The following suggestions for building a low-cost ambulatory surgery center come from Surgery Center Services of America's "Developing a Low Cost Ambulatory Surgery Center."
1. Perform a feasibility analysis. Collect data on case volumes for expected surgeries in the ASC and determine the value of the procedures with CPT codes to estimate ASC revenue. Then subtract total costs — for supplies, operating expenses and debt service — from total revenues to determine cash flow.
2. Consider the law. Determine ownership structure and ownership of the ASC's real estate, and have a legal counsel prepare documents detailing an operating agreement for admitting new partners, buying out old partners, dealing with conflicts of interest and laying out initial capital contributions and non-competition agreements, among other items.
3. Locate and design the facility. Hire an architect who will provide a fully engineered plan. Consider the law in the facility's design, as some states may have regulations or process delays of which to be aware.
4. Hire construction, begin building. Either a construction management agreement or bidding out the project are feasible options, though be aware that each option comes with different considerations regarding design, construction and cost. Be sure the architect or design consultants perform weekly or bi-weekly visits to the facility during construction to monitor progress and prevent delays or mistakes.
5. Select equipment. Consider using a consultant who has experience in purchasing equipment for ASCs. Understand exactly which equipment is necessary before considering sales proposals, and have sales representatives contact the consultant directly. Complete equipment selection 90 days before the ASC opens, and order no later than 75 days before the project's completion.
6. Get certified. Again, consider hiring a consultant with experience in helping ASCs get licensure and certification. In addition, build relationships with the individuals who will ultimately certify the ASC, and be sure to ask them for certification advice, rather than trying to go it alone. Be aware the certification process may take many months, and plan accordingly.
While time is of the essence in many of the stages of new surgery center development, proper management of each step will prevent the process from becoming unduly expensive, according to the article. For additional details on any step in the process, click here.
1. Perform a feasibility analysis. Collect data on case volumes for expected surgeries in the ASC and determine the value of the procedures with CPT codes to estimate ASC revenue. Then subtract total costs — for supplies, operating expenses and debt service — from total revenues to determine cash flow.
2. Consider the law. Determine ownership structure and ownership of the ASC's real estate, and have a legal counsel prepare documents detailing an operating agreement for admitting new partners, buying out old partners, dealing with conflicts of interest and laying out initial capital contributions and non-competition agreements, among other items.
3. Locate and design the facility. Hire an architect who will provide a fully engineered plan. Consider the law in the facility's design, as some states may have regulations or process delays of which to be aware.
4. Hire construction, begin building. Either a construction management agreement or bidding out the project are feasible options, though be aware that each option comes with different considerations regarding design, construction and cost. Be sure the architect or design consultants perform weekly or bi-weekly visits to the facility during construction to monitor progress and prevent delays or mistakes.
5. Select equipment. Consider using a consultant who has experience in purchasing equipment for ASCs. Understand exactly which equipment is necessary before considering sales proposals, and have sales representatives contact the consultant directly. Complete equipment selection 90 days before the ASC opens, and order no later than 75 days before the project's completion.
6. Get certified. Again, consider hiring a consultant with experience in helping ASCs get licensure and certification. In addition, build relationships with the individuals who will ultimately certify the ASC, and be sure to ask them for certification advice, rather than trying to go it alone. Be aware the certification process may take many months, and plan accordingly.
While time is of the essence in many of the stages of new surgery center development, proper management of each step will prevent the process from becoming unduly expensive, according to the article. For additional details on any step in the process, click here.