Becker's ASC Review

25 EXECUTIVE BRIEFING 2 EXECUTIVE BRIEFING SPONSORED BY Opening a physician-owned and operated ASC: Lessons learned from Riverfront Surgery Center I n recent years, ASCs have been growing in popularity across the United States. These facilities offer increased access and high-quality care to patients while providing benefits for surgeons, such as easier scheduling of cases, increased revenue due to consistent case loads and greater operational control. Although some physicians are taking advantage of the opportunity to invest in and be an owner of an ASC, those who have been involved in the startup process of constructing, equipping and opening new ASC facilities know that it can be daunting. Becker's ASC Review recently spoke with Dawn McElhone, RN, administrator at Riverfront Surgery Center in Chattanooga, Tenn., about her team's experience developing and opening a new ambulatory surgery center and how partnering with an experienced solutions provider like Stryker has simplified the process. Riverfront Surgery Center was created to provide a patient-centered approach to surgery About four years ago, Jay Jolley, MD, and David Wiles, MD, were discussing how Chattanooga had very few surgery centers compared to other major cities in Tennessee. At the time, Chattanooga only had two surgery centers that did orthopedic procedures and one was closed to physicians outside of the associated practice. Prior to joining Dr. Jolley's practice, Dr. Wiles did many procedures at a surgery center in Johnson City, Tenn. The ASC model was attractive to him, since surgery center procedures are less expensive than those performed in the hospital setting. According to Ms. McElhone, "Dr. Jolley and Dr. Wiles asked other independent physicians in the Chattanooga area if they would be interested in joining an ASC and they got a positive response. Most of these doctors had never worked at a surgery center before and they liked the idea of investing in a patient-centered approach to surgery that would benefit the community." Today, 14 physicians perform surgeries at Riverfront Surgery Center, seven of whom are owners. Riverfront focuses primarily on spine, orthopedics and pain management. As Ms. McElhone noted, "We do total joints, sports medicine cases and any type of arthroscopy. We also are doing podiatry and we have a heavy emphasis on spine procedures. Our physicians do microdiscectomies, laminectomies, cervical fusions, lumbar fusions and total disc replacements." Given the complexities of opening an ASC, physicians need knowledgeable administrative staff Riverfront Surgery Center was incorporated in 2019 and physicians then had to obtain a certificate of need. In early 2021, the construction team broke ground for the building. As the administrator for Riverfront Surgery Center, Ms. McElhone was the first employee on board, starting in June 2021. "I have been a nurse for 12 years. Ten years ago, I moved to Tennessee and worked as a floor nurse, caring for patients who had just had surgery," she said. "After a few years on the postop floor, I started working at a local hospital in Chattanooga, where I met several of the doctors who are involved with Riverfront Surgery Center. Dr. Jolley approached me to work at the center as the administrator." In her role as administrator, Ms. McElhone has been involved in building the ASC from the ground up with the physicians. She oversees daily operations and every step needed to open the ASC's doors, from writing policies to meeting with physicians, purchasing equipment, implementing the EMR system, finalizing insurance contracts and more. During construction of Riverfront Surgery Center, pandemic- related supply chain issues created various challenges. "We anticipated opening in September 2021, but that was delayed until January 2022," Ms. McElhone said. "We had an incomplete HVAC system for a couple of months and our fire doors were on backorder. Fortunately, we were able to implement temporary fixes that didn't delay us significantly." In January 2022, Riverfront Surgery Center obtained its state license and started seeing patients. "You have to treat 10 patients before you can begin the accreditation process," Ms. McElhone said. "We have now been accredited by the Accreditation Association for Ambulatory Health Care. In June of this year, we received our Medicare status and are working toward Medicare Advantage." Now the ASC is focused on obtaining commercial insurance contracts which will expand the number of patients that physicians can see. Riverfront Surgery Center is currently serving a lot of workers' comp and Veterans Administration patients. The near-term goal is to work with all the insurance companies that the ASC's 14 physicians already accept. "We want to match that, so we can serve as many of our doctors' patients here as possible," Ms. McElhone said. "We hope to have our insurance contracts completed in the next couple of months."

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