Becker's ASC Review

11 THOUGHT LEADERSHIP How ASCs are adapting to supply chain struggles By Paige Haeffele A lthough expense management is always something leaders consider when managing ASCs, in recent years cutting costs has become even more important to grapple with ongoing supply disruptions, increasing costs of supplies and labor and decreasing reimbursements. Hospitals and large health systems are struggling with the same issues, but many ASCs do not have the resources available to their larger counterparts. Becker's recently connected with ASC leaders to see how they are managing to stay afloat. Editor's note: ese responses have been lightly edited for length and clarity. Question: What is your strategy for dealing with rising practice costs? Suzi Cunningham. Administrator of Advanced Ambulatory Surgery Center (Redlands, Calif.). Honestly, at AASC, we are mindful of every expense. Staffing, supplies, medication, service agreements, and so on. Expenses are reviewed monthly, quarterly, annually and year over year. e saying is true, be careful not to be penny wise and dollar foolish. For example, it costs a lot more time, resources, and in the end, money to keep hiring and re-training staff. We are finding it is wiser to pay our staff well and keep them long term rather than deal with the high cost of turnover. We also have been reconsidering the wisdom of service agreements. e cost of our equipment is high enough; then to have to pay for it over and over again in the form of an annual service agreement to keep it working is just ridiculous. I realize the manufacturers don't want to hear this, but we simply can't afford to pay $100K for a piece of equipment and then pay another $60K or more for a service agreement. Stephen Gilkeson. Executive Administrator at Young Eye Institute (Lawton, Okla.). To deal with rising costs in our practice, we typically focus on three main areas: reducing expenses, improving efficiency and expanding our service offerings. While there are a myriad of ways to reduce overall expenses, some of the more impactful areas we focus on include continuous human resource management, price negotiation with vendors, using volume ordering when practical and managing our public utility costs. While we don't expect to "cut our way to profitability," controlling our expenses is increasingly important every year. To improve our efficiency, we continually optimize our patient schedules, implement advanced technology that improves our patient flow, and conduct studies to reduce and/or eliminate burdensome and unnecessary steps to all processes including medical, surgical and business related areas. Finally, one of the most important ways to deal with rising costs has been to increase revenues through expansion of our service offerings. As an ophthalmology practice specializing in the treatment of cataracts, this expansion includes offering premium intraocular lens implants, such as multi- focal and light adjustable technology, as well as the utilization of laser services in cataract surgery. Aaron Greenspan, MD. Gastroenterologist at Metro East Gastroenterology (Belleville, Ill.). I'm currently an independent gastroenterology provider. It is impossible to survive in the fee for service environment given rising costs, especially aer COVID-19, and decreasing reimbursement. e overhead is crushing and the workload is overwhelming. Being an employee is not something I want to do, so I am closing my practice. I will be doing some work at a small, community hospital under a professional service agreement and working two days a week for one of our local medical schools at their GI faculty. And I am looking towards retirement in a few years. Robert Lerma. Administrator at Coronado Surgery Center (Henderson, Nev.). ese are strategies that I employ routinely: 1. Assess where the pricing costs have risen and compare to the prior year and question the vendor for the increase in price. 2. Ensure that GPO (group pricing organization) agreement is compliant How weight loss drugs may impact the ASC industry By Riz Hatton G lucagon-like peptide-1 receptor agonists such as Ozempic have surged in popularity over the past year. But what does this increased popularity mean for the ASC industry? Jackie McLaughlin, BSN, RN, manager of surgical services, outpatient infusions and pain clinic at Aspirus Howard Young Medical Center in Woodruff, Wis., connected with Becker's to discuss how Ozempic will impact the ASC industry. Note: This response has been lightly edited for length and clarity. Question: How will Ozempic impact the ASC industry? Jackie McLaughlin: Ozempic and other GLP-1 medications have become the hot topic in the surgical world. The American Society of Anesthesiologists recommends that patients on the GLP-1s hold the medication for one week prior to anesthesia. If the patients that are on the GLP-1 medications are not discovered at least eight days prior to the procedure, the rate of cancellations is going to increase. Having the surgical staff educate the patients on this requirement leaves holes in the care coordination of the patient. For example, if the patient is on the GLP-1 medication for diabetes, they must follow-up with their primary care provider to discuss how to manage their diabetes for the week that they are off of the medication. Another factor that is concerning my staff are the patients that receive their GLP-1s from markets that are not regulated by the FDA, and therefore not prescribed by a physician. If the patient fails to disclose they are on this medication, there could be great risk to the patient. n

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