To navigate the ever-changing, increasingly complex healthcare landscape, ASCs nationwide are exploring opportunities to enhance care coordination, meet patient demand and ensure optimal outcomes — all while reducing costs.
While the shift to value-based care can be a challenge for surgery centers, partnering on key opportunities with vendors, patients and payers will help ASCs thrive, according to Meredith Warf, CPA, DPT, administrator at the Surgery Center at Mississippi Sports Medicine in Jackson, which is a single-specialty orthopedic ASC owned by 17 orthopedic surgeons.
Prior to taking on the administrator role at MS Sports Medicine's surgery center in 2017, Dr. Warf worked at the ASC's clinic for eight years. She began her career with PricewaterhouseCoopers in public accounting.
Here, Meredith discusses key opportunities for surgery centers to thrive in today's healthcare environment, offers advice for administrators looking to streamline product lines and explains the success of several programs at MS Sports Medicine.
Editor's Note: Responses have been lightly edited for length and clarity.
Question: What are some of the biggest opportunities for surgery centers today?
Dr. Meredith Warf: There are three big opportunities for ASCs: Partnering with payers, partnering with patients and building strong relationships with vendors. The process of partnering with payers starts with collecting data. No payer wants to look at contracting and partnership opportunities until you have the data to support what you're trying to accomplish as a center. We began our first bundled payment partnership four years ago which has gone extremely well. After those years of outpatient data, MS Sports Medicine secured better contracts with all the major payers to perform outpatient total joints in our surgery center — except for Medicare — which has allowed us to expand the program significantly. I think this is an opportunity most surgery centers can capitalize on.
The second opportunity is partnering with your patient. We have a nurse navigator, essentially a clinical liaison, that meets with outpatient joint patients in their homes. This allows the navigator to assess the patient's home environment and educate him or her on the surgery and recovery process. Patients also have our navigator’s cellphone number, so they can contact her with any problems or questions. Establishing an open line of communication with patients is an area that surgery centers can focus on to help achieve better outcomes. We have also worked with technology to create a two-way communication pathway for our patients.
The third opportunity is working closely with vendors to build a strong relationship. We use a single source for our total joints for implants, meaning greater than 90 percent. We are mostly dual-source for sports and trauma cases, with a few outliers. We get most of our supply from Cardinal Health, which also helped us evaluate how effective our group purchasing organization is on pricing, how our supply deals are structured and how we can improve our custom pack agreements. We've seen great results and have been able to cut costs, while improving outcomes.
Q: What successful initiatives or programs have you implemented at MS Sports Medicine to capitalize on those opportunities?
MW: In partnering with payers, we are taking on more risk as a surgery center as the industry transitions to value-based care. As we take on more risk by tying patient outcomes and quality of care received to the amount we are paid, quality of care and safety remain our utmost goals. This requires a full team approach through the entire episode of care.
When it comes to partnering with patients, surgery centers must generate buy-in from each of them, so that they participate in the communication. We know education and two-way communication is key to a positive outcome. We started looking into programs that allow us to connect to every patient. In some instances, this means finding new ways to communicate with them outside of a phone call or the patient portal.
With vendors, I believe a partnership-like relationship means that you are in this together. You and your vendor should both work to achieve a goal. When you meet that goal, the vendor will reward you for that, maybe with better pricing, a rebate on certain items or capital equipment. When you streamline everything to single-source and develop that partnership, it becomes a little easier to keep the prices as low as possible, which is one of our biggest priorities in the ASC setting.
Q: What sort of benefits have you seen from single-sourcing vendors?
MW: One way we began saving money was looking at our custom pack utilization every year, because we wanted to minimize waste. We recently looked at our hand surgery pack. We have three different hand surgeons that perform the surgery three different ways. After looking at how each surgeon performed the procedure and what tools they used, we found that we could cut out $40 just by using three napkins instead of one big drape for 90 percent of the surgeries. If someone needed a bigger, more expensive drape, we would have one stocked on the shelf, but wouldn't include it in the pack. When we began consistently looking at what was being done, what supplies were being used and what products were really needed, we began seeing great success in terms of cost and waste reduction. We also recently made a transition in the pharmacy with our vendor. We've been able to save several thousand dollars a month just simply by looking at GPO pricing efficacy and bringing on our own pharmacist from our clinic’s retail pharmacy instead of outsourcing a pharmacist.
Q: What advice would you give to another surgery center that's considering moving to a single-source vendor, working with a new vendor or looking to streamline its product lines?
MW: It can seem overwhelming when you have vendors come into your facility offering proposals or suggesting new items. It can also be challenging when your staff is trying to test new supplies to ensure the physicians like the product without messing up workflow. It can be a hassle, but my best advice is that it is important, and it is worth it. If you can trial these supplies and truly collaborate with a vendor, you not only make sure you're getting the best value, but you also make sure you have products that the physician wants. The right vendor will want physicians to make the final decision on a product but will present them with the right options for the best value.
Another piece of advice in terms of selecting the best vendor goes back to finding a truly collaborative and a well-resourced vendor. A good vendor will provide a comprehensive product line and help you meet your organization's goals by finding the best contracts and working with you on your initiatives.
Another thing we found helpful in terms of reducing costs at the ASC is posting the prices of certain supplies in the supply room. We've recently made staff very aware of some of the more expensive items so employees take an extra second to understand how much each product costs before grabbing an extra supply.
To learn more about how Cardinal Health is helping ASCs achieve success, click here.
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