff is gone so you have to now actually run your center."
Mike Lipomi, president and CEO of Surgical Management Professionals, says benchmarking reports can give ASCs an idea of where their salary costs are and how they stack up against nationwide averages. Reed Martin, COO of Surgical Management Professionals, says centers should track cash balance, operating room schedule and staffing schedule on a daily basis; case volume, charges, collections, quality statistics/agenda and employee and physician satisfaction on a weekly basis; net income, cash flow statement, accounts receivable days, accounts payable balance and cases and charges by physicians on a monthly basis; and distributions, supply costs with physical inventory correction and block utilization on a quarterly basis.
Related Articles on ASC Turnarounds:
10 Surgery Center Physicians in the News
7 Points on Unicompartmental Knee Arthroplasty in the Surgery Center Setting
16 New Statistics on Surgery Center EBITDA