Here are five creative ways ambulatory surgery centers can improve profitability in 2013.
Chris Zorn, vice president of sales at Spine Surgical Innovation, said he has seen devices developed with an emphasis on making the healthcare system more efficient and less costly, particularly since reimbursement is under tremendous pressure. “What can we do to help make the procedures less traumatic for patients, easier for the surgeons and less expensive for the healthcare systems paying for all of this?” he said. “Delivering surgery in an ASC is obviously different from surgery in a hospital. You have to keep an eye on what you’re doing and look for incremental changes that can help you or your patient in the OR, and changes that you can get paid for.”
According to VMG Health’s Multi-Specialty Intellimarker 2011, the average administrator salary for all multi-specialty surgery centers is $109,184. But a contracted administrator, who visits the surgery center on a regular basis but does not work full-time, can cost around half that, says Tom Jacobs, president and CEO of MedHQ, and administrator of a GI HOPD. “It was a great way for the facility to benefit from the administrator role without paying for the role full-time,” Tom Jacobs, president and CEO of MedHQ, and administrator of a GI HOPD, discusses his experience as a contracted administrator. In addition to the leadership of clinical and office managers, the administrator can benefit from a strong medical director in the facility. “If you have a doctor who is very involved in the center and has great pride in ownership, that’s a good situation for a contracted administrator.”
Consider what additional cases from each specialty could be performed in the center. It may require purchasing new technology, but the return will be worth it. “Centers that are well run and stay on top of technology are doing well,” says President of National Medical Billing Services Lisa Rock. “Hiring professionals to negotiate contracts and applying those professionals throughout the entire operation will serve you well. Those that do not own a thing will not do so well.”
Coders often feel the push to have cases coded and submitted within 24 hours for optimal cost and time efficiency, but that metric isn’t taking the entire process into consideration, says George Kaplinksi is the vice president of operations for ASC billing services at SourceMedical. “Our goal is always to have the case out as quickly as possible but it’s worth the time to be sure that all information is correct, rather than risk missing coding errors which can cause claim denials, receiving a reduce reimbursement or other issues that might delay payment,” he says. Often, coders will have questions about physician dictation or need more information about exact procedures performed. Twenty-four hours is not always enough time to gather all necessary information and ensure the claim is error-free.
If claims are submitted with errors — including about pathology, diagnosis codes that do not meet a payers medical necessity guidelines or implants costs — surgery centers can have substantial costs to correct the information. It’s worth it to make sure all of the information is present prior to submission. “Our goal is coded and out-the-door in 48 to72 hours, but we want to make sure we are doing things right the first time, not just fast,” he says.
It’s important to understand the value of your surgery center, and bringing in an outside group to conduct the valuation can be helpful. “We did a business valuation (real estate, equipment, and operations) for an ASC owned by a group of physicians,” says Adam Lynch of Principle Valuation. “They were considering selling to a local hospital and wanted to know the different values. This valuation was done before any discussions took place with the hospitals.??”
Why was it smart? It is crucial to know what you are worth and why. “An owner may have an idea what they are worth or the number they would prefer, but getting an outside valuation gives you market value,” says Mr. Lynch. “This group was proactive and was able to use our information to help with their strategy.”
Ref. Becker’s Healthcare
This post was first published December 5, 2012 and was updated July 29, 2020.