Independent ASCs face specific challenges when it comes to payer contracts and opportunities for growth.
Lori Martini, CASC, administrator of SOG Surgery Center in Tupelo, Miss., spoke to Becker's ASC Review on the reimbursement issues her center faces and where she's focusing on growth.
This interview was edited lightly for clarity.
Question: What were your biggest revenue challenges in the past year?
Lori Martini: Aside from the obvious challenges presented by the COVID-19 pandemic, we have challenges related to a limited payer mix and implant reimbursement. As a fairly new, independent ASC opened in 2019, negotiations with certain commercial payers have been a challenge. We are not yet in network with three major commercial payers, despite the substantial savings they would recognize by contracting with the ASC. We have had to provide explanations of benefits from hospital outpatient department cases in order to negotiate fair contract rates. We have been in negotiations with these payers for over a year and are hoping to finalize those contracts in the next few months.
In an effort to maximize the profit on our current revenue, we are in the process of implementing a program to automate our preference cards and allow us to capture more detailed case-costing data.
Q: Where are the biggest opportunities for growth in your ASC?
LM: We have several growth opportunities over the next few years. We are a single-specialty, single-practice ASC. We are actively recruiting new surgeons in multiple orthopedic subspecialties. We added a spine surgeon in 2020, so growing that specialty alongside outpatient total joints represents a significant growth opportunity over the next 10 years.
Physician recruitment is a high priority for Specialty Orthopedic Group. We expanded the number of satellite clinics in 2020 in an effort to drive cases to our ASC and expand its footprint — currently with four satellite clinics, in addition to our two primary clinics in Tupelo and Oxford.
This allows us to reach a broader population and increase the surgery volume at our ASC. We are fortunate to have strong marketing efforts and community outreach, which has helped us become recognizable as a leader in orthopedic care in the North Mississippi region.