33
CODING
&
BILLING
5 Hospitals, Health Systems
Opening or Planning ASCs
By Jessica Kim Cohen
H
ere are five hospitals and health systems that
have announced plans for ASCs.
Delta Region Authority provided Houston-
based Texas County Memorial Hospital $150,000 to
open a new surgery center.
Cincinnati-based TriHealth selected Fort Mitchell, Ky.-
based Paul Hemmer Co. to renovate its new campus in
Anderson Township, Ohio, which includes an ASC.
Mercy Health-Fairfield (Ohio) Hospital has undertak-
en a surgical renovation project totaling $14 million, in-
cluding work on its ASC.
Seattle-based The Polyclinic and Swedish Medical
Center celebrated the opening of the First Hill Surgery
Center, the largest independent surgery center in the Pa-
cific Northwest, on Nov. 21, 2016.
The New Lenox (Ill.) Village Board gave Silver Cross Hos-
pital in New Lenox approval to build its ASC.
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20 Staffing Statistics for ASCs
By Laura Dyrda
H
ere are 20 statistics
on full time employee
staffing for ambulato-
ry surgery centers from VMG
Health's 2016 Intellimarker
Multi-Specialty ASC Study.
Nurse FTE
Mean: 15
25th percentile: 10
Median: 13.3
75th percentile: 19
90th percentile: 24.7
Tech FTE
Mean: 6.4
25th percentile: 3.9
Median: 5.8
75th percentile: 8.5
90th percentile: 11.2
Administrative FTE
Mean: 9.5
25th percentile: 5.7
Median: 8.4
75th percentile: 11.2
90th percentile: 15.8
Total FTE
Mean: 31
25th percentile: 20
Median: 28
75th percentile: 38.7
90th percentile: 49.9
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The CORE Institute's Condition-based Bundles — A New
Approach to Eliminating Waste
By Laura Dyrda
T
he Harvard Business Review profiled Phoenix-based e CORE
Institute's new condition-based approach to eliminating unneces-
sary care as an alternative to procedure-based bundled payments.
In 2009, e CORE Institute took on financial risk for the physician-re-
lated medical expenses based on a per member per month fee from the
insurance company that totaled around 20 percent of the physician medi-
cal expense for care. Now, the practice handles the entire diagnosis-based
spend, meaning the provider can choose alternative therapies to surgery.
e practice covers all scenarios, whether it's an MRI, hospitalization
aer surgery or medication for musculoskeletal pain. e article high-
lights three key notes about the diagnosis-based payments:
1. e CORE Institute designed the condition-based bundle to keep
patients healthy and prevent further issues. e practice has evidence-
based protocols and patient pathways to optimize care as well as a post-
operative blood clot clinic to prevent patients from returning to the ER
with blood clot-related issues aer surgery.
2. e condition-based model incentivizes physicians to select high
value treatment, whether it's operative or nonoperative.
3. The CORE Institute physicians can choose the site of service — a
hospital, surgery center or another facility. The CMS bundled pay-
ment program currently focuses on hospital admissions, a more ex-
pensive site of service.
e practice implemented analytics and practice management tools
to track patient information and automate functions when possible to
remain efficient, effective and compliant. e CORE Institute's IT has
become so sophisticated they now have launched predictive analytics
tools with the ability to identify the most successful site for patients to
recover from surgery, among other uses.
Since beginning the condition-based care program in 2012, the or-
ganization has reduced per member per month costs by around 50
percent with some at risk patient populations and showed their costs
are around 30 percent lower than others in the region. Savings primar-
ily came from fewer readmissions aer surgery and discharging fewer
patients to nursing homes.
"For medical conditions or sets of related medical conditions that
can easily be treated on their own, the advantage of the condition-
based payment model relative to the global payments model is that
the provider is only financially accountable for the types of diagno-
ses that it can reasonably influence," wrote David J. Jacofsky, MD,
CEO and founder of The CORE Institute, and Derek A. Haas, proj-
ect director of the Value-Based Care Delivery initiative and Harvard
Business School fellow, in the article.
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