Grow Your ASC Focus on these keys to success BY ANDY WHITENER

It is no secret that growing an ASC can be a challenge. Every ASC administrator is faced with the same goals: optimizing capacity and

continuously growing the center’s vol- ume. The multispecialty center—four operating rooms and two procedure rooms—that I manage was no excep- tion. In 2010, the center was barely per- forming 100 cases each month, and we were competing in a very tight market. Within a five-mile radius of our center, there were no fewer than 17 single-spe- cialty surgery centers.

Despite the challenging market cir- cumstances, I believed there were growth opportunities, even if not readily visible. I knew volume loss was inevitable if we did not focus our efforts on growth and that growth was necessary to survive. To foster growth, I have found cer-

tain key areas are the tickets to success: great clinical outcomes and patient and physician satisfaction. These three cen- ter attributes are the result of a great team and critical to enable growth. We have certainly had our stumbles, but over the past five years, we have added close to 40 surgeons and been able to grow volume 84 percent. It was helpful for me and our leaders to break growth down to its basic elements (see table on page 18). This alignment helped us set goals and make assignments without losing sight of our goals to serve our physicians and patients while providing superior clinical services. 1. First, I assumed that every sur- geon—whether employed by the hospital, an owner of a surgery center or under some other ar- rangement—wanted to use our center. Today, eight surgeons who have their own surgery center use our center for various reasons, including insurance coverage,

Growth Same procedures New procedures Internal (share of practice)

* More cases from same physicians

* Different procedures same physicians

patient or physician convenience, patient choice, costs or capacity.

2. I revised our bylaws to allow sur- geons to be credentialed anywhere within a certain radius, as long as they had an agreement with a peer on staff at the hospital to care for their patient in an emergency. Previ- ously, they were required to be cre- dentialed at the local hospital. We also lowered the minimum required surgeries per year for procedures we routinely perform. These changes allowed me to add multiple sur- geons to our staff.

3. Early in 2011, our office received a couple of calls each month from prospective patients wanting to compare our prices with other pro- viders. These types of calls have been increasing for years and repre- sent the evolution of patients to con- sumers. In response to this, I began to provide education directly to the public about our services through targeted local advertising that in- cluded newspaper and magazine ads and radio commercials.

4. We also educated the local primary care physicians about our services and developed a process for them to refer some procedures directly to our center. Making them aware of the savings for their patients also facilitated use of our surgeons. If the primary care doctors are part of any shared service contracts, they can maximize the gains by referring their patients to lower cost services.

5. We have a good relationship with the local hospital, our general part-

External (share of market)

* New physicians same procedures * Acquisitions

* New physicians new procedures * Acquisitions

ner, and work hard to compete po- litely. Our goals are merging as we move toward value-based payment structures and our patients become consumers. We have worked hard to identify common goals, regard- less of how small, to create as many win-win opportunities as possible. This has minimized some of the turf issues that can arise with the em- ployed physicians. These actions have had significant impact on our center. We expect to aver- age more than 400 cases each month in 2016. We have been profitable for the past five years, and we still have about 50 percent capacity, so future growth will have a significant impact on our bot- tom line. We now have 15 different spe- cialties and nearly 70 surgeons on staff. It is a lot of specialties and personalities to accommodate, but it is a tribute to our staff and shared goals that we are able to accomplish this.

Our office and clinical leaders have

learned to embrace flexibility, and we continue to explore various opportunities to accommodate our doctors and expand the breadth of care we provide to include Saturday surgeries, extended hours and new specialties. We also reach out directly to self-insured employers, payers and the public. In these ways and many others, my ASC and ASCs everywhere are having a big impact on improving health care in America.

Andy Whitener is the chief executive officer and administrator of Gainesville Surgery Center in Gainesville, Georgia, an affiliate of Surgical Care Affiliates. Write him at

The advice and opinions expressed in this column are those of the author’s and do not represent official Ambulatory Surgery Center Association policy or opinion. ASC FOCUS SEPTEMBER 2016 17

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