requires careful consideration. Some of the considerations ASCs should make include:

Are your surgeons on board? Strong physician support and involvement is essential. Their involvement in making the case for your facility will be impor- tant in building and executing your plan and in demonstrating readiness to payers, patients and your community.

What payer requirements do you need to meet? Payers typically have established criteria providers must meet to qualify for reimbursement for these procedures. Review and prioritize your payer mix, and assess the requirements of the largest payers. If your facil- ity does not already have the required accreditation, it needs to be factored into your planning. Requirements per payer might vary, so it is important to understand where you have the most work to do for your payers and identify dependencies, costs and timelines.

Do you have a system or plan in place for data collection? As previ- ously mentioned, evaluating a deci- sion on these complex procedures, meeting payer requirements and nego- tiating contracts requires that a facil- ity can provide data on its historical case and surgeon performance and outcomes data. This demonstrates that your ASC has historically achieved positive results and that an infrastruc- ture is in place to facilitate continued positive outcomes as you take on more of these complex procedures. Tech- nology plays a vital role in recording this information and pulling necessary analytics. The ability to track results also ensures your facility’s payments are maximized as the industry moves toward value-based care.

What is your potential patient popu- lation? Adding complex procedures to your case list is a big undertaking that requires capital investments to get up and running. Consider the patient pop-

While it is becoming more common for complex cases to be performed in outpatient facilities, doing so requires significant preparation and investment of time and capital.”

— Lindsay McQueeney Hanrahan SourceMed

ulation within your reach, as well as current and emerging competition, to ensure there is enough demand.

Does your facility have enough space? Because these cases are lon- ger than more common ASC proce- dures (i.e., a torn rotator cuff repair or cataract removal), they require more time in recovery. Patients are up and start to move around within a few hours of surgery, therefore, addi- tional space is needed for a safe and comfortable recovery, ambulation and meeting with physical therapists. If space is limited, you need to decide if this initiative is critical enough to your facility’s long-term strategy to consider expansion or relocation.

What relationships do you need to expand with other providers in the community? Outpatient care pro- viders, like physical therapists and skilled nursing facilities, play a key role in helping patients recover from these procedures, which is essen- tial to achieving positive outcomes.

It is important to develop relation- ships with other care providers within the community so that physical ther- apy can begin at your facility, and that there is a smooth transition of care to a skilled nursing facility, in-home care and/or recurring physical therapy.

How will you screen patients? Pro- cedures that are more complex also involve more risk given their increased duration and anesthesia and pain management requirements, there- fore, require more rigorous screening. Patient engagement technology that allows patients to log into a secure sys- tem and complete their medical his- tories at a time that is convenient for them helps yield more accurate results and saves staff time. Customizable screening tools can help in assess- ing each patient for comorbidities and risks such as Deep Vein Thrombosis (DVT), sleep apnea and fall risks in advance of a procedure. Systems with red flag alerts can help your staff to ensure no issues are overlooked. While it is becoming more common for complex cases to be performed in outpatient facilities, doing so requires significant preparation and investment of time and capital. It is important to do the work needed to understand what is involved and whether adding these cases to your case mix aligns with your facility’s long-term strategy before bringing these cases into your ASC. Networking with other ASCs that

have already begun performing these cases is essential to this process. By sharing information and learning from each other, preparing for and expand- ing into new procedures, techniques and technologies will ensure contin- ued growth of the ASC industry and the patients it serves.

Lindsay McQueeney Hanrahan is the vice president of product management at SourceMed, headquartered in Birmingham, Alabama. Write her at lindsay.hanrahan@


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