Becker's ASC Review

Practical Business, Legal and Clinical Guidance for Ambulatory Surgery Centers ASCREVIEW September/October 2014 • Vol. 2014 No. 7 INDEX ASC Turnarounds: Ideas to Improve Performance p. 18 Transactions & Joint Ventures p. 29 Coding, Billing & Collections p. 55 Supply Chain p. 70 Accreditation p. 80 Data Analytics for ASCs How ASCs are catching up with data gathering in the digital age and using analytics to their advantage. p. 18 4 Smart Moves for ASC Owners Industry experts discuss the smartest things ASC owners do to increase center value. p. 8 10 Keys for Great Administrators Some of the best ASC administrators give their advice to up-and-comers. p. 10 11 Cost-Cutting Strategies ASC administrators share how their centers executed cost-reduction initiatives. p. 81 How Could Midterm Elections Impact ASCs? By Ellie Rizzo On Capitol Hill, ASCs are the little guy. The hospital lobby is powerful, and though the Patient Protection and Affordable Care Act has thrown some bones to the ASC industry lately, the ASC position in Washington, D.C., is at times precarious. Midterm elections will be held November 4, 2014, with all House and 33 Senate seats contested. One of the most con- troversial issues widely expected to affect which candidates emerge from their races victorious is the PPACA. But will a change in the partisan dynamic have an impact on ASCs? Politically speaking, a Congressional changing of the parti- san guard seems likely. As of the end of July, a CBS News/ A joint venture ambulatory surgery center may be a powerful, effective business, but like any business it will always need fresh blood — new physician investment. Phil Spencer, Executive Vice President of Business Development with United Surgical Partners International, out- lines the buy-in process at joint ven- ture ASCs and the unique challenges and opportunities these ASCs face in the hunt for new physician investment. 1. Buy-in process. The guide- lines of new physician buy-in do not change, despite the presence of a hos- pital partner, says Mr. Spencer. The standard rules apply: • Establishing fair market value for shares • Credentialing • Physician approval of potential partners In a purely physician-owned ASC ownership dilution is relatively sim- ple, but with a hospital and perhaps a management company in the mix, how new investment shifts the own- ership dynamic becomes more deli- cate and complicated. "There really isn't one formula that describes how an ASC joint venture must be split up, nor how dilution will occur," says Mr. Spencer. Possible formulas for dilution include: ASC Payer Mix — Developing the Best In-Network, Out-of-Network Strategy By Laura Dyrda The appropriate payer mix in today's healthcare en- vironment depends on the center's experience and healthcare market. New centers begin out-of-network to perform cases for Medicare certification and some stay that way while others opt to negotiate in-network contracts as soon as possible. It typically takes four to six months to negotiate a good contract with payers, says Senior Director of Managed Care for Surgical Care Affiliates Holle Ho. "The first step continued on page 57 continued on page 30 continued on page 16 INSIDE: 60 ASC Management & Development Company CEOs to Know; Becker's ASC 21st Annual Meeting – The Business and Operations of ASCs New Physician Buy-In: 4 Trends for JV ASCs By Carrie Pallardy Becker's ASC 21st Annual Meeting The Business and Operations of ASCs October 23-25, 2014 • Chicago Keynotes: Terry Bradshaw, Co-Host and Analyst, FOX NFL Sunday and NFL Legend; Bill Taylor, Founding Editor, Fast Company and Best-Selling Author; Lolo Jones, 2-Time Olympic Hurdler and World Champion, 2014 Olympic Bobsledder For more information, call (800) 417-2035 30 Great Surgeons, 36 Leading Administrators and 80 Surgery Center Speakers in Total

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