Becker's ASC Review

8 ASC Management W hat is the biggest change on the hori- zon for ASCs? How can ASC owners and operators overcome the challeng- es and prepare for the future? Physicians Endoscopy CEO Barry Tanner dis- cusses the two changes impacting ASCs today and where they're headed in the future. Barry Tanner: I believe that there are two sig- nificant changes that are slowly gaining momen- tum. e first is that with the continued growth of high-deductible health plans the biggest single payer for ASCs is rapidly becoming the patient. As a result, ASCs are beginning to face the pros- pect of also becoming lenders. Within our specialty of gastroenterology the procedure costs are relatively low and therefore somewhat more manageable but in other special- ties, where the procedures are far more costly, this is going to be a mounting problem. We are exploring several options to assist patients in paying for their deductible including third-party financing programs and internally financed pay- ment programs. While we have come up with no perfect solution, it is a growing concern that will consume significant resources. e second area of change is that ASCs will need to realign their position within the healthcare provider compendium so that ASC are not viewed as competition to hospitals but as part of the over- all solution toward delivering the best care in the lowest cost setting. Right now ASCs and hospital HOPDs in most markets compete for the same patients. Physicians have aligned themselves pre- dominantly in one camp or the other. Payers are in many respects caught in the crossfire because they absolutely need the services that hospitals provide for their subscribers and yet they are fully aware that the quality and cost of care in an ever- growing list of common procedures is far better for patients in a freestanding ASC setting. Speaking from the ASC standpoint, the "we win, you lose" scenario has to change and ASCs, hos- pitals, physicians and third-party payers need to begin to work collaboratively to deliver the right care in the right setting at the best possible price. at is the goal. e only way to accomplish this is to identify how each of these constituents can fairly participate in the savings that would be gen- erated from accomplishing the goal. We are truth- fully just in the thought process of how to begin to try to achieve this. Our ASCs are increasingly aligning with hospitals but in truth, GI procedures are not terribly high on the radar screen for payers and as a single-specialty provider, in most regions of the country, we are simply not big enough in aggregate dollars to en- gage payers in meaningful conversation. At Physi- cians Endoscopy we also are currently limited in both our knowledge and influence to the facility portion of GI procedures which is really only one part of the GI service-line. In order make progress toward the goal we absolutely need to also have physicians, hospitals and payers ready, willing and motivated to engage in meaningful and collabora- tive discussions. is may still be a way off. n The ASC Industry Won't be the Same: 2 Significant Changes Slowly Gaining Momentum By Laura Dyrda Barry Tanner ese lar1ger medical centers were willing to partner with a surgery center, without a financial stake, based on the benefits the ambulatory set- ting could provide. Once proven safe and effec- tive in the outpatient setting, bariatric procedures could move to the ASC's operating rooms, freeing up the medical center's ORs for other, more com- plicated cases. "ere is always an opportunity to set up a comprehensive program built around a procedure or set of procedures," says Dr. Bozorgi. "is will make the center more attractive to phy- sicians, payers and patients." 2. Hospital-employed physicians. Once Magna Surgery Center had established its bar- iatrics program and the program's reputation began to build, physicians from other hospitals became interested. "For every physician and network exposed to the level of efficiency at an ASC, there is the opportunity for word to spread," says Dr. Bozorgi. Hospitals were will- ing to let their employed physicians take their cases to the surgery center based on its reputa- tion and the efficiencies it offered. 3. Device companies. Surgery center lead- ers oen have relationships with various device company representatives. ese relationships can be used to expand a center's caseload. For example, Gramercy Surgery Center in New York partnered with a company that developed a shockwave therapy machine designed for podia- try procedures. e machine had a capital cost of $700,000, but the surgery center allowed the device company to simply store the machine at their center. e center paid a per-use fee each time a procedure was done using the machine. Physicians were now able to see and use a new device; the surgery center was gaining business and helping the device company do the same. "We teamed up with reps of numerous compa- nies," said Jeffrey Flynn, CASC, COO and ad- ministrator of Gramercy Surgery Center. "We allow them to come with us to physician offices." e reps are able to get exposure to physicians, and the surgery center is able to benefit from the use of new technology. 4. Residents. Surgery centers can also open their doors aer hours to offer device com- panies and physicians use of available space. Gramercy Surgery Center has partnered with companies such as Smith & Nephew, DePuy Synthes and Integra to host cadaver labs and seminars. Educational programs can draw practicing physicians seeking to hone old skills or physicians in training seeking to learn new skills. "On the short term, ASCs may dismiss residents, but that is short-sighted," says Mr. Flynn. "e majority of residents I have come across stay in New York. ese are our future customers. We know 75 percent of audience for one of these seminars will be residents. We would be crazy not to embrace them." n Breaking Tradition: Don't Discount These 4 Potential Partners (continued from cover) "There is always an opportunity to set up a comprehensive program built around a procedure or set procedures." — Dr. Kenny Bozorgi of Magna Health Systems

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