Issue link: https://beckershealthcare.uberflip.com/i/170043
ASC Turnarounds: Ideas to Improve Performance class and may need training to think like a savvy business partner. "Informing surgeons about best business practices can be very helpful," says Dr. Won. "Bring them all into a room and give them an idea of the big picture of the surgery center and where the costs are involved. Make sure the surgeons feel invested as true partners and once they are more involved, they are likely to assist administrators in cost-cutting initiatives." The initial meeting about cost cutting may take a few hours to bring everyone up to speed, but after that administrative duties and check-ins shouldn't take more than a few hours per month. "Once they are engaged in the ASC, they want to know about the health of their business," says Dr. Won. "This is something surgeons want to be involved in." 5. Arrange physician-to-physician conversations for outliers. Hopefully all surgeons will be onboard with cost-cutting initiatives from the beginning, but if one or two are resisting change then whole program could fail. Coordinate a meeting between the ASC's medical director or senior physician and the outliers so they can discuss their issues at the same level. "If a surgeon is not cooperative, first you need to have him sit down for a one-on-one discussion with the surgery center's medical director because it's always easier when physicians speak to other physicians with the support of the administrator," says Dr. Won. "Reason with them and give them proof on how they need to assist the ASC." This may be particularly challenging with non-investors because they don't have the same financial incentives to maintain a profitable ASC. However, instead of relaxing on cost-cutting initiatives, the administrator can work harder to accommodate them by providing high quality service to their patients and make their experience as surgeons better. "Even with the non-investors, we are going to do due diligence on what implants they use and what their convenient hours are," says Dr. Won. "We'll ask them to schedule cases at a certain time and help us with negotiating prices with their vendors because physicians have a lot of influence over implant companies. If there is something they want to use, the ASC can negotiate those contracts, but it's easier if the surgeon is involved." 6. Consider case profitability. Profitability at the surgery center depends on spending resources wisely and performing cases where costs are lower than overall payment for services rendered. As a re- 15 sult, advise surgeons to perform unprofitable cases at the hospital instead of the ASC. "For certain types of products we shared our costs per case with the surgeons and showed them we were losing money on those cases," says Dr. Won. "The physicians had no idea — they thought just bringing cases into the ASC was making it profitable." Another important aspect of profitability is case scheduling. While it may be convenient for surgeons to obtain block time or schedule last minute cases at the ASC, it may not always make the most economic sense when running a business. "Sometimes they want to schedule cases in late afternoon on Mondays or Tuesdays when all our other cases are in the mornings," says Dr. Won. "When this happens, the full team must be available all the way through the afternoon, which increases staffing costs. Staffing is a significant cost to the ASC, so we need the surgeons to understand how to schedule so it's convenient and cost-effective." If all cases are finished in the morning one day, the staff can go home early. On the other hand, if there is a day when only a few cases are scheduled — such as on Fridays — the ASC can shut down one of the operating bays to save overhead costs. n