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35 13th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference + The Future of Spine – Call (800) 417-2035 Should You Sell Your ASC? 17 Questions to Ask By Scott Becker, JD, CPA For more information, call 425-657-0494 or visit our website at www.eveia.com Eveia's Clients: · Ambulatory Surgery Centers · Surgical Hospitals · Health Systems with ASC Relationships · Physician Practices · Anesthesiologists ASC Operations Compliance & Consulting Services Preparing for excellence Provider Business Services Optimizing opportunity Provider Contracting Services Reimbursement experts T his article briefly outlines 17 questions to ask that should help drive the decision as to whether to sell your ASC and how well it will do in a sale process. Obviously, it requires more analysis than this, but this is a great starting point. 1. Is the ASC's income sustainable? 2. Is the income going up or down? 3. Is the center over-reliant on a few surgeons? 4. Are key surgeons close to retirement, or are surgeons leaving? 5. Is there a strong group practice connected to the surgery center? 6. Is that group practice growing or getting smaller? 7. Are there potential surgeons to invest in the surgery center that are independent? Is there a viable plan for succession and for adding sur- geons to the center? 8. Is the reimbursement of the center per procedure or case generally sustainable or at great risk? 9. Does the center rely on out-of-network reimbursements? 10. Does the center rely on workers' compensation? 11. Are the center's core commercial carriers willing to negotiate con- tracts with the center at reasonable prices? 12. On a personal level, is the center a small portion of the surgeon's portfolio or his or her entire portfolio? 13. Does the physician need the proceeds from a sale to secure his or her retirement? 14. What are the after-tax proceeds of a sale versus the after tax proceeds of distributions over the next five or seven years? Are returns sustain- able for five to seven years? 15. Where will the surgeon invest the money if he or she sells? 16. Will a partner help the center's profitability or simply provide a cash- out event? 17. What price will the center gain in a sale process? What percentage of the center would be sold? n Do Financial Incentives Improve OR Efficiency? By Ellie Rizzo F inancial incentives may reduce operating room turnaround times and improve on-time start accuracy, according to new research in JAMA Surgery. Researchers studied the effect of a financial incentive program on the efficiency of OR teams, including surgeons, anesthesiolo- gists, nurses and surgical technicians. They studied 10 months of surgeries performed at an academic trauma hospital in 2013. turnaround time was defined as "wheels out" to "wheels in," and an on-time start was one occurring within six minutes of the scheduled start time. Before implementing the financial incentive program, turn- around times were between 77 minutes and 83 minutes on av- erage, and between 18 percent and 26 percent of turnaround times were less than one hour. On-time starts occurred around one-third of the time. After the financial incentive, turnaround times of less than one hour increased to 52 percent and on-time starts improved between 31 percent and 64 percent, depending on the OR team in question. While researchers suspect the financial incentive played a role in improving times, they also said the cost of the program, about $8,300 for every two months worth of incentives, was unlikely to be the only contributing factor. Also important were improved communication channels regarding start times and turnaround times, likely brought into focus for teams as they participated in the financial incentive program. n