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mentation throughout the care process; ensuring proper adherence to clinical, compliance and billing guidelines; and billing and collections on the back end.”

Added Incentives

What to consider when setting up a bonus pay program in your ASC. BY SAHELY MUKERJI


SCs interested in establishing a bonus pay plan for their em-

ployees have several options. One ap- proach, suggests Ronald L. Brank, group vice president of finance of the Atlantic Operations Group of Sym- bion Inc. in Nashville, Tennessee, is a plan based on a surgery center’s per- formance criteria, including budgeted goals and improvement over the prior- year results. “Performance criteria should be aligned with the main goals of the ASC and coupled with those activities truly within the control or significant influence of the ASC staff eligible for the plan,” Brank says. “While ASC profit is an important part of a bonus program, other areas such as success- ful accreditation and compliance with

quality indicators should be consid- ered when setting objectives. “Profit sharing plans can work only

if the partners are on board with the program,” Brank adds. “In essence, profit sharing plans share with the ASC employees any profit at the sur- gery center. Since profit and cash are not always the same, these types of plans must link to actual cash available to distribute.”

Another approach could be “pay- ing a percentage or tiered rate of cash collection . . . because it involves the entire spectrum of care/revenue cycle,” says Brent A. McLean, administrator at Memorial Mission Surgery Center in Chattanooga, Tennessee, “includ- ing everything from the moment the patient walks in the door, registers and pays upfront dollars to accurate docu-

This approach also allows for consideration of bad-debt recovery, McLean points out. “One note is that cash needs to be increasing along with income to qualify, for obvious reasons, but also because a facility could increase cash collections and see decreased income due to the lack of focus on cost, cases, etc. If increased cash collections—or good accounts receivable—are simply being eaten up by costs then there is no real gain.” For ASC staff, when it comes to a bonus pay program, “set metrics/ goals to be achieved in quarterly or six-month intervals,” McLean says. “To qualify, patient satisfaction must stay above a certain percentage for the entire period, which is not hard to do in an ASC. If this is achieved, then a measured bonus is administered to the staff. This helps the culture in tangible and intangible ways. The measured bo- nus makes the incentive piece real to the staff and encourages them to buy in to it . . . what we call the ‘acceler- ated bonus.’ We add an increase to the patient satisfaction bonus if the staff achieves an additional goal set for the period.”

Once everyone is educated, set the

metric every period to something in need of extra focus within the facility, McLean suggests. “Managers help de- termine the goal, and then, they take a sample by auditing before informing the staff of the metric. Once a base- line is known, inform the staff of the mark to be achieved, and if it is not, then no accelerated bonus should be distributed.” To achieve this, “make sure everyone is working on the same goal, otherwise you will have inter- departmental disagreement over the difficulty of reaching different metrics, especially when one department suc-


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