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Practical Business, Legal and Clinical Guidance for Ambulatory Surgery Centers ASCREVIEW May/June 2014 • Vol. 2014 No. 4 INDEX Operational Efficiency p. 20 Gastroenterology Roundtable p. 34 Transactions & Joint Ventures p. 43 Anesthesia p. 53 Coding & Billing p. 60 Gastroenterology p. 74 Supply Chain p. 75 Accreditation Issues p. 76 ASC Physician Owner Financial Dashboard The most important financial metrics can paint a picture of the ASC's profitability, diversification and operational efficiency. p. 36 Coding Updates for Key Specialties There were 335 changes in the 2014 CPT code set — see which are most important for ASCs. p. 63 Eliminate Staffing Overlaps Seven strategies to maximize staff scheduling and minimize overtime expenses. p. 20 How Physician Owners Impact ASCs Physicians can control several tangible factors that impact an ASC's value. p. 43 8 Thoughts for ASCs on Out-of-Network Services By Ellie Rizzo Being able to accept out-of-network patients is an issue am- bulatory surgery centers cannot ignore. Leveraging out-of- network reimbursements can be good for patients and prof- itable for the center when it is done right. However accepting out-of-network patients can be difficult and full of pitfalls for the ill-prepared. Here are eight key thoughts on current and future out-of-network challenges and opportunities. Healthcare has been in flux over the past five years, creating new oppor- tunities for ambulatory surgery cen- ter owners and operators focused on providing high quality, low cost care. Navigating this terrain requires a keen eye on the healthcare landscape and focusing on the operational ef- ficiency essentials. "How does your ASC remain profit- able and viable? By making sure you are doing every case you possibly can at the ASC and trying as hard as you can to get fair compensation for these cases through continual contract re- negotiation," says Jeff Péo, Chief De- velopment Officer for Ambulatory Surgical Centers of America. "Know which cases are profitable and which cases you are losing money on, and then have a laser-like focus on doing these cases more profitably." The key to success is much the same as it was a decade ago: relentless attention to patient care and op- timizing return on each case. How- ever, there are outside market factors making an impact on ASC success: • Payer markets • Accountable care organizations • ASC saturation • Physician employment levels "If the hospital employs surgeons and primary care physicians in the market, that really makes a difference for opening a new ASC or turning How Health Insurance Exchanges Are Impacting ASCs By Laura Miller Health insurance exchanges are up and running and the individual mandate requires insurance coverage. This means more people in the United States are be- coming insured — albeit with high deductible plans — and providers could see a higher volume of patients in the future. continued on page 16 continued on page 10 continued on page 60 INSIDE: 75 Gastroenterologists to Know; 21st Annual Ambulatory Surgery Centers Conference Brochure 12th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference + The Future of Spine June 12-14, 2014 • Chicago To learn more or register, visit www.beckersasc.com/beckers or call (800) 417-2035 132 Sessions • 168 Speakers • 63 Physician Leaders • 28 CEOs Keynote Debate: Former U.N. Ambassador & Republican Diplomat John Bolton Former Six-Term Democratic Governor of Vermont Howard Dean ASC Growth & Evolution in the New Healthcare Environment By Laura Miller