Here are profiles of 20 ophthalmology-driven ASCs to know.
Ambulatory Eye Surgery Center of Louisiana (Metairie, La.). This ASC, with two ORs and seven to eight physician-investors, is performing well despite the recession, says Chad Veal, regional vice president for AmSurg, which is a partner in the center. "This center has been very strong and continues to grow," he says. He attributes recent growth to the New Orleans area's recovery from Hurricane Katrina in 2005. "People are slowly coming back," he says. The ASC is now ready to launch retina operations. He says ophthalmologists are eager to come over from the hospital. "They're pushed aside at the hospital," he says. "They're the red-headed stepchildren." At AmSurg, Mr. Veal oversees 13 ophthalmology centers in nine states. Premium IOLs, introduced four to five years ago, are now used in 25 percent of cataract cases. www.eyesurgerycenterla.com
Cataract Specialty Surgery Center (Berkley, Mich.). This center has two ORs and one treatment room for laser, Yag or SLDs for glaucoma. It has three physician-partners while Novamed owns 51 percent. The center's chief selling points for prospective partners were access to two ORs, a turnaround time of 5-7 minutes and an easier paperwork process because internists on site perform required history and physicals of patients. www.cataractspecialty.com
Dulaney Eye Institute (Towson, Md.). Having opened almost 15 years ago, the center now has 21 ophthalmologists from nine competing practices, but they fully cooperate on key decisions such as OR scheduling and capital purchases, says Administrator Andrea Hyatt. "They are a very cohesive group that is willing to leave egos behind them for the success of the center," she says. The ASC logged about 7,800 procedures in 2009, an increase over 2008. The surgeons collectively perform anterior segment, glaucoma, corneal transplants, ocular-plastic surgery and retina procedures, but they made a decision years ago not to take on LASIK surgery and have stuck to it, she says. The ASC has recently replaced a retina laser and is getting ready to replace a sterilizer. www.omnieyespecialists.com
Eye Center of Columbus (Ohio). The surgeon-owners of this four-year-old ASC had the foresight to embrace all specialties and levels of ophthalmic care in what they call an "eye mall, including an optical shop, pharmacy, eye bank and deli," says Executive Director Pam Canfield. The six-OR facility, with one refractive room and three procedure rooms, is used by 48 surgeons who logged more than 9,000 cases in 2009. The ASC has brought billing and other financial functions in-house under a business manager who is a certified coder. "It has made a huge difference," Ms. Canfield says. "Within nine months of making this move, by the end of 2007 and into 2008, we were able to move out of the red and into the black." This included renegotiating payor contracts to reflect more transparency and improved reimbursement. www.theeyecenterofcolumbus.com
Eye-Q Vision Care (Fresno, Calif.). This center has two ORs, used by nine surgeons, with a volume of around 5,000 procedures annually, excluding LASIK. It hosts cataracts, glaucoma, cornea and some pediatric eye surgery, and added retina in 2003. The center is owned by Eye-Q Vision Care, which also owns an ophthalmology practice. CEO Scott Bridgeman says readers of the Fresno Bee have selected it the best eye practice in the area for five consecutive years and Eye-Q has also been selected for the past three years as one the top five Fresno companies to work for. "Our goal is to have the latest technology in our ASC, whether it is equipment or supplies, to provide our patients with the opportunity to have the best possible outcome," Mr. Bridgeman says. The ASC just purchased three Spectralis OCT machines from Heidelberg Engineering, at a total cost of about $375,000. www.eyeqvc.com
Eye Surgery Center of Northern California (Citrus Heights, Calif.). Scott George, clinical director of the ASC, says the center has one surgeon, Richard Meister, MD, who does 35-40 cases there per month. The center is open when the practice is closed. Volume is strong, with appointments booked out one and half months in advance. Volume is mostly cataracts and about 15-20 percent of cataract patients get premium IOLs, which cost $1,000- $2,000 out of pocket. Dr. Meister was one of the first U.S. doctors to specialize in LASIK, performing the procedure outside of the country in 1994, a year before use of the excimer laser was even approved by the FDA. www.lasermeister.com
Eye Surgery Center of Michigan (Troy, Mich.). This 2.5-year-old center has two ORs and one procedure room. Nine investing physicians come from three groups. St. John Providence Health holds minority interest. Administrator Michael Cosgrove says he has a very active group of physician-owners, new equipment and committed employees. Volume has been off but not by as much as at the local hospital or other ASCs. The big problem, he says, is reimbursement rates. Rather than entering negotiations for rate increases, payors have been cutting rates. For example, Blue Cross Blue Shield of Michigan reduced many reimbursements for ASCs on July 1. "We're waiting to see what's going to happen with the new healthcare plan," Mr. Cosgrove says. The center is accredited by the Accreditation Association for Ambulatory Health Care. www.eyesurgerycentermi.com
