Fall 2017


• Emergence of the Mega Group Practice and Role of ASCs ...............2

• ASC Development Pros Share Secrets to Success .............................2

• Working for You: How ASCA Helps ASC Physicians ....................................3

• Study: ASC Colonoscopy Patients Prefer Propofol ...................................3

• Patient Selection in the ASC: An Ever-Changing Process ....................4

• Study: Faster Discharge of Medicare TKA Patients Safe ...........4

Message from the CEO

On November 1, the Centers for Medicare & Medicaid Services (CMS) released its final 2018 ASC payment rule.

Key takeaways include: • on average, ASC payment rates will increase by 1.2 percent in 2018;

• total knee arthroplasty was removed from the inpatient-only list for 2018 (but is not yet approved for ASC reimbursement);

• CMS is delaying mandatory implementation of the Consumer Assessment of Healthcare Providers and Systems Outpatient and Ambulatory Surgery Survey; and

• CMS removed three quality measures for the CY 2019 payment determination and subsequent years.

As I write this message, ASCA is conducting a comprehensive review of the final payment rule and working to update our Medicare rate calculator.

We will host a webinar on December 5 to discuss the final rule. Learn more and register today by visiting

Bill Prentice Chief Executive Officer

Filling the Schedule: Getting Non-Owners into Your ASC

Four physician leaders share ideas for encouraging non-owners to bring cases to their ASCs.

Don Bartnick, Chief Executive Officer of Annapolis Surgery Center in Annapolis, Maryland, and Principal in Donveritas Consulting: Surgical scheduling for peak performance is an extremely challenging task requiring strategy, organization, flexibility, intelligence data, insight, persuasion and common sense. At the ASC, we strive to minimize the time a surgeon needs to be at the center. We implemented a mobile phone-based dictation system that is extremely surgeon-friendly. We offer block time to our non-owner surgeons to help their offices get patients posted easily. We even hired a valued scrub tech to join our staff to perform cases part-time for a specific surgeon.

We also employ a posting secretary with extraordinary awareness of the schedule. She monitors the postings into block time, identifies potential slack time and calls non-owner surgeons’ surgical coordinators to encourage direction of cases to our center. Her observation of and relationships with the surgical coordinators result in the addition of cases that may have gone elsewhere.

Thomas Feldman, Chief Executive Officer of the Center for Health, Ambulatory Surgery Center in Peoria, Illinois: I try to target non-owners with different information based on their needs. I speak to the surgeons about specific equipment needs and preferences with regard to staff numbers and skill set.

Oftentimes it’s about getting a single case in before they start their day elsewhere. I work to shoehorn them in at the top of the day with that case and trust that a good outcome and patient experience will get them interested in more time. We end up being able to secure a few cases (perhaps later in the

day) presented in a fashion that works for them within their practice pattern.

Scott Glaser, MD, Co-Founder and President of the Pain Specialists of Greater Chicago in Illinois: When you get right down to it, we’re in a service industry. The first time that non-owner comes to your ASC, you need your key personnel greeting them at the door with open arms. Then you need a manager or lead nurse who serves as the face of your ASC to that physician. This is the individual who the physician feels most comfortable with and knows he or she can reach out to if there are any issues.

When the physician starts doing cases, it’s a matter of blocking and tackling. Make sure staff is on time and no mistakes are made. If you can keep that up, everything will usually flow naturally. But that first impression really is a huge part of whether you succeed.

Dianne (Wallace) Appleby, RN, Executive Director of Menomonee Falls Ambulatory Surgery Center in Menomonee Falls, Wisconsin: Getting non-physician owners to use open time on the surgery schedule is challenging. For the most part, our owner physicians have reserved blocks of time on our schedule. These reserved blocks “release” several days ahead of time, providing an opportunity for other doctors to take those open slots.

Non-owner physicians are given the option to reserve time as well. For those who choose not to, our schedulers contact their offices periodically to inform them of available schedule time, particularly as blocks release and “prime” time becomes available.

We work hard to become our non- owner physicians’ facility of choice. We work closely with them to identify their supply and equipment needs and try to pair them up with staff who are tuned into their unique surgical needs.


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