Looking Ahead Ten biggest challenges and opportunities facing ASCs in 2015 BY TERRY BOHLKE, CASC

To quote Albert Einstein, “Out of clutter, find sim- plicity. From discord, find harmony. In the middle of difficulty lies oppor-

tunity.” And as it is with physics, so it is with health care. The most effec- tive ASC leader has the ability to over- come challenges, seize opportunities and execute the right strategies for his or her organization. Following are 10 challenges most of us will face this year and suggestions on how to tri- umph over them.

1 Consolidation of the Health Care Industry

Spurred by health care reform and the advent of accountable care organiza- tions (ACO), the health care industry is experiencing unprecedented con- solidation. Large health systems and “super group” physician practices are acquiring independent doctors at an alarming rate. Older physicians are retiring and younger physicians are more frequently seeking employment rather than hanging their own shingle. This trend is concerning for indepen- dent ASCs, as the larger systems can control the referrals for procedures, especially surgeries. This can have a devastating impact on an ASC that is not a part of this new referral network.

Opportunity: ACOs are typically suc- cessful only if they can reduce cost. ASCs are the most cost-efficient option for outpatient surgery and should be an important part of any ACO. Whereas a hospital-ASC joint venture might not have been attractive in the past, an ASC might want to reconsider its stra- tegic partnerships given the consoli- dation that might have occurred in its community. It is a good time to nur- ture your relationships with your local


health system and look for ways you can work together.

And there are still many physicians

who wish to remain independent. Pay- ing particular attention to these doctors can help solidify your referral base.

Heightened awareness of health care costs has put tremendous pressure on managed care companies to con- tain costs and minimize increases in health insurance premiums. If you have renewed a managed care contract lately, you have likely experienced the harden- ing of network contractors and the diffi- culty in obtaining increases. You might be finding that negotiations are taking longer as network contractors have to seek higher approval for certain levels of increase, and it is to the health plan’s

2 Managed Care

advantage to delay your increase past your contract’s expiration.

Opportunity: Discuss expectations with health plans early in the negotiation pro- cess. A “meeting of the minds” with your network contractor can help you understand each other’s needs and create a starting point that is closer to a mutu- ally acceptable end point. If you ask for a double-digit increase with the hopes of getting a single-digit increase, you might be setting yourself up for an unnecessary delay, as the network contractor might look at your proposal as a “non-starter” and give it a low priority. Alternatively, if they know your contract is up for renewal and your request is reasonable, they are more likely to get it done. Most managed care companies are looking for innovative ideas to reduce costs. ASCs are still the most efficient

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