Becker's ASC Review

9 13th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference + The Future of Spine – Call (800) 417-2035 "This is an opportunity for non-for-profit health systems to demonstrate their cost-effectiveness," says Mr. Stroup. "Many hospital systems may want to dial down their cost per episode and you can't do that with 95 percent inpatient." There are three ways Mr. Taparia sees ASCs participating in population health: 1. Quality — ASCs have a lower infection rate than hospitals and can treat patients in the highest quality setting. 2. Focused operations — ASCs do more specific surgeries and have built service lines around a single procedure with less variation and proper protocols, which leads to fewer complications. 3. Access — ASCs are easier to construct and expand to multiple locations around the city for easier access for community members. They can also co-locate in medical office buildings to create a consumer-centric feel. Ad- ditionally, ASCs are smaller and less complex than hospitals, making them more patient-friendly. The ASC's parking lot is easier to navigate and it's not a maze to find the surgery desk; patients are in and out. "Population health also pays attention to outcomes per dollars spent," says Mr. Taparia. "When you lower the cost equation as part of a value-based sys- tem, ASCs have a role to play. Quality, cost and access all play an important role for ASCs to further population health with communities." But as part of population health initiatives, providers are taking on more risk. Most payers and providers don't currently have an infrastructure that effi- ciently transitions risk. "We are helping our provider partners put themselves in a good position to accept risk," says Mr. Stroup. "Leading NFPS with effective risk management skills will seek to broaden their assumed risk to increase the breadth of poten- tial savings and control over care. One can see why the traditional ASC would partner or acquire ancillary services, freestanding emergency departments, home health and urgent care — to secure a larger slice of the pie." Most ASCs won't be able to acquire all verticals, but they can work with oth- ers focused on similar issues to take more out of every dollar. Right now, many providers are pursuing packaged pricing but in the future you could see a transition to managing the episode of care so the facility works to keep patients out of the operating room instead of just focusing on making the OR more efficient. "There are people doing that now with total joints and GI," says Mr. Stroup. "These are more easily defined specialties so physician groups can provide surgery as well as the ancillaries. Many ASC companies are trying to figure out how they and the hospital partners can bundle services and sell those to employers, self-funded insurers, hospital partners and payers." Bundled payments also simplify the billing process. "There is less red tape to go through before patients have access to surgical care," says Mr. Taparia. "This also furthers the goals of population health." There are some surgery centers making changes to the traditional indepen- dent, physician-run model to become more desirable as a partner in popula- tion health. Hospitals are trying to create "care communities" focused more on outpatient services than inpatient care, and ASCs are partnering in either joint ventures or other alignment options to fill that void. ASCs are expanding to multiple locations and becoming part of medical cam- puses that also include services like lab testing, pharmacies and health clubs in addition to clinical space. "The idea is to create a model for convenient healthcare that is consumer-cen- tric and focused on retail," says Mr. Taparia. "The care is out in the community instead of making the community come to the care. At this campus you go to the health club, you can also eat the healthy food and it's also close to a Star- bucks. You can do ordinary things within the same area of the clinical services." The first step to making this transition is looking at your service lines and deciding where to really focus efforts. "You're not going to take half the dollar spent tomorrow, so make it easy for the risk-bearing entities to transfer risk to the ASC," says Mr. Stroup. "Figure out how to pinpoint the costs with an easy-to-implement service and align physicians with ancillary providers on the bundle." This is easier for single-specialty centers; putting resources in to a bundle for seven GI procedures performed per week at a multispecialty center doesn't make sense, but 70 procedures at a GI center does. Hospital partners may help, but aren't necessary for physician groups to take advantage of population health. "You don't have to be partnered with a health system to participate," says Mr. Taparia. "There are medical groups out there participating in risk-based contracts and these organizations own ASCs. It's helpful to integrate with a broader health system, but not imperative." n How ASCs Fit Into Population Health: Where are the Best Opportunities? (continued from cover) info@physiciancontrol.com or call 404.920.4950 www.physiciancontrol.com At IMS affiliated ASCs, physician owners are involved with decision making for the organization, a rare concept in today's ASC environment. IMS specializes in development and management solutions for all types of ASCs. Our emphasis on physician control and our no-nonsense ap approach set us apart from traditional ASC management companies. Our experience allows us to finalize transactions quickly, so you can focus on what matters: your patients. Let us show you how partnering with IMS can enhance your center's success through physician control. Interventional Management Services Less Red Tape. More Time For What Matters. ASC Spending Up 4.87% in 2014 4Q By Brandon Howard A nalysis of U.S. Census data from the Center for Sustainable Health Spending notes healthcare spending increased 5 per- cent last year, reports Bloomberg Business, where they note this increase follows five consecutive years of record slow growth for the healthcare industry. Figures from the Census report itself show ASC spending grew in the fourth quarter of 2014 from the same quarter last year by 4.87 percent. n

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