Ten surgery center leaders and industry experts share their thoughts on the top priorities for ASC administrators now.
Margaret Acker, administrator of Southwest Surgical Center in Byron Center, Mich.:
I think the most important thing administrators can do now is read and participate in their state and national ASC organizations. I think it important to network with others and share information that benefits patients. We all wonder how the ASC will fit into the new healthcare reform. I believe we must be knowledgeable and able to join as one collective voice to ensure we are heard in Washington.
My concerns will probably be the same as most administrators, but here they go:
• Hospital systems recruiting and eventually employing surgeons. These doctors no longer can bring patients to the ASCs.
• Inability to fairly contract or fairly with insurances controlled by hospitals
• How to remain profitable while paying significantly more for supplies and staff —especially healthcare benefits. It is ironic — we sit on the provider side and the employer side. We collect less for our services and pay more for staff benefits.
• What impact will ACOs have on freestanding ASCs? The ambiguity, with no ability to learn more or do more, is frustrating.
• As most ASC RNs aren't young, how do we recruit and retain qualified RNs?
• What will the requirement for EMR in ASCs really be? Should we move forward, or hold out until we know?
Jessica Cooley, sales executive of strategic accounts for Provista:
The uncertainty in the reimbursement for health care services highlights the importance for taking a strategic approach to the management of your supply chain. The ASC chains I work with are focused on incorporating information technology to manage inventory, purchasing and their revenue cycle. Also, several are exploring ways to focus their supply utilization by standardizing products used across locations, looking for opportunities to aggregate purchases with suppliers to take advantage of the best pricing tiers available and reducing supply waste by creating custom procedure kits. A good way to approach supply chain improvement is to schedule periodic business reviews with your distribution partner and GPO representative.
Pam Ertel, president of the Pennsylvania Ambulatory Surgery Association:
The top items for me are:
1. Implementation of electronic health records.
2. Be politically astute. Keep abreast of state and regulatory issues that pertain to ambulatory surgery facilities. Get to know your local politicians.
3. Develop a strategic plan for obtaining benchmarks.
4. Maintain a dashboard of outcomes.
5. The most important: Provide a quality environment that focuses on customer satisfaction. Be the choice for providing outstanding patient care.
Steve Henry, administrator of Fremont (Neb.) Surgical Center:
Two of the top priorities are to work with vendors to find ways to lower costs of supplies and implants and to continue to recruit new physicians. In addition, for those surgery centers who are partnered with hospitals, [administrators must] continue to ask them to earn their percentage through payor negotiation, joint recruitment among new physicians and other contracted service lines.
Bob Kahn, CEO of Orthopedic Specialists of Texarkana:
[The most important thing an ASC administrator can do right now] is to keep the ASC solvent and maintain current levels of physician productivity at the ASC.
Stuart Katz, FACHE, CASC, executive director of Tucson Orthopaedic Surgery Center:
Take a deep breath and relax. Many of us often find themselves in a series of dilemmas which require thoughtful processing, and we do not make time to fix issues once and for all. I am of the opinion that healthcare is like a merry-go-round, in that there are not many new problems, just the same old ones that keep coming back around. We are measured or should be measured on our ability to slow down the merry-go-round so that we are not dealing with the same problems day-to-day, week-to-week or month-to-month. Finding permanent solutions to issues can be life-saving, and the life one saves might be your own.
The other important item for any administrator is understanding what you don't know so that you can get assistance from either within or outside your organization. You cannot be a "jack of all trades," as there is not enough time in the day to do it all. Knowing your limitations is very important.
Brad Lerner, MD, FACS, clinical director at Summit Ambulatory Surgery Centers in Houston:
Important things that ASC administrators should be doing now:
1. Exploring potential partnerships with hospitals/hospital systems.
2. Exploring potential new lines of service to bring into the ASC that make sense from a clinical and cost effectiveness standpoint.
3. Pursuing competitive bidding to look to decrease both supply and service costs in the ASC.
4. Maximizing use of supportive staff and OR time — look to expand hours if demand is there, and look at staggered scheduling for staff to optimize staffing and avoid over-staffing.
Mike Lipomi, president and CEO of Surgical Management Professionals:
[Administrators must] pay attention to the smallest detail and every penny spent.
Sarah Martin, of Symbion:
The ASC administrator must look at the big picture. It is easy to get caught up in the financial or clinical aspect of the role specifically and then neglect environment of care issues. The administrator must surround himself with strong managers and staff that can assist in keeping the big picture in view. With the new focus on ASC quality, the administrator is going to need to allocate resources to ensure quality is met and reported properly, in addition to ensuring positive financial and clinical outcomes.
Holly C. Ramey, group vice president for Surgical Care Affiliates:
[Administrators must] hold the team accountable to the highest quality of care and engage/partner with physician.
