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Practical Business, Legal and Clinical Guidance for Ambulatory Surgery Centers ASCREVIEW June 2015 • Vol. 2015 No. 5 INDEX ASC Management p. 10 Transactions & Joint Ventures p. 21 Coding & Billing p. 39 Quality & Accreditation p. 46 Healthcare M&A Up 19% in Q1 Seven key trends in healthcare mergers and acquisitions p. 21 ASC-Specific Bundled Payments California ASCs could take advantage of new program p. 40 37 Spine-Driven ASCs to Know This list covers 37 ASCs focused on spine p. 16 Total Joint Replacement in ASCs Three orthopedic surgeons discuss patient selection for the outpatient setting p. 19 5 Big Dysfunctions in ASCs — And How to Fix Them By Laura Dyrda Janie Kinsey, RN, CASC, administrator at Saint Luke's Surgicenter—Lee's Summit discusses five big dysfunctions that can occur at ambulatory surgery centers and solutions to fix them. 1. Preoperative assessment chaos. When ASCs struggle with lopsided payment systems, it's difficult to bud- get the proper staffing to cover preoperative assessments. This is especially true as the population becomes heavier, Healthcare reform had a rocky first five years, and the next five are equal- ly uncertain in today's political land- scape. Here are five key observations on how future healthcare reform implementation could impact am- bulatory surgery centers. 1. The cost containment coun- sel will convene for the first time. The counsel charged with making recommendations on Medi- care payments — with the goal of eliminating waste and overspending — will convene for the first time next year. For the first two years, the coun- sel can only make changes to physi- cian and ancillary reimbursement as well as drug costs; after 2018, the counsel can also focus on hospitals. "We don't know who will be on the counsel and there is no direct Con- gressional oversight," says Tom Mal- lon, founder and CEO of Regent Sur- gical Health. "We are exposed to their decision-making, but we don't know who they are or how they will impact reimbursement." Hospitals receive around $0.40 for every healthcare dollar Medicare spends; ASCs are just 2 percent of Medicare spend. "What they do to us in cutting costs will not be hugely material," says Mr. Mallon. How to Use the 4 Pillars of ASC Lean Staffing Without Sacrificing A-Team Employees By Carrie Pallardy Salary, wages and benefits consistently top the list of ambulatory surgery center operations expenses. These costs are necessary to retain a high-quality staff, but this does not mean the expense can go unchecked. The tenets of lean staffing can be applied to manage staffing costs effectively, while keeping your A-team of employees motivated and satisfied. continued on page 10 continued on page 8 continued on page 11 INSIDE: 16 ASCs Adding New Procedures, Becker's 22nd Annual Ambulatory Surgery Center Conference Brochure Healthcare Reform Marches On — 5 Key Observations for ASCs in 2015 & Beyond By Laura Dyrda Becker's ASC 22nd Annual Meeting - The Business and Operations of ASCs October 22 - 24, 2015 • Swissôtel - Chicago, Illinois 51 Great Surgeons, 55 Leading Administrators and 110 Surgery Center Speakers in Total For more information, visit www.beckersspine.com or call (800) 417-2035. ASCREVIEW