Becker's ASC Review

10 Skyway Surgery Center launched its 1st bundled payment agreement in early 2018 — Why it won't be their last R aymond Hino is administrator of Chico, Calif.-based Skyway Surgery Center, overseeing operations at the ASC. He will participate on a panel titled "What Do Payer Consolidation and High Deductible Plans Mean for ASCs" at the Becker's ASC Review 25th An- nual Meeting in Chicago, Oct. 18-20. Here, Mr. Hino examines bundled payments and the best opportunities for the future. We are facing many challenging issues, from competing with larger hospitals for not only patients, but also for employment of the best clinical staff. We are also dealing with rapid growth in an aging facility. Perhaps our big- gest challenge, however, is securing reason- able payer contracts with the health plans in our area. As we all know, historically, ASC payments have lagged well behind hospitals and HOPDs. is has been both a bless- ing and a curse. We like being the low-cost, high-quality provider in our community and it helps us with payers and patients. However, just like hospitals, we have to be able to cover our costs and provide a reason- able return. Unfortunately, many of our costs are similar to the costs for hospitals, e.g. em- ployee salaries and supply costs. Our strategy has been to make our case with the health plans to demonstrate the value that we bring and our ability to help payers save money. We seek to be partners with the health plans in serving our community. is is a win-win opportunity as an increase in ASC surgeries helps both parties. is strategy has helped to open some doors that were previously closed and is positioning us well for the future. To date there has been very little effect of value- based care on our facility. However, we expect that to change in the near future as mandatory reporting requirements and reimbursement of ASCs continues to evolve. As a Medicare- participating ASC, our facility participates in the Ambulatory Surgery Center Quality Report- ing Program. Addition- ally we have voluntarily chosen to participate in the Outpatient and Am- bulatory Surgery Survey Program. Although not currently required, participation in OAS CAHPS, provides our fa- cility with national peer comparison data so that we can measure our- selves against other facilities. In my opinion, the result has been a success. We consistently achieve scores in the 90th percentile, which is a marketing advantage and we are position- ing our ASC for success if this survey ever becomes mandatory. Value-based care is not only about man- datory quality reporting; it is also about changes in reimbursement. We entered into our first bundled payment agreement earlier this year. It will not be the last one. Since we are already partners with our physician providers, it makes sense that we would become partners for innovative pay- ment systems as well. We are actively involved in pursuing additional bundled payment agreements that will fuel our organization into the future. I believe that the biggest op- portunity for growth for our ASC in the future is in total joint replacement surgery. We are already performing total joint procedures at our facility. However, with the eventual likelihood that total knees and total hips will be given an established payment rate, it is inevitable that more Medicare total joint surgeries will be moving to ASCs like ours. We are preparing for that eventuality with a facility expansion project that will add another OR specifically for total joints and more 23-hour beds. We also see tremendous growth potential in other procedures that we perform, such as laparoscopic hysterecto- mies and cataracts. n A Colorado-based ASC hired a financial counselor to improve the patient experience — Did it work? L ori Tamburo, CASC, is administrator of Boulder, Colo.-based Foothills Surgery Center. She will participate in a panel titled "How to Be a Great Administrator" at the Becker's ASC Review 25th Annual Meeting in Chicago, Oct. 18-20. Here, she discusses the patient experience at ASCs. e smartest thing Foothills Surgery Center has done to improve the patient experience, aside from the typical advantages of an ASC over a hospital, is that we hired a finan- cial counselor. It is a new role which was developed over the past year in an effort to educate our patients about their financial re- sponsibility and ensure that they understand "I believe that the biggest opportunity for growth for our ASC in the future is in total joint replacement surgery. " — Raymond Hino, Director of Operations, Surgery Pa

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