Becker's ASC Review

26 Executive Brief: ASC Benchmarking Last year's SOIX Cost Benchmark study showed an average for total days in A/R days of 40. Centers falling above that benchmark needed to seek ways to improve. "Even if the center was within the benchmark for overall profit margin or net income per case, they could still improve their bot- tom line if they reduced the number of days in A/R," says Ms. Green. "But the key is understanding that this means getting bills and claims paid faster. How are they handling past due accounts? How often are they evaluated? Are there trends? Does one payer consistently pay later than others and if so, why? Sometimes it's about improving even when you meet the benchmark." Benchmarking beyond accreditation Benchmarking is important for achieving accreditation and meet- ing regulatory requirements, but with pay-for-performance be- coming more important in the healthcare field, centers are bench- marking beyond just those requirements. "The reality is that pay-for-performance is becoming more and more important and facilities that only benchmark to meet a re- quirement for accreditation, or state or federal regulation, may suf- fer the consequences of pay-for-performance," says Ms. Green. "It's really very simple; if we don't perform well, we can't expect our business to grow and prosper, and once a center closes it no longer matters whether or not they received accreditation." Going forward, Ms. Green sees centers expanding their current benchmarking methods to improve the quality of their data. Ex- perts recommend comparing "apples-to-apples" when bench- marking, and this can be difficult because there are a lot of dif- ferences across surgery centers. How can a surgery center that does only ENT compare their rate of return to surgery with a center that does only ophthalmology? How can an orthopedic center compare their incidence of post-op pain to a GI endos- copy center? "I think one key to improving data quality is by sharing bench- marking results with the staff that was involved in collecting the data," says Ms. Green. "For example, if you benchmark your rate of post-op pain following discharge but don't share those findings with the staff that are entering this data in the computer, how can they truly appreciate the importance of their data ac- curacy?" n J ennifer Green, RHIT, Vice President of Network Develop- ment at Surgical Outcomes Information Exchange answers the most common questions she hears about benchmark- ing and why the process is so essential for ambulatory surgery centers going forward. Q: Why is benchmarking required and how can i meet those requirements? A: ASC administrators not well-versed in performance improve- ment and benchmarking often know they need to begin doing it for accreditation, but don't know where to start. Companies such as SOIX can help them navigate required benchmarking and help them understand how they can benefit from gathering the required information. Leaders more well-versed in benchmarking and quality perfor- mance improvement know the next question is about how data is collected and who they'll benchmark against. "When they get their first series of reports [from SOIX] they may not need any help from SOIX in interpreting their results and instead just need the basic orientation to the reports such as which reports contain what data and how to avoid missing the forest for the trees," says Ms. Green. Q: What are the most important benchmarks for ASC leaders to track? A: ASC leaders track clinical, operational and financial bench- marks. Ms. Green says clinical benchmarks are a first priority, just as providing quality care is the center's primary focus. "The fact that an ASC is also a business means that the sec- ond priority is making sure your costs are not higher than your income," says Ms. Green. "Then, it becomes an issue of balance. You cannot provide good care if you cannot stay in business and you will not stay in business if you don't provide quality care." Q: how do i deal with devia- tions from the benchmarks? A: When ASC administrators identify areas where their cen- ter falls below the benchmarks, there is an opportunity for improvement. Consider whether the deviation is expected — sometimes unique circumstances mean an individual ASC will be different. Then consider whether the de- viation impacts the bottom line. "Sometimes the reason for the deviation is immediately known, and it is a matter of proving what you have suspected so you have the ammunition needed to support making a change," says Ms. Green. "Other times the deviation is a complete surprise and a full quality improvement study is needed to determine why the devia- tion occurred and how to best handle it." There are times when the administrator looks at the big picture and assesses the deviation in conjunction with other findings. For example, if the center has a longer than average recovery time for knee arthroscopies but their complication rates, postoperative 6 Frequent Questions on ASC Benchmarking Answered By Laura Miller Jennifer Green

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