In a weekly e-newsletter, Regent Surgical Health highlighted the key ways ASCs fail to manage risk and explained how to turn those shortcomings into opportunities for growth.
Here are four common mistakes.
1. Poorly managed payer contract negotiations. Busy schedules often keep administrators and office managers from dedicating the attention necessary to negotiate expiring payer contracts successfully. ASC administrators can retain more money by negotiating payer contracts that will sufficiently cover the full cost of services and streamline healthcare costs.
Four strategies can help accomplish this goal:
- Incorporating CMS changes into contracting
Planning for future case mix changes and updated procedures
Building in annual increases and multi-year contract increases
Paying careful attention to terms when it comes to PPOs and third-party administrators
2. Skyrocketing expenses. Administrators must monitor costs and track trends. Replacing older, less precise metrics with electronic preference cards can provide a clear view of supply expenditures by collecting and comparing data across member facilities. This change also allows ASCs to identify which physician items drive up costs and determine where savings can be captured. Integrating the data with electronic procurement systems such as Inventory Optimization Solutions helps ASCs improve cost management both at individual centers and throughout the entire organization.
3. Failure to provide high-reimbursement cases. ASCs need to add profitable procedures that may not be available elsewhere; otherwise, they'll lose those cases to the competition. Major spine cases and total joint replacements are two potentially profitable procedures that work in the ASC setting for clinical and financial reasons. Before adding these procedures, evaluate outcomes on an inpatient versus outpatient basis to determine any variation in the results by setting type or provider.
4. Inattention to revenue cycle management strategies.
The ACA, Medicare and Medicaid payment bundling, as well as forthcoming updates to ICD-10 guidelines are quickly changing the revenue cycle landscape. ASCs need to have specialized expertise and anticipate new opportunities without treating revenue cycle management as an afterthought. Focus on developing, executing and refining RCM strategies, and invest in advanced tools and technologies.