One of the biggest issues for mature ASCs — those 10 years or older — occurs when the founding partners approach retirement. The partners can either choose to close their practice, sell to a hospital or bring on new physician partners to continue their business. Each solution comes with a specific set of challenges, especially when bringing on a new partner.
"The new doctors are just building their practice, so the ASC takes a significant hit because the case volume drops," says Ann Geier, MS, RN, CNOR, CASC, chief nursing officer at SourceMed. "In some cases, if the doctors that formed the center are around the same age, this can have a devastating effect on the bottom line."
Furthermore, healthcare changes over time, but a single ASC may stagnate. Existing physicians may not have the cutting-edge technology or training to bring in the new, high-revenue procedures like spine surgery and total joints, and as their careers wind-up they may be risk-adverse to bringing such cases into the center.
"The older owners may also want to spend less on new equipment as they are not going to be using it if they retire," says Ms. Geier. "But they need to stay abreast of what is happening in the industry. What new procedures are other centers trying? Is there a better way to build the mouse-trap?"
In addition to evolving technologies, payment models and government regulations are also changing.
"While clinical systems have not been widely deployed, in the new era of healthcare, integrating clinical and payment systems will become more important," says Walter Groszewski, Vice President of Professional Services at SourceMed. "Information will be a critical asset to success in the new world."
The surgery center's success depends on understanding patients, physician partners and the overall community. Here are six key thoughts on breathing new life into your ASC:
1. Value-based healthcare is driving new government regulations, so understanding the different value-based reimbursement methodologies is important. New payment models such as bundled payments and risk-sharing arrangements will become more popular in the future. "Centers must determine how they are going to fit into the various models that are being evaluated and then how technology will complement that journey," says Mr. Groszewski.
2. Stay informed about the healthcare ecosystem with social media. "Doctors and patients are communicating online and patients are receiving education over the internet both for pre- and post-care information," says Mr. Groszewski. "Getting plugged into online communities can be an excellent vehicle to stay aware of changes in the industry."
3. Keep the interior of the ASC looking young with updated furniture and an eye toward cleanliness. ASCs can also purchase new equipment, supplies and technology that keeps the center on the cutting-edge. "That doesn't mean you buy everything because it's new. It means doing your due diligence to see if it's a good match for your facility," says Ms. Geier. "Older ASCs cannot let themselves become stale."
4. Recruit young and dynamic physicians, and help those physicians succeed. Participate in your Chamber of Commerce and other community leadership positions. "All this will help you recruit new physicians and patients," says Ms. Geier. "Your best recruiters are your owners. If you have a physician-leader who can sell the center to other physicians, use him as your lead recruiter. Bring in new specialties and stay fresh."
5. Let go of non-profitable cases and adjust the schedule to eliminate using resources wastefully. "This can be hard to do, but doing more [unprofitable cases] only means you lose more money," says Ms. Geier. "If the case volume has dropped, how has the center adapted? Did it close ORs? Close one day per week? Can you consider leasing space on the one day per week you are closed?"
6. Believe in your center as owners and operators, and stay active in the organizations and associations that support ASC industry interests. "Let your Congressmen and Senators know what our industry is all about by inviting them to your center," says Ms. Geier. Bringing in legislators can rejuvenate the staff and show how important the center is to the community.