Becker's ASC Review

13 Sponsored by: Executive Briefing: Smart Moves for ASC Physician Owners M y family and I live next to one of the premier paragliding and hang gliding training/flying spots in the world. On warm summer evenings, it is not uncommon to count 50 or more paraglid- ers and hang gliders soaring high over the rooftops of the homes in my neighborhood. Several years ago, curiosity got the better of me, and I signed up for lessons. As you would expect, the training process was rig- orous and carefully monitored by my sea- soned, expert instructor, Jonathan. While I was racking up my solo flying hours, Jonathan was always standing below on the ground watching me, and giving me feed- back via an earpiece. This feedback kept me not only out of harm's way, but also in the good air that would ensure a nice long flight. One morning, as I was flying along a long ridge, I began to "sink out" of the good air, and started to head towards the sagebrush and gravel of the hillside. Jonathan saw exactly what was happening, and calmly repeated, over and over, the steps that I needed to take to get back into the good air that would allow me to continue my flight, and avoid a harsh crash landing on to rough ground. The directions were simple, but as my velocity increased in the direction of the ground, my body froze and refused to execute the commands that Jonathan was repeating. The resulting scraped arms and legs and severely bruised ego of my crash landing could have been avoided and my flight extended, had I been able to put into action the seemingly simple pieces of advice my experienced instructor was offering. During my time at Ambulatory Surgical Centers of America (ASCOA), I have been asked to look at the health of hundreds of surgery centers, who have fallen out of the "good air," and are sinking towards a harsh and ungraceful landing. I have spoken with thousands of physicians, and shared sim- ple, straightforward, proven principles and advice, that could help keep them flying high. Some have been able to react and execute. Others have not. There is nothing that I will say here in this article that will be earth shattering or unique to me. My guess is that you will have heard, and probably even thought of implementing most of these principles. The question is this: Will you, right now while you are still flying, implement some of these proven pointers that will keep you in the "good air," or will you sink out during this increasingly difficult time to fly? Know Your Surgery Center One of the most important things that you can do to build a smarter business is to put in the time and effort to understand the cur- rent status of the business that you have. By understanding the strengths and weakness- es of your surgery center, you will be able to make the changes necessary to optimize your surgery center. You must know your baseline and your desired end point in order to decide the best path to get you there. Here are some things that each physician owner needs to know: • Case volume from owners • Case volume from non- owners • The cost of doing each of your cases • The profitability of each specialty • How much debt the surgery center has, and the expected payoff date • Are the surgeon partners in the ASC nearing retirement? • How long it has been since the payer contracts were renegotiated • When the contracts are up for renewal • The age of the equipment in the sur- gery center Knowing this information helps to create an action plan to keep the surgery center "in the good air" and avoid the painful shock of "sink- ing out." Most of this information can be re- viewed at board meetings, so all the partners understand the state of the business. If the trend line is pointing in a negative direction, be engaged in helping solve the problem. Know Your Market In addition to knowing your surgery center, a partner trying to build a smarter ASC should understand the market dynamics in both the community, the state and on a national level. Locally: • How strong are the competitive sur- gery centers in your market? Are any of them an attractive acquisition? Could you merge your center with that center to create a more robust and stable ASC? • What are the outpatient strategies for each of the local hospitals? • What are the employment strategies for each of the local hospitals? • Will the local hospitals allow their em- ployed physicians to still be owners in a surgery center? • Are any surgeons finishing their em- ployment contract with a local hospital? • Are the local physician groups or hos- pitals forming an ACO? • Is there a staffing shortage or surplus in your community? • Where do the surgeons in your com- munity do their outpatient cases? • Which surgeons have ownership in competitive surgery centers, and which are employed by a hospital? • Develop a target list of available sur- geons that you would like to recruit to your center. • Are you seeing patient responsibilities changing for local insurance plans? • Is the hospital leadership changing at the local hospitals? • Are new surgery centers being built in the area? Top Strategies for ASC Physician Owners to Build a Smarter Business By Jeff Peo, Chief Development Officer at Ambulatory Surgical Centers of America

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