Becker's ASC Review

ASC Turnarounds: Ideas to Improve Performance 15 • Want competitive bids? • Want the best price and terms? • Want to partner with a hospital? • Which of the 30 ASC companies is best for you? • Want to sell your ASC real estate? Want to sell your ASC or endoscopy center? ASC Sales Purchases Mergers Acquisitions Valuations Joint Ventures Partnering Consulting Jon Vick, President of ASCs Inc., has facilitated over 250 ASC partnership transactions. He specializes in ASC sales, strategic partnering, and ASC/MOB real estate sales. To find out how we can facilitate the sale of your ASC, contact Jon Vick at JonVick@ASCs-Inc.com or 760-751-0250 Get more information about how ASCs Inc. can find you the best deal, visit www.ASCs-Inc.com today! on opportunities to ensure their pricing remains current with the market and they are capturing the full reimbursement afforded by their payer contracts. "If the fee schedule doesn't remain cur- rent with payer reimbursement, it's possible to leave a significant amount of money on the table," says Ms. Woodruff. "With reimbursement con- tinuing to decline, every dollar counts and some- times an outside reviewer picks up on things the facility has unintentionally overlooked." 6. Key benchmarks. The ASC's financial reports provide an overview of the center's margins so own- ers and operators can see where they are and wheth- er key benchmarks are met. Important benchmarks to consider include: • Net revenue per case • Salaries, wages and benefits per case and as a percentage of revenue • Supplies per case and as a percentage of rev- enue • Revenue cycle benchmarks including AR days, days over 120, patient balances as a percentage of total AR, non-contractual write-offs and up front collections "Digging into the details of an ASC's financial re- ports tells us whether the center is in line with what we would expect for the types of services they pro- vide in the area of the country they operate in," notes Ms. Woodruff. If not, the center can make changes. 7. Facility policies and procedures. Review- ing facility policies and procedures for content and adherence to CMS and/or accreditation standards provides an excellent facility overview. "More im- portantly, confirmation that facility personnel are actually following these policies via direct observa- tion is key," says Shelley Longgood, director of op- erations at Pinnacle III, 8. Quality assessment and performance improvement. The reviewers look for docu- mentation of quality assessment activities and outcomes including, but not limited to, infection rates, hospital transfer rates, case cancellations, safety checklists, peer review and risk manage- ment. "This information needs to be actively measured and analyzed, communicated through appropriate committees to the board and de- tailed in meeting minutes," states Ms. Longgood. "Likewise, there should be evidence of com- munication from the top down regarding these measures which provide for a culture of patient, physician and staff satisfaction." 9. Physician credentialing. Adherence to phy- sician credentialing requirements and maintaining updated files is important for ASCs. "We want to make sure all physician credentialing information is up-to-date," says Ms. Longgood. Without the ap- propriate credentials, the ASC is at risk of violating state and federal laws. 10. Handling protected information. The digital age has opened up opportunities to mishan- dle patient information and violate HIPAA. Staff members are often aware of how to handle patient information correctly, but don't always translate those concepts into every day practice. "Are all staff aware of the minimum necessary requirement? Do they know how to avoid unnecessarily expos- ing PHI and creating a breach? Although HIPAA was enacted in 1996, education must be ongoing and training conducted at least annually. Every year there are 'new' scenarios added to the treasure trove of danger zones," notes Ms. Woodruff. In summary, Mr. Carrera notes that often the dif- ference between an ASC performing adequately and achieving their full potential is attention to these kinds of details. "Not every facility we review requires vast improvement. Sometimes there are no glaring problems, just minor tweaks that can yield improvement. Our reviews often facilitate communication. Physician investors, hospital partners, board members and staff ap- preciate having an objective assessment of their operations." n

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