Issue link: https://beckershealthcare.uberflip.com/i/759093
20 ASC MANAGEMENT setting and payers are more willing to reimburse for spine in ASCs. Also, improved MIS techniques and postoperative pain management solutions are assisting the move of traditionally inpatient procedures to the outpatient setting. "Some form of a bundled payment program will further stimulate the move from the inpatient to outpatient setting," says Mr. Bishop. "As surgeons take on more risk in terms of outcomes, you will also see a push towards reducing postoperative costs." 2. Implant pricing. e popularity of high-acuity outpatient pro- cedures as well as the increase in bundled payment models will result in a downward pressure on implant prices. e rationale is that if a surgeon is an ASC owner, they have incentive to use a cost-effective implant solution, says Mr. Bishop. Surgeons haven't historically moni- tored implant pricing, but that is changing with the risk acceptance of bundled payments and ASC ownership. 3. Cybersecurity. "One thing that keeps me awake at night is the issue of cybersecurity," says Mr. Bishop. "When you think of improv- ing profitability, you wouldn't normally lump this into this article, but a lot of our ASC brethren have been hit with ransomware attacks." In July, Langhorne, Pa.-based Ambulatory Surgery Center at St. Mary sent letters to nearly 13,000 patients whose personal information may have been breached following a ransomware attack. In the letter, the ASC stated the hackers installed ransomware, which tried to prohibit the ASC from accessing files until it paid ransom. If you start investing a lot of time and money in dealing with data breaches, that will negatively impact your profitability, notes Mr. Bish- op. Also, it may harm your surgery center brand and thus, your case volumes. Cybersecurity insurance and other cyber defensive mea- sures are a top priority for Regent's centers. 4. Revenue cycle management. Providing high-quality care is only part of the ASC profitability equation. e other side is contracts, billing and collections. Mr. Bishop says that many ASCs work very hard to deliver great care but don't pay as close attention to the block- ing and tackling of their revenue cycle. Regent finds that they can of- ten create a 5 percent to 30 percent increase in value from this key category by applying its 15 years of experience and expertise. "Our 11 years performing RCM exclusively for ASCs have equated to setting the gold standards in our industry, including setting a record recently of 28.6 days outstanding average for our facilities," says Regent's Vice President of Revenue Cycle Michael Orseno. 5. Staffing. Managing staffing at your surgery center effectively is key to a profitable ASC. Mr. Bishop suggests looking closely at your staffing practices to ensure you are paying fair market value and not over- or under-paying. He also notes that a chronic issue in the ASC industry tends to be overstaffing. "ere is a mistaken concept that all four operating rooms in a four- OR ASC need to be staffed at all times," he says. "If you only have enough cases to fill two rooms, don't staff and run four rooms, shut down two rooms. is requires understanding physician partners who are willing to support schedule compression and the resulting, proper staffing model." 6. Reporting regulations. e increasing regulations focused on reporting remains a challenge for ASCs, albeit a challenge resulting in net positives, says Mr. Bishop. Additional reporting requirements and data sharing helps ASCs improve quality of care, which leads to improved profitability. "Our industry is doing a better job of reporting data that supports our superior surgical outcomes," he says. "As CMS expands the criteria that they want to measure our ASCs by, centers that are lagging are forced to raise their capabilities. Ultimately, data drives better outcomes." n 6 Key Notes on ASC Nondiscrimination Requirements By Laura Dyrda A mbulatory surgery centers must now abide by new nondiscrimination requirements, according to an ASCA report. Here are six things to know: 1. The ACA's Section 1557 prohibits sex discrimination and requires language assistance for people with lim- ited English proficiency. The covered entities must use qualified interpreters and translators. A facility may have third party vendors interpret, but the vendors must be compliant with Section 1557. 2. Healthcare facilities are required to post taglines in- dicating language assistance is available in the top 15 languages spoken in their state by people with limited English proficiency, according to the report. 3. Covered entities are required to make electronic in- formation and newly-constructed or altered facilities available for people with disabilities. 4. The law also requires effective communication for people with disabilities. The healthcare facilities must provide the "appropriate auxiliary aids" as well as ser- vices for people with disabilities. 5. The providers must explain a notice of patient's rights in a language and manner the patients or the patients' surrogate can understand. 6. ASCs were required to comply with the regulations by Oct. 19, 2016. n "One thing that keeps me up at night is the issue of cybersecurity." — Chris Bishop, CEO, Regent Surgical Health