8 Reimbursement and Business Concepts for Spine

Lynn S. Feldman, RN, MBA, administrative manager of Eastwind Surgical, a spine center in Westerville, Ohio, discusses eight reimbursement and business concepts for spine.

1. Educate payors about prices. Payors may balk at the relatively high price of spine surgery compared with other specialties. One spine operation can take eight hours, so if the payor pushes down margins, the center cannot offset them by raising volume, as in other specialties like ophthalmology. "A spine center needs a good margin on each case," Ms. Feldman says. Challenge payors to compare the ASC's charges with those of inpatient facilities. Invite payors to visit the center and enlist your surgeons to explain why spine is moving to the outpatient setting.

2. Ensure high patient satisfaction. Since word of mouth can be a center's only form of advertising, it is important that every patient leaves the center totally satisfied. Pay special attention to fully informing the patient before and after surgery. Getting the proper instructions is especially important for long and complicated surgeries like spine.

3. Reach out to the community. Remember, an ASC's employees are its ambassadors and it is important that they always speak highly of the center. "Instill pride [in] your facility within your entire staff," Ms. Feldman says. Events such as the national ASC open house day give centers a chance to showcase the facility to the community.

4. Treat your surgeons well. "Your surgeons are truly one of your biggest assets," Ms. Feldman says. "They have a choice as to where they perform surgery. Treat them respectfully and politely at all times. There should be a very cordial relationship." For example, send them a text message the day before surgery, letting them know we are ready for them the next day. Also, make sure ORs turn over fast. Quick turnover has less impact on efficiency in a spine center, because there are fewer cases, but it still means something to the surgeons. "You don't want them to be idle," she says.

5. Treat surgeons' practices well too. The practice's staff, especially the scheduler, will have an impact on your center's success. "Make the practice's job as easy as possible," Ms. Feldman says. Help track down preadmission testing, and when patients have questions, do your best to answer them instead of referring them back to the practice.

6. Make friends with competitors. Get on friendly terms with your counterparts at the local hospital and other surgery centers in the area. "The amicable relationship our center has with other facilities has truly been a win-win situation," Ms. Feldman says. It can involve sharing instruments and supplies as well as advice on compliance, accreditation and other matters. "With good relationships like these, you don't have to spend money on a consultant," she says.

7. Keep your schedule flexible.
When no cases are scheduled, send clinical personnel home or cross-train them to help with administrative functions.

8. Enlist surgeons to reduce implant costs. "Your surgeons work closely with company reps, so it is easier for them to ask for lower prices for implants," Ms. Feldman says. "They have more leverage with the companies than an administrator could have." Many surgeons simply don't want to talk about prices, but those who do are invaluable in keeping costs down.

Learn more about Eastwind Surgical.

Read more about spine:

-Study: New Protocol Nearly Eliminates Infection in Spinal Surgery Patients

-10 Established Best Practices for Increasing Spine Surgery Center Profits

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