Island Eye Surgery Center (Carle Place, N.Y.). This ASC, located on Long Island, has three ORs. The 36 doctors on staff, 15 of which are partners, performed 9,400 cases last year. Cases are in all ophthalmology subspecialties except retina. Administrator Bob Nelson, a physician assistant, assists on cases such as corneal, glaucoma and plastic surgeries. Volume has been going up every year. With a 96 percent room utilization rate, physician-owners are discussing plans to expand the facility. "There is great demand out there," Mr. Nelson says. "I turn away doctors every day." The center is accredited by the Accreditation Association for Ambulatory Health Care. www.islandeye.net
Laser and Surgical Services at the Center for Sight (Sarasota, Fla.). This three-OR facility is a high-volume ASC, with eight surgeons performing 14,000 procedures a year, half of which are cataracts and the rest cornea, glaucoma, retina, oculoplastics and full facial plastic surgery. Two of the surgeons are owners and another six are employees. Surgery volume rebounded at the end of 2009. While cosmetic surgeries have shown a slight decline, functional plastic surgeries have increased. Chief Administrative Officer James Dawes says the ASC selects surgeons from the best training programs, provides continuous in-house staff training and prides itself on a hotel-like atmosphere. In addition, the center tracks and reports selected performance benchmarks and patient satisfaction levels for all of its employees weekly. www.centerforsight.net
Mattax-Neu-Prater Eye Center and Surgery Center (Springfield, Mo.). When Leo T. Neu, III, MD, opened the center as a retina facility in 1999, he did it for his own convenience, not for money. Physician reimbursements for retina were low at the time and Medicare wouldn't pay a facility fee. The facility has two ORs but the second is used only for LASIK. Four surgeons now use the ASC, each with his own day of the week. All of the surgeons perform cataract surgery, two perform LASIK, one glaucoma surgery and Dr. Neu is the only one performing retinal surgery. He says cataract volume at the center has been rising in the past few years, retina volume has held steady and LASIK volume has been off since the recession started. www.mattaxneuprater.com
New Vision Cataract Center (Norwalk, Conn.). New Vision, which opened in 1999, has two ORs and a LASIK room in 8,000 square feet of space. It is owned by Scott Spector, MD, whose practice, Spector Eye Care, is next door. Dr. Spector performs about 95 percent of all cases which include cataract surgery, lens implants and all types of laser eye surgery, including LASIK and epi-LASIK. Mark Spector, Dr. Spector's brother and administrator of the practice, says the center has low employee turnover, even for per-diem employees who only come in on surgery days. He says the economy has affected the center's LASIK volume but not cataract volume. www.spectoreye.com
Northern Virginia Eye Surgery Center (Fairfax, Va.). The center opened in May 2008 but it took 20 years of struggle with nearby hospitals to get approval of this ASC under Virginia's strict certificate of need process. William Rich, MD, and other investors had to document scheduling difficulties at local hospitals and commit to performing charity care. In its first year, the one-OR ASC hosted 2,400 surgeries. Thirteen doctors in two groups use the facility, performing cataract surgery, DSAEK corneal transplant surgery, penetrating keroplasties (PKPs), YAG operations and occasionally blepharoplasties. Dr. Rich ascribes the ASC's success to "committed, efficient docs using the same kind of equipment and lenses." In the future he plans to increase efficiency and fill the Friday schedule. www.novaeyesc.com
NovaMed of Chicago Northshore. There are more cases done here than in many multiple-OR facilities, according to John Calta, the regional vice president for NovaMed. Procedures take an average of 10-12 minutes, with some physicians taking just seven minutes. The ASC, a joint venture with NovaMed, has six partners and a total of nine to 10 users. "We have streamlined the process," Mr. Calta says. "We worked with each physician and they have agreed on basically the same kind of process." The facility has been in operation since 1988 and is state-licensed, Medicare-certified and AAAHC-accredited. www.novamedchicagonorthshore.com
