Becker's ASC Review

20 Operational Efficiency "There is more pressure than ever to maintain these relationships," says Nap Gary, COO of Re- gent Surgical Health. Here are five initiatives ASC joint venture leaders can pursue. Reimbursement improvement Payer contract negotiation is one of the main at- tractions hospitals offer as a joint venture partner, but gaining improved reimbursement is an ongo- ing process. "One of the fundamental elements of ASC strategy is looking for opportunities to im- prove reimbursement," says Mr. Gary. At least on an annual basis, ASC leaders should revisit payer contracts and constantly be aware of upcoming contract expirations. Specialty mix examination The physician market place regularly changes, new procedures gain approval for the ASC setting and patient demand for specialties shifts. Spine is a relatively new and optimal specialty for the ASC. In some Regent centers, Mr. Gary has observed the chance to bring spine and general surgery to the table in contracts that largely focused on pain and GI. New procedures add diversity to an ASC's specialty mix and open the door to previously un- tapped sources of revenue. Purchasing alignment Hospitals often have larger purchasing power than ASCs and management companies, but even after bringing on a hospital partner analyzing purchases for cost savings opportunities is impor- tant. "Align purchasing where the most savings can be achieved," says Mr. Gary. Some purchases made through the hospital could translate into greater savings if purchased through the manage- ment company. New physician ownership New physician investment is an excellent way to promote ASC/physician engagement, but three-way joint venture ASCs must consider all partners before taking on new investors. "Bringing on new physician owners is different when a hospital is involved," says Mr. Gary. "Flexibility is not unlimited." Hospitals often have a majority stake in an ASC, a stake that remains unchanged as new owners come on board. New physician investment dilutes the ownership of existing partners. As a result, new physician investment becomes opportune as partners leave the center or retire. Market awareness ASC leaders need to ask: "Is this the optimal posi- tion in my market?" says Mr. Gary. As the rollout of the Patient Protection and Affordable Care Act continues, the ASC leaders that constantly moni- tor their markets for emerging changes and op- portunities, such as the possibility of ACO align- ment, will find their centers among some of the most successful providers. n Nap Gary Call 508-520-3003 or visit www.Arthrosurface.com to learn more Finally, implants that are designed to truly fit the shoulder. "The non-spherical prosthetic head replicated the native head shape more accurately than the spherical prosthetic head." Jun BJ, Iannotti JP, McGarry MH, Yoo JC, Quigley RJ, Lee TQ. The effects of prosthetic humeral head shape on glenohumeral joint kinematics: a comparison of non-spherical and spherical prosthetic heads to the native humeral head. J Shoulder Elbow Surg. 2013 Oct;22(10):1423-32. 56 mm 52 mm The Humeral Head is Ovoid not Spherical HemiCAP OVO: S/I is 4mm larger than A/P For additional product information, inlcuding indications, contraindications, warnings, precautions and potential adverse effects, please visit www.arthrosurface.com An Inlay Glenoid is 10 times more stable than an onlay glenoid. "The study suggests that the humeral head is not a perfect segment of a sphere and an osteotomy along the anterior cartilage-metaphyseal inter- face does not remove only the proximal humeral articular surface. Even with a fully adaptable prosthetic implant, replacement arthroplasty is not able to restore original head geometry. Alterations to head geometry with the osteotomy described may alter the line of force through the prosthetic joint, producing eccentric loading at the glenoid, and contribute to early failure." Harrold F. Wigderowitz C. 2013 Jan 22(1):115-21,doi:10.1016/j. jse.2012.01.027.Epub 2012 May 14. J Shoulder Elbow Surg. ASTM dynamic loosening tests on file at Arthrosurface Inc. Polishing the 3-Way Partnership: 5 Priorities for Joint Venture ASCs in 2014 (continued from cover) W inborne Macphail, senior vice presi- dent of sales and market development with Surgical Care Affiliates, answers questions on one of the most pressing issues in the ASC industry: physician recruitment. Question: how can ASC leaders identify potential physicians to bring new cases or investment to the center? Winborne Macphail: With the increase in phy- sician employment and heavy competition for ASC investors, recruitment efforts are increas- ingly becoming more complicated. To successfully recruit physicians into ASCs, our SCA leadership teams implement the following action items to ensure success: 1. Perform a market assessment to identify all surgeons in their market and their affilia- tions. 2. Develop a recruitment plan by dedicating time with their leadership team to deter- mine service and specialty offerings and create a profile for what their facility's "ide- al" physician might look like. 3. Perform due diligence on their physician prospect list by utilizing their facility team and current physicians to narrow the list to those most suited for their facility and seek ways to gain warm introductions. 4. Develop a value statement for each intro- duction that is customized to each physi- cian and focused on why they should con- sider your facility. Q: As market saturation grows, how do ASC leaders need to change strategies used in the past? WM: As markets become more saturated, health systems are tightening their volume reigns and physicians are generally hesitant to move their cases. To protect and grow their volume, ASCs must take a creative and active approach and think beyond traditional marketing strategies. ASC leaders must provide a higher level of service to their existing physician base and engage them regularly to discuss their partnership status and additional needs. ASCs must also develop programs to create new referrals for their facilities, working, for example, with primary care physicians and employers to identify surgery needs and providing direct access for consumers to schedule their procedures. More than four years ago, we introduced the Physician Office Liaison role at SCA facilities to develop and grow relationships with our physicians and their practices. Build an Effective ASC Physician Recruitment Strategy: Q&A With Winborne Macphail of Surgical Care Affiliates By Carrie Pallardy

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