Here are three administrators and CEOs of ambulatory surgery centers discussing the challenges and benefits of introducing retina procedures into ophthalmology-driven ASCs.
Question: What are some of the challenges of bringing retina procedures into the ASC, and how can they be overcome?
Steven Klein, CEO, Sheepshead Bay Surgery Center, New York: Availability of operating room time as well as upfront acquisition cost of equipment, instruments and supplies and reimbursement rates. Other challenges are the need for retinal surgeons with volume and identifying types of retinal cases that can be performed in the ASC.
Paul Lucas, CEO, Georgia Retina, Conyers: Retina procedures are typically much more tedious and time-consuming that the general ophthalmology cases. So, operating room time will be consumed by far fewer cases which will reduce facility fees. They also require additional equipment such as a vitrectomy machine. They can also require expensive supplies such as oil. Keeping room turnover efficient and managing inventory with minimal quantities are the primary offsets to these dilemmas.
Q: Despite these challenges, what are the advantages of bringing retina procedures to ASCs?
Linda Phillips, Southgate (Mich.) Surgery Center: One of the biggest advantages is that it offers the opportunity to be a full-service ophthalmology center. This is an advantage in terms of marketing to patients and allows your center to offer comprehensive quality care. The other advantage is that for a lot of the retina procedures the reimbursement is higher, so it does help with your bottom line.
Q: How can surgery centers prepare for the operational changes that retina procedures will bring about in the ASC?
Mr. Lucas: Specific training for surgical assistants will be required, again due the tedious work of the surgeon. This keeps case times reasonable and the flow of the day consistent and efficient.
Ms. Phillips: The biggest adjustment will have to be made to the staff's training, particularly, the nursing staff in the OR. They will have to have things ready for the retina surgeons, for which they will have to learn a new skill set. We bought new equipment for retina procedures, and we had the representatives here to train the staff. We also visited other retina surgeons to observe.
Q: Do you think more ASCs will begin performing retina procedures in the future?
Mr. Klein: Yes, payers will force it to happen because it's less expensive in the ASC. Also, with smaller gauge instruments, cases will be performed faster.
Mr. Lucas: ASCs committed to ophthalmology will no doubt consider retina. Growing volumes, maintaining strong ties to groups that offer retina and maintaining a common surgical venue for patients within the provider group will be motivators.
Ms. Phillips: I think that ASCs are not seeing high reimbursement, so it will be a challenge for ASCs to bring these procedures in. Unless they can find retina surgeons who can bring in high volumes of patients, I don't think you will see an increase in retina surgeries in ASCs. Having said that however, we feel that adding retina was a positive for our center. It was a nice addition to providing ophthalmic care, and it's also been a positive for our patients because nobody was doing retina in our area so patients had to travel for over an hour for those procedures.
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Question: What are some of the challenges of bringing retina procedures into the ASC, and how can they be overcome?
Steven Klein, CEO, Sheepshead Bay Surgery Center, New York: Availability of operating room time as well as upfront acquisition cost of equipment, instruments and supplies and reimbursement rates. Other challenges are the need for retinal surgeons with volume and identifying types of retinal cases that can be performed in the ASC. Paul Lucas, CEO, Georgia Retina, Conyers: Retina procedures are typically much more tedious and time-consuming that the general ophthalmology cases. So, operating room time will be consumed by far fewer cases which will reduce facility fees. They also require additional equipment such as a vitrectomy machine. They can also require expensive supplies such as oil. Keeping room turnover efficient and managing inventory with minimal quantities are the primary offsets to these dilemmas.
Q: Despite these challenges, what are the advantages of bringing retina procedures to ASCs?
Linda Phillips, Southgate (Mich.) Surgery Center: One of the biggest advantages is that it offers the opportunity to be a full-service ophthalmology center. This is an advantage in terms of marketing to patients and allows your center to offer comprehensive quality care. The other advantage is that for a lot of the retina procedures the reimbursement is higher, so it does help with your bottom line. Q: How can surgery centers prepare for the operational changes that retina procedures will bring about in the ASC?
Mr. Lucas: Specific training for surgical assistants will be required, again due the tedious work of the surgeon. This keeps case times reasonable and the flow of the day consistent and efficient.
Ms. Phillips: The biggest adjustment will have to be made to the staff's training, particularly, the nursing staff in the OR. They will have to have things ready for the retina surgeons, for which they will have to learn a new skill set. We bought new equipment for retina procedures, and we had the representatives here to train the staff. We also visited other retina surgeons to observe.
Q: Do you think more ASCs will begin performing retina procedures in the future?
Mr. Klein: Yes, payers will force it to happen because it's less expensive in the ASC. Also, with smaller gauge instruments, cases will be performed faster.
Mr. Lucas: ASCs committed to ophthalmology will no doubt consider retina. Growing volumes, maintaining strong ties to groups that offer retina and maintaining a common surgical venue for patients within the provider group will be motivators.
Ms. Phillips: I think that ASCs are not seeing high reimbursement, so it will be a challenge for ASCs to bring these procedures in. Unless they can find retina surgeons who can bring in high volumes of patients, I don't think you will see an increase in retina surgeries in ASCs. Having said that however, we feel that adding retina was a positive for our center. It was a nice addition to providing ophthalmic care, and it's also been a positive for our patients because nobody was doing retina in our area so patients had to travel for over an hour for those procedures.
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