Becker's Spine Review

66 ASC 10 factors that can make or break an ASC in the next 2 years By Laura Dyrda T he pandemic affected ASC case volume and operations in several ways in the last year, with some centers adapting while others are struggling to stay afloat. Here are the factors that could make or break an ASC within the next two years, according to seven administrators and physicians. 1. Case volume. ASCs base desired payer rates and budget projec- tions on expected volume, which drives the surgery center's revenue. If case volume falls short of expectations, the center will miss finan- cial goals. LuAnne Jordan, administrator of Savannah (Ga.) F&A ASC, said her center will depend on boosting case volume to succeed in the next 24 months. "We are a single-specialty surgery center and just limited as to what procedures we can do," she said. "We need to recruit more physicians so we can increase our volume." Shawn Menke, administrator of Genstler Eye Center in Topeka, Kan., said a consistent demand for cataract surgery will be an important factor to ongoing operations at his ophthalmology-driven ASC. "Ophthalmology was one of, if not the hardest-hit specialties" affect- ed by the pandemic, he said. "e demand for cataract surgery seems to be coming back, but it has been a slow climb." 2. Physician engagement. ASCs need physicians excited and motivat- ed to bring cases to the surgery center, whether they are owners or not. "If the surgeon is not made to feel welcome nor respected," that surgeon "will take their cases to the nearest outpatient surgery center," said Robert Lerma, administrator of Blue Springs Surgery Center in Orange City, Fla. "e center must accommodate the surgeon within its means." 3. Direct contracting with employers. Employers are increasingly in- terested in direct contracting with surgery centers through regional and national contracts, said Mike Grant, administrator of Surgery Center of Amarillo (Texas). e additional contracts will boost ASC volume. "As the cost of healthcare benefits for employees continues to rise, we are seeing continued requests for contracts that allow employers to provide high quality care services to their employees at a significant cost savings to the employer," he said. 4. COVID-19-related limitations and expenses. e policies and guidelines for operating surgical facilities during the pandemic rap- idly changed at the national and state level in the last year. It has been a challenge for ASCs to adapt to a limited case volume and increased personal protective equipment expenses. "Elective surgical work under our new normal has several require- ments, such as coronavirus testing methodology for patients, screen- ings for staff, wearing PPE and comprehensive cleaning protocols," said Seth Silver, MD, medical director of Ambulatory Care Center in Vineland, N.J. "e economic impact of the coronavirus has been significant on our facility. We need to return to our previous caseload. What will break our facility is additional expenses in the face of de- creased surgical numbers." 5. Payer behavior. Commercial payers' policies affect the survival of independent ASCs across the U.S., including North Pines Surgery Center. Administrator Tammy Stanfield, BSN, RN, CCRN, said an increase in the number of pending authorizations from insurance companies or more frequent denials could break the center. Success also depends on how fast the center receives reimbursement. "Turnaround for payment from insurance companies, including Tri- care, is slower than ever right now," said Ms. Jordan of Savannah F&A ASC. "e insurance companies find so many ways either to delay payment or not pay at all." 6. Contract negotiations. Adequate preparation for payer nego- tiations will lead to more aggressive and lucrative payer contracts, which are vital for the center's existence. "I spend a lot of time in preparation for contract negotiations to know my costs and the Medicare fee for the CPT codes used for my local ZIP code as a percent of reimbursement that will be derived from the Medicare fee schedule," said Mr. Lerma of Blue Springs Surgery Center. 7. Cost containment. ASC costs must remain low to meet budget ex- pectations for net income. e center can't spend more than it's tak- ing in. Melissa Hermanson, MSN, RN, CASC, administrator of Am- bulatory Care Center in New Jersey, said financial recovery from the months when the center was closed last year and efficient resource use will make or break the center. Carlos Carrasco named president of Orlando Health Jewett Orthopedic Institute By Eric Oliver O rlando (Fla.) Health named longtime executive Carlos Carrasco to lead the still-in-develop- ment Orlando Health Jewett Orthopedic Insti- tute, the health system announced March 2. Mr. Carrasco has been with Orlando Health for 25 years. He most recently served as COO of the system's Orlan- do Regional Medical Center. In his new role as president, he'll oversee the $250 million project's development and its operations once it opens. Orlando Health Jewett Orthopedic Institute will feature a 75-bed orthopedic specialty hospital with 10 surgery suites, a medical pavilion and an ASC. The system plans to open the facility in the summer of 2023. Mr. Carrasco took over as president March 29. n

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