Kim White, a consultant with Numerof & Associates, discusses five core concepts for driving revenue at ophthalmology surgery centers.
1. Stay updated with quality data reporting. As of October 1, Medicare-certified ASCs must submit CMS outcomes and quality data; if they don't, they could see a 2 percent annual payment reduction, which is significant for surgery centers serving Medicare patients.
"For surgery centers, this is new territory," says Ms. White. "They need to know what to submit, when and what format so they can protect reimbursement because that's important. Protecting reimbursement is a key part of the broader strategy for the center."
For some ophthalmology cases, Medicare is actually reimbursing at a higher rate than in the past. You want to show them, as well as other payors, the value of higher reimbursement for these procedures.
"With added benefits comes added responsibility," says Ms. White. "If CMS sees more dollars flowing from them, they are going to want to see the impact of their investment. Surgery centers should meet and exceed quality baselines."
2. Demonstrate the value of additional services at the center. Many patients covered by Medicare will need cataract surgery, or other typical degenerative procedures, and patients may be willing to pay additional out-of-pocket costs for services that Medicare doesn't cover if the center can show them why it's worth it.
"Having data showing why they should select these extra services and pay that premium will help surgery centers capture additional out-of-pocket revenue," says Ms. White. "Medicare will pay for some basic procedures, but it doesn't necessarily cover all technologies."
Extra services to enhance care could also be a valuable marketing tool for the surgery center, especially if you can feature your own outcomes improvement relative to the current standard of care.
3. Know your audience when touting outcomes. Surgery centers must market directly to patients, local surgeons, referring physicians and payors to drive a steady stream of patients into the ASC. All groups are looking for positive outcomes data, but not all presentations should be the same.
"If there are no outcomes, there will be no income," says Ms. White. "Present information in a way that the audience will understand. A consumer may not understand the relative importance of a seemingly small statistical difference. A clinician is another story; they understand it could make a significant difference."
Take time to develop different presentations for the different audiences and help them understand the significance of your data for their situation.
4. Invest in new technology. Even though new technology might not be covered by Medicare, having it available for patients who want the added value could enhance your surgery center's revenue. Eventually, these technologies may show a broader clinical and economic benefit and could be covered in the future.
"The traditional methodology may still give good results, but if the new technology is better, some people are willing to pay for that," says Ms. White. "You want to show the clinical and economic benefits of the additional dollar."
Clinical benefits could include better precision and reproducible outcomes. Economic benefits could include faster functional improvements or quicker return-to-work times.
"A surgery like LASIK was initially very expensive for patients, but as more evidence was developed to support it as a viable solution, more people sought the procedure and prices went down," says Ms. White. "As additional advances are made to medical devices in other areas, they can leverage those for better outcomes and revenue."
5. Differentiate your surgery center from other providers. A key aspect of driving case volume and reimbursement is demonstrating why you are better than other providers in the area, which could include other surgery centers or hospitals. Market your good outcomes, positive patient satisfaction and high quality to patients and other referral sources.
"Your outcomes should demonstrate how you differentiate yourself from others," says Ms. White. "You want to demonstrate to the consumer and the payor how you are different and why you should receive the compensation that you ask for."
Another way surgery centers can differentiate themselves is with new technology, as long as it is proven to produce better quality. This is especially important in competitive markets where an ASC's survival depends on demonstrating its success.
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