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With Physicians in Control, ASCs’ Future Looks Bright


The surgery center setting will continue to be a win-win-win for patients, physicians and insurers BY TOM STAMPIGLIA


Over the past several years, ASCs have been a bright spot in health care delivery. Now, in the face of


growing and increasing regulatory


competition require-


ments, ASCs must work to maintain this standing. I believe they are posi- tioned to do so.


ASCs were born from a desire by


physicians to control the way they prac- tice. This sentiment, which remains today, will drive the next round of inno- vation in surgical services. This year is sure to be exciting as physicians and their ASCs set out to prove to insurers, hospitals, self-insured employers and consumers that they can scale their suc- cess by bringing more complex spine, joint and cardiovascular procedures into the outpatient setting. As with all of health care delivery,


the ASC industry is facing tremendous challenge and opportunity. For ASCs, these trends will require them to proac- tively address new pressures. Success will be achieved if ASCs are able to maintain lean operations, demonstrate and publicize quality metrics more vis- ibly, employ new tactics to drive vol- ume to their centers and deliver on the experience patients are expecting when undergoing outpatient surgery.


Cost Effective ASCs are in the driver’s seat to make arrangements that best suit the financial goals of their facility, patients and the entire health care system. Such arrange- ments may include partnerships with hospitals/health systems and accepting new payment models (e.g., bundled pay- ments) as a means of driving additional volume to the ASC setting. To do so,


centers must work to better understand and manage their expenses at a very detailed level. This includes areas such as inventory management, staffing and case costing. ASC management soft- ware remains a key tool for supporting these efforts, and solutions are evolving to support new ASC endeavors. As the volume and mix of surgical procedures changes, ASCs will need new tools and insights into their data to support them as they scale. ASC man- agement cannot afford to wait until the end of the month to see where the busi- ness stands. By then, poor cost man- agement can have a significant negative effect on an ASC’s bottom line. There- fore, more centers are embracing ana- lytics to better manage key performance indicators such as accounts receivable, case volumes and cash collections daily against monthly targets. ASC analytics provide more than a static view; they deliver drill-down analysis capabilities that enable ASCs to obtain the informa- tion they need to make business deci- sions that drive improvements. ASCs will need to remain focused


on improving their revenue cycle. Such efforts are currently driving tech- nology needs that support efficiency and documentation throughout the entire surgical care experience. One trend to watch is ASCs partnering with third parties for coding, billing and collections rather than managing those functions in-house. ASCs also will continue to explore partnerships with third-party management companies to provide expertise that enables them to focus more on care delivery and less on running the business. This year, I expect ASCs to look for ways to unlock the data in their ASC


solutions in ways that provide a deeper understanding of their financial perfor- mance and deliver meaningful cost- cutting opportunities that may have otherwise remained hidden or difficult to access. This operational expertise will be critical for ASCs to thrive in an environment of changing operational and payment models.


High Quality Advances in surgical techniques, anes- thetics and pain management all sup- port the continued migration of surgery volume out of the inpatient setting and into ASCs. Absorbing increased sur- gical volume and maintaining quality outcomes, particularly for higher acu- ity cases, will require even more focus from ASCs going forward. This comes on top of increasing reporting require- ments. ASCs were required to report on 11 quality metrics in 2017 (see www.asc association.org/qualityreporting), and the trend toward increased quality reporting is likely to continue. Such quality demands and report- ing requirements are driving the need for greater use of electronic documen- tation technologies that allow ASCs to facilitate those efforts in ways that allow them to maintain efficiency and avoid negatively impacting clinician satisfaction. Last year, the 21st


Century Cures


Act was enacted. It exempted physi- cians who deliver most of their Medi- care services in ASCs from penalties associated with not using a certified electronic health record (EHR) under programs including Medicare’s mean- ingful use program and the Merit- Based Incentive Payment System (MIPS). The Cures Act also autho-


The advice and opinions expressed in this article are those of the author and do not represent official Ambulatory Surgery Center Association policy or opinion. ASC FOCUS JANUARY 2018 |www.ascfocus.org


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