Related Articles on ASC Operations:
12 Ways for ASCs to Improve Payor Contracting
10 Steps to Profitable and Successful ENT in Surgery Centers
25 Statistics on Surgery Center Growth
Margaret Acker, administrator of Southwest Surgical Center in Byron Center, Mich.:
I think the most important thing administrators can do now is read and participate in their state and national ASC organizations. I think it important to network with others and share information that benefits patients. We all wonder how the ASC will fit into the new healthcare reform. I believe we must be knowledgeable and able to join as one collective voice to ensure we are heard in Washington.
My concerns will probably be the same as most administrators, but here they go:
• Hospital systems recruiting and eventually employing surgeons. These doctors no longer can bring patients to the ASCs.
• Inability to fairly contract or fairly with insurances controlled by hospitals
• How to remain profitable while paying significantly more for supplies and staff —especially healthcare benefits. It is ironic — we sit on the provider side and the employer side. We collect less for our services and pay more for staff benefits.
• What impact will ACOs have on freestanding ASCs? The ambiguity, with no ability to learn more or do more, is frustrating.
• As most ASC RNs aren't young, how do we recruit and retain qualified RNs?
• What will the requirement for EMR in ASCs really be? Should we move forward, or hold out until we know?
Jessica Cooley, sales executive of strategic accounts for Provista:
The uncertainty in the reimbursement for health care services highlights the importance for taking a strategic approach to the management of your supply chain. The ASC chains I work with are focused on incorporating information technology to manage inventory, purchasing and their revenue cycle. Also, several are exploring ways to focus their supply utilization by standardizing products used across locations, looking for opportunities to aggregate purchases with suppliers to take advantage of the best pricing tiers available and reducing supply waste by creating custom procedure kits. A good way to approach supply chain improvement is to schedule periodic business reviews with your distribution partner and GPO representative.
Pam Ertel, president of the Pennsylvania Ambulatory Surgery Association:
The top items for me are:
1. Implementation of electronic health records.
2. Be politically astute. Keep abreast of state and regulatory issues that pertain to ambulatory surgery facilities. Get to know your local politicians.
3. Develop a strategic plan for obtaining benchmarks.
4. Maintain a dashboard of outcomes.
5. The most important: Provide a quality environment that focuses on customer satisfaction. Be the choice for providing outstanding patient care.
Steve Henry, administrator of Fremont (Neb.) Surgical Center:
Two of the top priorities are to work with vendors to find ways to lower costs of supplies and implants and to continue to recruit new physicians. In addition, for those surgery centers who are partnered with hospitals, [administrators must] continue to ask them to earn their percentage through payor negotiation, joint recruitment among new physicians and other contracted service lines.
Bob Kahn, CEO of Orthopedic Specialists of Texarkana:
[The most important thing an ASC administrator can do right now] is to keep the ASC solvent and maintain current levels of physician productivity at the ASC.
Stuart Katz, FACHE, CASC, executive director of Tucson Orthopaedic Surgery Center:
Take a deep breath and relax. Many of us often find themselves in a series of dilemmas which require thoughtful processing, and we do not make time to fix issues once and for all. I am of the opinion that healthcare is like a merry-go-round, in that there are not many new problems, just the same old ones that keep coming back around. We are measured or should be measured on our ability to slow down the merry-go-round so that we are not dealing with the same problems day-to-day, week-to-week or month-to-month. Finding permanent solutions to issues can be life-saving, and the life one saves might be your own.
The other important item for any administrator is understanding what you don't know so that you can get assistance from either within or outside your organization. You cannot be a "jack of all trades," as there is not enough time in the day to do it all. Knowing your limitations is very important.
Brad Lerner, MD, FACS, clinical director at Summit Ambulatory Surgery Centers in Houston:
Important things that ASC administrators should be doing now:
1. Exploring potential partnerships with hospitals/hospital systems.
2. Exploring potential new lines of service to bring into the ASC that make sense from a clinical and cost effectiveness standpoint.
3. Pursuing competitive bidding to look to decrease both supply and service costs in the ASC.
4. Maximizing use of supportive staff and OR time — look to expand hours if demand is there, and look at staggered scheduling for staff to optimize staffing and avoid over-staffing.
Mike Lipomi, president and CEO of Surgical Management Professionals:
[Administrators must] pay attention to the smallest detail and every penny spent.
Sarah Martin, of Symbion:
The ASC administrator must look at the big picture. It is easy to get caught up in the financial or clinical aspect of the role specifically and then neglect environment of care issues. The administrator must surround himself with strong managers and staff that can assist in keeping the big picture in view. With the new focus on ASC quality, the administrator is going to need to allocate resources to ensure quality is met and reported properly, in addition to ensuring positive financial and clinical outcomes.
Holly C. Ramey, group vice president for Surgical Care Affiliates:
[Administrators must] hold the team accountable to the highest quality of care and engage/partner with physician.
Related Articles on ASC Operations:
12 Ways for ASCs to Improve Payor Contracting
10 Steps to Profitable and Successful ENT in Surgery Centers
25 Statistics on Surgery Center Growth