Becker's ASC Review

11 the financial end of surgery in an ASC. ere is potential for patients to receive four EOBs for one surgery and providing the patients with individual attention to set their expecta- tions upfront has been very beneficial. We have seen much higher patient satisfaction as a result. Over the next two to three years, our ASC will be focusing on utilization of case-costing data to drive improved profitability. Pin- nacle III employs a data analyst to provide detailed case-costing data to each facility they manage. is data allows administrators to identify areas where there are substan- tial variances between surgeons in the same specialty performing like-surgery. Engaging surgeons and educating them about things like the impact of operating room minutes to their profitability as well as how their sup- ply and implant costs compare to their peers will be significant in maintaining and achiev- ing greater profitability. Standardization of supply will be an ongoing initia- tive, which we are currently beginning to focus on. Con- tinuing to manage vendor contracts closely and taking advantage of the benefit the management company (Pin- nacle III) brings to aggregate contracts will also be key. n The evolving role of an ASC administrator M ichael McClain is executive director of Renton, Wash.-based Proliance Orthopedic Associates will par- ticipate on a panel titled "Joint Ventures and Physician / Hospital ASC Relationships" at the Becker's ASC Review 25th Annual Meeting in Chicago, Oct. 18-20. Based on his years of experience in the ASC space, Mr. McClain discusses how the role of today's ASC adminis- trator is changing. e new ASC is much more complicated and takes a different set of skills to run than it did 10 years ago. e ability to look critically and strategically at ways to partner with non- traditional partners is critical. I had the good grace as a consultant to spend time with organizations in Southern California, and there are a lot of progressive models of ASCs working with physician groups and others to go at-risk for lives, even in the fee-for-service model. You see more joint ventures and practices having to diversify their businesses with urgent care and ancillaries; the ASC has gone from being a value driver for surgeons to becoming just a piece of their portfolio. As an administrator, you have to know where the ASC fits. In some cases, you may need to take on pro- cedure types that weren't typically performed in the ASC because they weren't reimbursed highly, but that gives you the opportunity to partner with physicians who wouldn't otherwise take cases to the center. We were partnering with a thoracic surgeon that was looking to develop private pay reimbursed procedures that were ASC appropriate, but most other centers around the country didn't have them. We had to figure out how to set up payment systems for the procedure that didn't exist in most ASCs with a cash-only model. You have to get anesthesia providers and surgeon leadership to agree on allowing these cases even if they're not the bread and butter of the ASC if it makes sense clinically and financially. e administrator has to be more creative today to bring in cases they didn't have before and develop relationships with atypical surgeons or non-owner surgeons. If you're going into a joint venture center, you have to be an expert of managing people who don't report to you. I've seen that as a consultant and first hand at my own ASC, a 12-operating room center in Seattle. e whole idea of going into the joint venture is to leverage the sup- port services of the hospital, but you are in essence managing people who don't report to you so you have to create a service agree- ment to get the services out of them that you expect. Medicare depends on the ASC to drive the bus, so you have to make sure everyone on the hospital end is providing services to the ASC up to your standards. If you use their power systems, make sure the engineers know how to generate power for the center; if you're using their HR, you have to make sure you can control the subcontracted services. In that instance, you are managing managers and working with practice managers in the hospital setting that don't have skin in the game and don't understand what an ASC is about. ey aren't indoctrinated to the ASC culture. Joint ventures are becoming more common, but you have to under- stand how hospitals oper- ate and how to manipulate the system to the ASC's benefit. You can't wait six weeks for a new hire and you don't have the revenue as a reimbursement. You don't get the cash that the hospital gets, so you need efficiencies that the hospital doesn't have internally to stay running. n "If you're going into a joint venture center, you have to be an expert of managing people who don't report to you." — Michael McClain, Executive Director, Proliance Orthopedic Association "Over the next two to three years, our ASC will be focusing on utilization of case- costing data to drive improved profitability. " — Lori Tamburo, Administrator, Foothills Surgery Center

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