Becker's ASC Review

15 ASC Turnarounds Staffing is consistently among the biggest costs for ambulatory surgery centers. However, it doesn't necessarily need to over- burden the ASC's financial resources. There are strategies for ASC owners and operators to turn staffing from a cost-center into a value-center. "As ASCs continue to face growing reimburse- ment pressures and competition for physicians and patient referrals, administrators are focusing more on expense management to improve profit- ability of the ASC," says Jessica Nantz, president of Outpatient Healthcare Strategies. "Full-time salaries are, on average, the largest expense items as a percentage of net revenue." Industry benchmarks show employee sal- ary and wages are typically 22 percent to 24 percent of net revenue, and the amount ASCs spend on staff increases when the center opts for a comprehensive health insurance plan and establishes a bonus structure. Adding new staff is also costly for training, licensing, education and IT considerations. "Staffing efficiently and effectively has a material impact on the profitability of an ASC, with cost savings falling to the bottom line," says Ms. Nantz. Here are her key steps to limit staffing costs: 1. Use benchmarking data to develop oper- ational strategies to control large expense items. "It is important to measure staffing costs to determine if the ASC is operating efficiently," she says. "Since staffing is a mix of fixed and variable costs, rather than a static measure, benchmarking is an effective way to assess the center." 2. Take a collaborative approach to bench- marking. "Explain the benchmarks and job re- sponsibilities that must be addressed, and work with your team to develop a staffing pattern that should project to exceed your center's benchmarks and therefore lower your costs," says Ms. Nantz. 3. Use pro re nata staff when it's appropri- ate to fill openings. "The best staffing models in the industry have fewer full-time core team mem- bers with a good mix of experienced PRN staff to ensure staffing is designed to meet the demands of the schedule, not a routine," says Ms. Nantz. 4. Cross-train employees so team mem- bers can fill in on slow days or when an- other member is out of the office, especial- ly for an extended leave of absence. "When you hire staff, set clear expectations about the team culture, work ethic and cross-training," she says. "Downtime in an ASC should be non-existent." 5. Send staff members home early on slow days to limit overtime so you have room to keep them late on busier days. "This expecta- tion should be clearly established," says Ms. Nantz. "In the event there is an opening in the schedule, leadership should make sure staff are using this time productively to work on other projects, such as quality improvement studies, in-services, updat- ing physician preference cards and even 'chores' such as cleaning and reorganizing storage closets." 6. Invest in electronic systems to reduce man hours spent on automated tasks. The center can also outsource tasks to lower the over- all staffing expenses. 7. Beyond limiting staffing costs, it's also important to create a culture where full- time staff assists with quality, infection control, risk management and safety re- quirements. You can use software to track pro- ductivity and then establish higher benchmarks or identify areas for improvement. 8. Engage staff members by celebrating their accomplishments inside and out- side the ASC. "When staff members believe leadership values and appreciates their contribu- tions, they are more likely to view their jobs less as work and more as opportunity to positively impact the lives of patients, physicians and fellow team members," says Ms. Nantz. n How to Turn ASC Staffing From a Cost- Center Into a Value Center — 8 Key Steps By Laura Dyrda Jessica Nantz U nited States prescription drug spending rose 13 percent in 2014 to $374 billion, the highest increase since 2001 when spending growth was 17 percent, according to a new report from IMS Health's Institute for Healthcare Informatics. Innovative new drugs for the treatment of hepatitis C, cancer and multiple sclerosis and higher spending on diabetes drugs were the biggest contribu- tors to spending growth, according to the report. The report also found that demand for healthcare services declined in 2014, even though it was the first year of insurance coverage for millions of people under the Patient Protection and Affordable Care Act. The report highlighted that some newly insured individuals, particularly in Medicaid, contributed to a substantial increase in dispensed prescriptions. Here are five other findings from the report: 1. In 2014, spending on new medicines including treatments for multiple sclerosis, cancer and diabetes drove nearly $9 billion of increased spending. 2. More than 161,000 patients started treatment for hepatitis C last year, nearly 10 times more than in the previous year. 3. Specialty medicine spending increased by 26.5 percent to $124.1 bil- lion in 2014. 4. Retail prescription growth in the first year of expanded coverage under the PPACA was primarily driven by Medicaid. Overall, Medicaid prescrip- tions increased 16.8 percent last year. 5. Medicaid prescriptions increased 25.4 percent in states that expanded Medicaid coverage, and 2.8 percent in states that did not. Nearly 25 percent of exchange plan patients and 9 percent of Medicaid patients may have been previously uninsured. n Prescription Drug Spending Reaches $374B in 2014 By Kelly Gooch

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