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23 ASC MANAGEMENT • Turnover time: e time physicians spend between patients is as im- portant as the time spent in the room. Administrators can examine how much time is spent between visits and identify ways to decrease turnover time between patients. "We pride ourselves on a fast turn- over time," she says. "Physicians want to be in your surgery center when they can work efficiently, and then get out to spend time with their families." • Late starts: Analyzing the start time of physicians and staff is impor- tant. If a physician has a coveted 7 a.m. OR time slot, but they consis- tently come in an hour late on ursdays; an effective administrator can schedule another procedure during the time. • Cancellations: Administrators want to examine each cancellation and get to the bottom of it, if possible. Compile data on cancellations and find out the root causes to eliminate them. Scheduled surgeries that are suddenly cancelled are a large liability on the bottom line. • Profitability: e most important question metrics can answer is: how much money is in the bank, and how much does it cost to run the center? "ose are things you need to look at everyday," she says. Ms. Chappell suggests using benchmarks, and referencing them fre- quently. "If you can trend it and track it, you can make changes," she says. 3. Perform case costing to evaluate profits. ASCOA gathers case-cost- ing data on a trailing three-month basis. e three-month lag allows for ample collection time, Mr. Beam says. Mr. Beam uses a simple formula to evaluate overhead cost per minute: • Run a profits and loss report in an accrual basis • Subtract out the cost of drugs, supplies, implants and any interest, depreciation or amortization expenses. • Divide that number by total operative minutes (Time in the OR) in the month at will equal the overhead cost per minute, which can be considered on a case-by-case basis. ASCOA uses this equation to answer two questions: Is the case a good fit for the center and is the procedure making money? e data is ex- plained and shared with physicians, and it helps them develop a better idea of procedure cost. For example, a pain physician used a drug costing the center $73 per vial. Mr. Beam saw the drug was on contract, but then found a LOC that dropped the cost to $6 a vial. With that factored in, every case the physician had was profitable. 4. Recruiting is an essential tool to bring in new revenue. e best thing an administrator can do is to "always be recruiting." Mr. Péo suggests working with physicians to bring new cases to the center and have phy- sicians help with recruitment as well. Adding specialties is a good way to expand a caseload, but careful anal- ysis is essential to ensure that the new specialty is not a costly mistake. ASCOA suggests renting or trialing equipment until an administrator is sure the new physician and specialty make sense for the center. Finding new physicians can be challenging, but one tip is to look for doctors at the end of their employment contracts. "ere's no magic wand you can wave and have the recruits pile in," Mr. Péo says. "Roll up your sleeves. Recruiting is hard work, but it can really add substantial value for the center." 5. Improving reimbursement is a hard thing to do as the industry shis towards value-based care. ASCOA is shiing from an all out-of-net- work scenario to completely in-network. Administrators shouldn't be afraid to bring in an outside party to negotiate a contract. Data and communication is invaluable during payer contract negotia- tions. Ensure staff is on the same page when it comes to reporting, and institute comprehensive metrics that account for every financial aspect of an implant procedure to maximize reimbursement. 6. Improve the center's collections. When it comes to improving collec- tions, the following questions need to be asked to start the conversa- tion: • What do you do to collect money owed to the center? • What is the collection process and how many employees know the process? • Do you look at each case on an individual basis? • Do you verify with insurance and verify that you're going to get paid? • How does your staff follow up with each payer? • What information is available to you? Like many of the other elements, communication between staff is cru- cial. Develop and follow a process while making sure all employees of the center know their roles. "You can never over-train your staff. ey're your most valuable asset when it comes to collecting," Ms. Chappell says. n Call: 888.416.2409 info@eSutures.com eSutures.com Lock in Big Savings with eSutures.com! Over 1,000 Synthes Items 30-40% Off Every Day! From individual screws, plates and instruments to complete sets, eSutures has all your surgical needs in stock, and ready to ship today! Low prices everyday, no contracts or minimum order requirements. We look forward to serving you soon! *Offer expires 12/31/16. Limit 1 per customer. Use promo code: SPINE10 for 10% OFF your order of $50 or more!*