NovaMed SurgeryCenter of Sandusky (Ohio). This one-OR center can turn over as many as 43 cases a day. Three eye surgeons do a variety of procures while a fourth does laser procedures only. Daniel Baker, vice president of operations at Novamed, oversees six eye ASCs, but "I can't get the other six centers to work like these guys do," he says. "They can turn over a room in just two to three minutes." One secret to success is surgeons participating in room turnover and cleanup, putting gowns in garbage and helping to adjust new patients on arrival, shaving a minute or two off each case half an hour per day, Mr. Baker says. Another factor in its success is teamwork. "The CRNA, the pre-op staff, they all just click," he says. www.surgerycenterofsandusky.com
Peninsula Eye Surgery Center (Mountain View, Calif.). Peninsula, a two-OR facility that opened in 2005, has more than a dozen affiliated ophthalmic surgeons performing one of the highest eye surgery volumes in northern California, including cataract, glaucoma and corneal operations, eye laser procedures and refractive surgeries. David F. Chang, MD, the managing partner of a two-OR cataract ASC in Mountain View, Calif., eschewed an ASC-management company and personally did much of the start-up process over a period of three years. "It took a lot of hard work to get it started and I'm happy it's over," he says. Dr. Chang recommends keeping in check the number of physician-investors, especially from competing practices. "The more partners you have, the more complex it gets," he says. www.pesc2020.com
Physicians Outpatient Surgery Center (Marietta, Ohio). This two-OR facility, the first one in the area, has been open for 11 years. The center, which also has a laser suite, is owned by three ophthalmologists, David S. George, MD; Scott H. Strickler, MD; and Zane P. Lazer, MD; who run a practice called the Eye MDs. Two other ophthalmologists use it. Three of the five ophthalmologists focus on cataract cases and two are retina specialists, says Administrator Patty Berkhammer. The center employs pharmacists, anesthesiologists, registered nurses, nurse anesthetists and surgical technicians. It is accredited by the Accreditation Association for Ambulatory Health Care. www.physiciansoutpatient.com
Prairie Surgery Center (Springfield Ill.). This $3 million center is scheduled to open in mid-September. In its proposal for state approval, the facility estimated when it opens that 2,500 outpatient procedures a year would move from two local hospitals to the ASC, but both hospitals supported the proposal. Prairie Surgery will host mainly cataract surgery but Sandra Yeh, MD, the owner, said she plans to seek state approval for orthopedic surgery. The center will be used by surgeons in Prairie Eye & LASIK Center, which is owned by Dr. Yeh and another eye surgeon and employs six physicians. The one-story ASC, behind the practice, will be staffed by 12 nurses, nursing technicians and clerical workers. www.prairieeyecenter.com
St. Luke's Cataract and Laser Institute (Tarpon Springs, Fla.). This six-OR ASC hosts 9,000-10,000 cases annually, performed by 11 surgeons, nine of whom are employed by an affiliated ophthalmology practice in the same building. Three of the ORs are dedicated to cataracts and one to retina; other procedures are cornea, glaucoma and oculoplastics. Administrator Brad Houser says the cataract surgeons have improved efficiency by agreeing to consistent protocols and use the same instrumentation and intraocular lenses. A former circulating nurse functions in a new position of turnover nurse for the cataract ORs, double-checking everything in the chart before the surgery to make sure nothing is missing. About 20 percent of cataract patients choose premium presbyopia-correcting intraocular lenses, which Medicare partially covers, with the rest of the price paid by the patient out-of-pocket. Mr. Houser says the more expensive presbyopia-correcting IOLs are growing in popularity with patients. www.stlukeseye.com
Surgical Eye Center of Morgantown (W. Va.). This two-OR facility, which opened in 1997, is the only ASC in West Virginia accredited by The Joint Commission, according to the center. Seven surgeons perform 2,000 surgeries a year and also use an attached laser room. The ASC hosts glaucoma, cataract, corneal surgeries, plastic lid surgeries, YAG operations, muscle surgeries and intacs for keratoconus, but not retinal surgery. Five of the surgeons are in the same group, Regional Eye Associates, with offices in three states, and Monongalia General Hospital is a minority partner. Administrative Director Heather Huffman says surgeons and staff consistently receive patient satisfaction scores in the 98-99 percentile range, with comments on the speed and quality of the care. www.readocs.com/lasik-west-virginia/surgical_center.htm
Winchester (Va.) Eye Surgery Center. When this one-OR ASC opened three years ago, Jodie Looker, RN, was hired away from the competing hospital to become the new clinical director. The hospital had a much larger operation, but she is as busy as ever because she covers more administrative functions than at the hospital. The ASC now logs 3,000 surgeries a year, and volume rose recently with the addition of a fourth surgeon. Ms. Looker advises new ASCs to hire an experienced, competent staff. Several of her employees were also lured from the hospital. www.winchestereyesurgerycenter.com