Five surgery center industry leaders discuss the biggest challenges for surgery center administrators in 2011.
Brent Ashby, administrator of Audubon Surgery Center in Colorado Springs:
From my perspective, one of the greatest challenges facing ASC administrators is keeping up with the ever-changing state and federal regulations. In the past few years, we have seen numerous regulation changes by CMS and the Colorado Department of Public Health and Environment. Achieving and maintaining Medicare and other accreditations has become more difficult of late. We are likely to continue to see increased regulatory activity, particularly if the new healthcare reforms get any traction. Staying on top of this consumes more of my time than it has in the past.
Mary Ann Cooney, administrator of Riverside Outpatient Surgery Center in Columbus, Ohio (managed by Health Inventures):
Some of biggest hurdles I face are lower reimbursements, stricter regulations from CMS and physicians choosing hospital employment. Having a strategic plan in place to recoup the volume from the flow of physicians out of ASCs toward hospitals is critical to our success. Managing supplies effectively through the education of staff and physicians through manufacturer comparisons regarding pricing and cost per case has led to supply standardizations among physician specialties.
Having a effective quality program requires the commitment of board members, physicians and staff members to bring about process change and clinical quality outcomes that will eventually affect reimbursement through pay for performance initiatives. Managing patient expectations is always a challenge, whether it be through facility design, throughput processes, or wait times during the perioperative experience. We have found that the patients and caregivers expect more and we are always challenged to provide that "wow" experience. My staff know they are always "on stage," similar to the Disney philosophy.
Luke M. Lambert, CEO of ASCOA:
1. Payor issues. Out-of-network [is] being eliminated and deductibles and co-pays [are] increasing, causing patients to defer care.
2. Employee compensation. It is hard to pass on cost-of-living increases to employees while payors are failing to give inflationary updates to centers.
3. Physician recruitment is getting harder because more are being employed by hospitals or are already committed to other surgery centers.
Amy McKiernan, nursing administrator of Louisville (Ky.) Surgery Center:
I would say the biggest challenge is recruitment. This is in part due to the competition with other centers [that] are out of network and can offer bigger dividends because their reimbursements are so much more. We are also seeing a large number of doctors who are becoming employees of the hospital.
Joe Zasa, managing and founding partner of ASD Management:
For independent non affiliated ASCs, the biggest challenge is physicians being purchased by hospitals and being directed away from the ASC. This creates pressure on surgery centers and requires focused recruiting efforts as well as dialogue, in some instances, with hospitals to discuss joint venture arrangements.
Related Articles on Surgery Center Operations:
The Value of a Feasibility Study for De Novo Centers: Q&A With Robert Carrera of Pinnacle III
12 Ways for ASCs to Improve Payor Contracting
10 Steps to Profitable and Successful ENT in Surgery Centers
Brent Ashby, administrator of Audubon Surgery Center in Colorado Springs:
From my perspective, one of the greatest challenges facing ASC administrators is keeping up with the ever-changing state and federal regulations. In the past few years, we have seen numerous regulation changes by CMS and the Colorado Department of Public Health and Environment. Achieving and maintaining Medicare and other accreditations has become more difficult of late. We are likely to continue to see increased regulatory activity, particularly if the new healthcare reforms get any traction. Staying on top of this consumes more of my time than it has in the past.
Mary Ann Cooney, administrator of Riverside Outpatient Surgery Center in Columbus, Ohio (managed by Health Inventures):
Some of biggest hurdles I face are lower reimbursements, stricter regulations from CMS and physicians choosing hospital employment. Having a strategic plan in place to recoup the volume from the flow of physicians out of ASCs toward hospitals is critical to our success. Managing supplies effectively through the education of staff and physicians through manufacturer comparisons regarding pricing and cost per case has led to supply standardizations among physician specialties.
Having a effective quality program requires the commitment of board members, physicians and staff members to bring about process change and clinical quality outcomes that will eventually affect reimbursement through pay for performance initiatives. Managing patient expectations is always a challenge, whether it be through facility design, throughput processes, or wait times during the perioperative experience. We have found that the patients and caregivers expect more and we are always challenged to provide that "wow" experience. My staff know they are always "on stage," similar to the Disney philosophy.
Luke M. Lambert, CEO of ASCOA:
1. Payor issues. Out-of-network [is] being eliminated and deductibles and co-pays [are] increasing, causing patients to defer care.
2. Employee compensation. It is hard to pass on cost-of-living increases to employees while payors are failing to give inflationary updates to centers.
3. Physician recruitment is getting harder because more are being employed by hospitals or are already committed to other surgery centers.
Amy McKiernan, nursing administrator of Louisville (Ky.) Surgery Center:
I would say the biggest challenge is recruitment. This is in part due to the competition with other centers [that] are out of network and can offer bigger dividends because their reimbursements are so much more. We are also seeing a large number of doctors who are becoming employees of the hospital.
Joe Zasa, managing and founding partner of ASD Management:
For independent non affiliated ASCs, the biggest challenge is physicians being purchased by hospitals and being directed away from the ASC. This creates pressure on surgery centers and requires focused recruiting efforts as well as dialogue, in some instances, with hospitals to discuss joint venture arrangements.
Related Articles on Surgery Center Operations:
The Value of a Feasibility Study for De Novo Centers: Q&A With Robert Carrera of Pinnacle III
12 Ways for ASCs to Improve Payor Contracting
10 Steps to Profitable and Successful ENT in Surgery Centers