The current healthcare landscape for ambulatory surgery centers may seem unstable, but ASC leadership teams can develop long-term strategies to ensure sustainable success.
David Cornett is the senior executive vice president of business development at Cejka Search in St. Louis. David McMillan is a principal at Pershing Yoakley & Associates in Knoxville, Tenn. Both Mr. Cornett and Mr. McMillan have extensive experience helping healthcare practices develop business strategies.
Here both experts outline their seven steps crucial to developing and implementing long-term surgery strategies.
1. Have deliberate, documented planning efforts. Deliberately setting aside time to sit down with all surgery center stakeholders is incredibly important to long-term success. Surgery centers without professional management probably have not invested time and resources into long-term planning efforts in the past, Mr. McMillan says.
While the results of the planning session are vitally important to sustainable growth, the session in and of itself is a crucial time to facilitate the research and questions needed to keep the center leadership on the same page, moving forward together.
"There are always options that need to be considered as a group regarding the center's future," he says. "What the planning process produces, other than the document itself, is the sharing of intelligence, ideas and knowledge; the process is just as valuable as the end result."
2. Be aware of challenges to financial stability. Physician-owned surgery centers face two main challenges to financial stability — reimbursements and access to patients. Such ASCs may find themselves in a market where they do not have the contracting leverage needed to maintain profitability, Mr. McMillan says. Networks are narrow in various markets across the county. And while payers want ASCs in their network to provide high quality services at lower costs, they also prefer comprehensives services to single-specialty practices. Thus, often commercial payers will pick a hospital over a surgery center for its wider variety of services.
Surgery centers bringing in multiple specialties or creating partnerships with multiple physician groups can result in a collaborative network that provides better patient care and a more satisfying professional experience for physicians, he says.
3. Stay informed. In the past, most physicians and surgery center personnel were not as informed about market conditions and regulatory matters as they are going to need to be in the future, Mr. McMillan says.
"Surgery centers run lean, and that is what makes them so cost-effective," he says. "It sounds antithetical for them to be spending money or resources on market research, but the fact of that matter is that all healthcare entities must define their story in the market or someone is going to define that story for them."
Market research will help an ASC know how to position themselves to best serve patients. Being informed and proactive are keys to survival.
4. Employ strong leaders. Physician leaders are pivotal in developing the clear vision for an ASC's goals in regard to patient outcomes, cost control and maximized reimbursement. ASC administrators and leaders must recognize the importance of such leadership and engage their physicians.
"Strong physician leaders must have a combination of clinical training and operational experience to bridge the gaps that will become costly in the new value-based economy," Mr. Cornett says.
5. Stay flexible. No goals set by ASC leadership should be set in stone, Mr. McMillan says. Once the team is committed to a strategy for meeting a particular goal, they should stick with the strategy for about a year before it needs to be developed.
Leaders must revisit plan annually to reprioritize and make sure what they are planning for is still relevant, he says.
6. Use data-driven physician compensation. The alignment of compensation for physicians delivering and supervising care in ASCs is a "game changer," Mr. Cornett says. Healthcare reforms will demand more patient satisfaction and quality measures tied to physician compensations, eve more so than what centers may have in place currently.
"Bundled payments and outcomes-based reimbursements will mean that physicians in all specialties must be incented to deliver care across the continuum of settings that is well-coordinated, patient-centered and based on evidence of success," he says.
Data-driven, outcomes-based compensation will give physicians more leverage in the long run and will bolster their role in the coordination of care. Mr. Cornett encourages ASCs to create compensation transparency and equity so physicians neither experience great windfalls nor major losses as a long term, strategic plan is implemented.
One way to do this may be through creating the role of vice president of physician compensation. The vice president can be tasked with implementing the new compensation system and showing physicians how it compares to their compensation under the current system.
7. Refrain from getting shortsighted. ASCs are often side tracked from long-term goals because of the "crisis du jour," Mr. McMillan says. "It's hard to maintain certain priorities that have a longer term return on investment in light of the day-to-day crises," he says. These daily crises can include equipment breaking down, staff members leaving unexpectedly or other unanticipated costs and disruptions.
Things that threaten business day-to-day take time, energy and resources away from longer terms plans that require more investment to mature.
Mr. McMillan says he has no across-to-board solution for these situations as each may require a certain tactic to handle without compromising other goals. Some centers may need to invest in additional personnel to keep moving toward bigger strategies and goals. An effective method can also be having a physician champion to lead the ASC's vision and keep other staff members on track and working toward the bigger picture goal.
Many hospitals and health systems use this method of having a compensated physician executive lead goal progression on behalf of their physician colleagues and partners, and ASCs would be suited to adopt it as well.
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