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23 Operational Efficiency t ransactions are common in the ambulatory surgery center market- place and with the increasing complexities in healthcare more physi- cian owners are turning to management and development compa- nies for operational expertise. Management companies can offer physician owners advice, leverage in con- tact negotiations, legal expertise and access to benchmarking from across their network. However, not every management company is a good fit for all centers and sometimes as the ASC evolves their needs change. According to the HealthCare Appraisers ASC Survey 2013, 35 percent of management and development companies examined one to five candidates for acquisition last year; another 29 percent looked at six to 10. Among those who were looking, 57 percent reported acquiring one to five centers while 6 percent acquired more than 16. Heading into 2014, 53 percent planned to acquire at least one to five centers, meaning there is plenty of opportunity for ASCs to find the right manage- ment company, or make a key switch. Typically, physician owners and opera- tors begin to have doubts about their current management when profits are consistently low, but in some cases other factors have a bigger impact. "Of course the economic performance of the surgery center is a clear barom- eter, but smart governing bodies will separate management company perfor- mance from fiscal performance initially when evaluating its management. An ASC with a good management company can have bad profits and ASCs with poor management companies can be very profitable," says Joe Zasa, Manag- ing Partner and Founding Partner of ASD Management. "You have to take the money out of the discussion and assess the management company objec- tively using established measures." Mr. Zasa says the four key core areas of ASC management include: • Sound clinical system support • Business office management • Managed care contracts • Clinical risk management and compliance "Make sure to benchmark your management company's performance in these areas and compare your numbers with other centers," says Mr. Zasa. "Figure out if there is clear evidence about whether the company has a posi- tive or negative impact on the ASC." There is also the subjective factor, but make sure that when evaluating based on subjective elements that you factor in the motivation of the respondent. How does the staff respond to the management company? Do you get leadership and direction from your management company? Is the information timely and ac- curate? Surgeons — investors or not — play a critical and important role in the success of the center, and their interactions with the management company is crucial. Do the surgeons like the current manage- ment company or not? "The management company should be able to communicate effectively with the surgery center physicians and adminis- trator," says Mr. Zasa. "They should help the center set goals and guide them along the way to meet those goals. Above all, the management company should demon- strate value through leadership and mea- sured performance. Demonstrable value is the test and it should be measured objec- tively and subjectively in order to make an informed evaluation." n ASC Management Company Outlook: How to Find the Best Fit By Laura Miller Joe Zasa Surgical Information Systems Acquires AmkaiSolutions By Laura Miller A mkaiSolutions, an ambulatory surgery center electronic medi- cal record and business management software company, has been acquired by Surgical Information Systems, a perioperative information systems company, according to a news release. SIS currently serves more than 300 hospitals and health systems in the United States and Canada, and the acquisition will enable the company to meet the needs of its current clients and extend its capabilities into the ambulatory surgery market. "Meeting the practice and information management needs of the outpa- tient and acute care environment enable information to be more easily managed and analyzed," said AmkaiSolutions Executive Vice President Joe Macies in a news release. "We look forward to combining our strong ambulatory experience with the rich, acute care experience of the SIS team. Together we will advance our ongoing mission to support our cli- ents' efforts to improve the overall healthcare provided by our clients, enabling them to deliver safe, efficient, cost-effective surgical services." As a result of the partnership, AmkaiSolutions will benefit form SIS' prod- uct development and client support. Over the past few years, AmkaiSolu- tions has experienced substantial growth and the company's systems are currently installed in more than 200 facilities in the United States. "The combination of these two industry leaders will help meet the changing needs of surgical care delivery and bring together a legacy of technology innovation, surgery and anesthesia expertise, as well as strong client and partner relationships to the market," said SIS CEO Ed Daihl in a news release. "The merger expands our ability to provide the solutions perioperative leaders need to help meet their safety, efficiency and financial goals in any surgical environment." n SIGN uP TODAY! Becker's ASC E-Weekly at www.BeckersASC.com or e-mail Scott Becker at sbecker@beckershealthcare.com Practical Business, Legal and Clinical Guidance for Ambulatory Surgery Centers ASCREVIEW