By Stephen W. Earnhart, MS
CEO
Earnhart & Associates
Austin, TX
Wouldn’t we all like the idea of trying things several times until we get it right, like Bill Murray’s character did in the movie Groundhog Day? My life would be so dramatically different, and so would yours! It would be so cool to tell your staff members or surgeons something, see their reaction, and then phrase it another way if that didn’t work. The concept is staggering!
Well, I might be able to share some of my "groundhog" moments with you today. Some of you might like them, and some of you might not. Some will make you question why you are even reading this, but all will make you stop and think.
1. If you have an existing ambulatory surgery center (ASC) that is just perking along, no highs, no lows, consider developing a second surgery center for just out-of-network surgery. Crazy? Hardly. Think about the implications of having another surgery center that has no contracts with payers, and you can strictly go out of network with them. Cost prohibitive? No! Explore it as an option, because others around you are!
2. Hospital surgical departments need to consider a management services agreement that allows surgeons to provide input into the management of the surgical department. No equity, no management; just structured input that they can be compensated for their input. Why are most surgeons doing their own ASC? Input into the decision-making process of where they do their cases! Open up, and let them in.
3. Spine surgery in ASCs is happening now for non-Medicare patients. Rumors are Medicare is going to start reimbursing for selected spinal procedures next year. If you wait until then, it might be too late to jump on the bandwagon. Think about combining point number one above with this one.
4. Most surgery centers have become so complex that it is very difficult to oversee all the details to be done without outside services that a management company can provide. (We do not provide management services, so this is not a plug.) I sat in on a presentation that an ASC management company made to a group of surgeons last week. The company detailed all the compliance issues related to ASCs going forward, and I was amazed at how the industry has matured and become complex and overwhelming for a solo ASC.
5. Outsourcing billing for hospitals and surgery centers soon will become a must. Hospitals, you say? Yes. Hospitals might collect the dollars, but all of the "change" is left uncollected. Again, billing and collections is too complex for even hospitals to do, let alone an ASC. Focus on safety, quality, and customer service, and let others deal with the billing. You cannot afford it, you say? The fact is, you cannot afford not to!
6. Pain procedure reimbursement continues to get beaten down by payers, but there is still gold in there if you look for it. Rumor has it that 2015 reimbursement is looking better. Read point number one again.
7. Hospitals need to outsource outpatient surgery. You have no choice if you wish to stay in the game. Surgery centers need to accommodate hospital outsourcing. Be creative and not greedy, and everyone can win.
8. Lastly, stay in touch with the resources around you. There is so much available to all of us if we are receptive to change – for "change" is the only thing that is not going to change! [Earnhart & Associates is a healthcare consulting firm specializing in all aspects of outpatient services. Earnhart & Associates’ address is 5114 Balcones Woods Drive, Suite 307-203, Austin, TX 78759. Phone: (512) 297-7575. Fax: (512) 233-2979. E-mail: [email protected]. Web: www.earnhart.com.]
