The healthcare market is in a transitional period with insurance companies and healthcare systems consolidating to stay profitable in the competitive market.
ASC leaders must be strategic in managing their centers to ensure it will withstand the evolving marketplace. Principal of Health Care Consulting, Susan Kizirian, discusses the key ways to succeed in today's ASC environment.
1. Leadership: An ASC cannot run efficiently and effectively with an eye on the future without a strong leader paving the way for success. Without strong leadership in place, an ASC's chance of success is minimal. Ms. Kizirian says, "ASCs need to have strong leaders who have a strong vision. Leaders who have the ability to see what others do not, move fast, adapt and implement their vision will successfully navigate their ASC through this transitional period."
2. Revenue cycle: A profitable ASC always has subject matter experts in revenue cycle management on staff or outsourced to ensure the ASC codes, bills and collects quickly and accurately. Ms. Kizirian explains, "You need an ever evolving level of expertise assure the ASC is paid quickly and correctly. ASCs that do not put an emphasis on proficiency in A/R management, require performance based on predetermined deadlines for filing, follow up on payment or understand the complexities involved, leave money on the table at the patient and payer level. The root cause of poor performance in revenue cycle management is 99.9999% of the time is a lack of engaging subject matter experts."
3. Payer negotiations: Hand-in-hand with revenue cycle management, successful ASCs employ or contract with negotiators with expertise in payer contracting. Ms. Kizirian says, "Payer contracting is another ever evolving complex process. It is often difficult for healthcare administrative generalists to grasp the depth and breadth of payer provisions and reimbursement methodology and even more so to keep up with the continuous changes. Those ASCs that are not financially successful most often do not have experts overseeing payer contracting."
4. Supply costs: Disposable medical supplies resides in the top three expense categories in any ASC. Ms. Kizirian says, "The most successful centers have predetermined protocols in place monitoring supply utilization and purchasing. Group purchasing organizations are understood and highly utilized. Staff is working with surgeons to ensure the supplies used are standardized, cost-effective without compromising quality."
5. Staffing management: "The best staffing model is to staff to patient demand," says Ms. Kizirian. "Minimizing payroll, yet make available the appropriate staff needed during patient care hours. The prudent Administrator, wanting to retain their talented staff, looks at scheduling of patients, surgeons and staff as a synergistic process. Compressing the schedule by vertically integrating cases across two or more surgeons on any given day is a challenging process, yet allows the hours the staff needs to commit to working at the ASC."
6. Case volume: ASCs simply cannot survive in this transitional market without growing case volume. Farsighted ASCs are continuously recruiting surgeons who will bring in cases to ensure the success of the center. Ms. Kizirian says, "Successful ASCs have an ever growing case volume. Since reimbursements are going down and cases are migrating to the physician practice setting, and expenses are always going up, successful ASCs know absolutely that growing their volume will sustain current financial status and grow their business."
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