Issue link: https://beckershealthcare.uberflip.com/i/346715
ASC Turnarounds: Ideas to Improve Performance 17 Dr. Bush-Joseph: Surgeons have a mix of different types of cases on any given day — low paying, medium paying and high paying. We try and maximize sur- geon throughput even at the risk of including lower paying cases at the center. This engenders physician loyalty and a sense of aligned interests. Dr. Callaway: The long acting local anesthetic Exparel offers great potential for pain management after ASC surgery. We think it will allow more joint replacements to move to outpatient facilities. The ASC will have to moni- tor its use, however, to make sure this drug is not overused for less painful procedures. We find patients are willing to pay for extras, such as cryotherapy. Although we sell them at cost now, they could be a potential source of income in the future. Q: Are there changes that need to be made in the ASC industry as a whole to allow orthopedic-driven ASCs to increase profit- ability? Dr. Petsche: I think insurance companies need to understand that ASCs offer the highest value possible for the dollar — we offer the most efficient proce- dures and good outcomes. I can't understand why this hasn't happened yet. We keep waiting for insurance companies to recognize the value that ASCs provide and the cost savings. But insurance companies don't do anything to incentivize the patient. Many procedures done at the hospital can be done at ASCs but many insurance companies don't pay for proce- dures done at ASCs. Dr. Bush-Joseph: I feel that ASCs have to get to more transparent about pric- ing and flexible in pricing. ASCs need to have the ability to accommodate the out-of-network patient or self-pay patient in a transparent way. The ability to sell both price and quality are critical. Dr. Callaway: Perhaps better integration of the ASC software with other clin- ical systems would help. Also more official support — guidelines, accredita- tion, etc. — for outpatient total joint programs would be helpful. Q: Looking ahead, do you think the future is bright or dark for orthopedic-driven ASCs? Dr. Redler: The future for orthopedic cases at ASCs is a bright one and one that will take on increasing importance in the overall performance of a sur- gical center. We have been able to increase the types of cases being done at surgery centers, including ACDFs, lumbar laminectomies and uni-knees. Dr. Bush-Joseph: Surgery centers need to think carefully about aligning with hospital systems or health plans. A surgery center that tried to function as a purely outside player is not a good long-term strategy. ASCs provide higher levels of care in a cost effective manner but independent ASCs are being forced to align or are being forced out of the market and how that plays out will be interesting. Dr. Callaway: Advances in anesthesia and surgical techniques will continue to drive orthopedic cases to ASCs. The future prospects of orthopedic ASCs are good. n "I feel ASCs have to get more transparent about pricing and flexible in pricing. ASCs need to have the ability to accommodate the out-of-network patient or self-pay patient in a transparent way." – Dr. Charles Bush-Joseph, Orthopedic Surgeon at Midwest Orthopaedics at Rush