Becker's ASC Review

13 ASC MANAGEMENT ASC approved in North Carolina city where Amazon is driving population growth By Laura Dyrda R aleigh (N.C.) Orthopaedic Clinic and Rex Healthcare are planning a third ASC in a community where population has increased 18.7 percent since 2010. The North Carolina Department of Health and Human Services granted the partners a certificate of need for their surgery center in Garner, N.C., Feb. 25. The surgery center will provide bone, joint and spine care to a growing community, which owes its expansion in part to an Amazon distribution center there. Raleigh Orthopaedic Clinic owns and operates a medical office building, clinic and urgent care center in Garner. The practice's surgeons will now be able to perform surgery at the ASC, which will also serve as a new location for Rex Health- care's outpatient orthopedic cases, adding capacity for other procedures to its main campus. The ASC will have one operating room and two procedure rooms. n 3 companies partner for new Florida ASC By Patsy Newitt A partnership between Raleigh, N.C.-based ASC developer Compass Surgical Partners, Tampa-based Orthopaedic Associates of West Florida and Orthopaedic Specialties of Tampa Bay announced a new joint, spine and orthopedic ASC in West Florida. Slated to open late 2021, the Tampa Bay Joint and Spine Center will be Tampa Bay's first dedicated out- patient joint replacement surgery center, according to a March 29 release. The center will include multiple operating rooms and an extended stay suite. The center will also be the first local ASC using a Mako, Stryker's robotic-arm as- sisted surgery system for total knee arthroplasty. n 6. Contract negotiations. Adequate preparation for payer negotia- tions 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 in Justice, Ill. 7. Cost containment. ASC costs must remain low to meet budget expectations for net income. e center can't spend more than it's taking in. Melissa Hermanson, MSN, RN, CASC, administrator of Ambulatory Care Center in Vineland, N.J., said financial recovery from the months when the center was closed last year and efficient resource use will make or break the center. "Our administrative teams will need to continue to be creative in allocat- ing resources, financial and human, to maximize efficiencies," she said. 8. Supply availability. Matthew Ewasko, administrator of Physicians Alliance Surgery Center in Cape Girardeau, Mo., said the supply chain is a huge challenge for his center. "We are in constant communication with our suppliers who are working to get us the items we need, but we have heard that price increases will be coming," he said. "While we haven't had to delay any surgical cases due to lack of supplies, we have seen a large increase in our supply costs due to these price increases." When the supply chain normalizes, Mr. Ewasko said the center will be able to return to business operations as they were before the pan- demic. But the longer price increases and back orders continue, the more he will need to reduce spending in other areas to account for the extra supply expenses. 9. Transition of cases from the inpatient to the outpatient setting. "e key factor that will influence our growth over the next 24 months will be the continued movement of procedures from the inpatient setting to the ASC by Medicare and commercial payers," said Mr. Grant of Surgery Center of Amarillo (Texas). "As more acute procedures continue to be approved for outpatient services, we will continue to develop our service lines to meet the opportunities for our patients in bariatrics, cardiology and orthopedic services." He also said commercial payers are implementing price structures that provide appropriate reimbursement for several procedures to moveto ASCs. e overall move of these procedures is positive, but he is concerned about high implant costs since vendors are accustomed to negotiating with hospitals, which receive higher reimbursement. "e price point for many of the implants associated with these procedures has not been adjusted by the vendors to account for the opportunity for these cases being done in the ASC setting with reduced reimbursement," said Mr. Grant. "Successful negotiation of appropriate price points for these implants will be key for our facility over the next 24 months." 10. Staff engagement. e staff culture and engagement affect pa- tient and physician experience at an ASC. Having the best equipment and modern decor are meaningless if the staff isn't taken care of, said Mr. Lerma. "e staff will treat the customer, patients and surgeons, by how well they are treated by the management. In my 20 years of surgery center management, I have seen a number of centers succeed and fail from this axiom." n

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