Becker's ASC Review

11 ASC Management "I really find that there aren't a whole lot of risks with multispecialty that don't already exist in single specialty, other than buying more equipment," says Mr. Neiberg. A multispecialty model allows an ASC to diversify risks. If one specialty takes a hit from reimbursements or a new non-surgical treatment, the surgery cen- ter could remain afloat with the strength of its other specialties. "You have a volume of physicians that are doing the work, so it may be easier to spread the wealth," says Mr. Neiberg. A single specialty model shouldn't be completely ruled out, though, accord- ing to Mr. Neiberg. Focusing on one service limits the amount of equipment needed, and "you know what you're getting yourself into, rather than spread- ing yourself too thin." Although some ASCs thrive in single expertise, Mr. Neiberg nevertheless thinks most surgery centers would opt to expand, with more surgeons in- house and more cash flow. Making the leap to multispecialty No magic number exists regarding how many specialties create the perfect multispecialty ASC. e strength behind the administration reveals how much surgery centers can handle. "We've seen centers with nine specialties that have done extremely well," says Mr. Neiberg. "ere are management companies that are that good, that can schedule well and make the most out of surgeons' time." If ASCs are considering expansion, Mr. Neiberg believes easing in is the best approach. Although each surgery center is case-specific, Mr. Neiberg sees successful complements in orthopedics and pain specialties as well as general surgery and GI specialties. "If you're dipping your toe in the water and not necessarily taking that giant leap, focus on cases where there would be less of an upfront investment," sug- gests Mr. Neiberg. Based on the centers HealthCare Appraisers observes, orthopedics, neurol- ogy and cardiology are strong forces. Mr. Neiberg says orthopedic ASCs even operate like multispecialty centers, as the specialty is profitable and brings in complicated surgeries. Major players in ASC specialties Whether operating a single specialty or multispecialty ASC, the following spe- cialties are worth considering based on impressive case volumes and revenue. Ophthalmology, orthopedics, GI and pain management comprise the four powerhouse ASC specialties. Ophthalmology, GI and pain management add up to the greatest number of cases to ASCs by case volume, while orthopedics provides a great amount of revenue. Ophthalmology is a leader in the ASC industry because many cases are Medi- care cases and Medicare reimbursement levels help ASCs survive commercial insurance market shis. Ophthalmologists retain independence more easily as hospitals are not aggressively hiring them. e demand for cataract sur- gery continues to grow, and most ophthalmology ASCs' cases yield high volume and medium reim- bursement. Gastroenterology and endoscopy is still a popular specialty. Around 35 percent to 40 percent of GI procedures and screenings are Medicare patients. With colon cancer becoming more common, gastroenterologists bring in many procedures in ASCs and hospitals don't want them. GI procedures are high volume with low to me- dium reimbursement. Pain management has not experi- enced an easy ride in ASCs, as payers are strict about the number of proce- dures and Medicare is strict about the utilization. Many pain management physicians move procedures out of ASCs due to reimbursement. Still, com- plex procedures oen stay in ASCs. e specialty is high volume with low reimbursement. Orthopedics differs from the other three powerhouse ASC specialties, as com- mercial reimbursement impacts it more than other specialties. Although hos- pitals actively seek orthopedic physicians, many physicians have maintained their independence in ASCs. Orthopedics in ASCs yields a sizable volume and the highest average reimbursement. Despite certain specialties dominating the ASC industry, no uniform recipe of specialties whips up a successful outpatient surgery center. But it may be wiser to mix in a couple specialties as opposed to a stand-alone service, because as Mr. Neiberg says, the multispecialty strategy is "really just a better business model." n ASC Single Specialty vs. Multispecialty — Which is Best? (continued from cover) 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 Stuart Neiberg BECKER'S SPINE REVIEW E-WEEKLY subscribe today free • educational • up-to-date Visit beckersorthopedicandspine.com or call (800) 417-2035

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