Posts tagged Ambulatory Surgery Center
Don’t self manage your ASC or hospital
Nov 11th
Don’t Go There Doctor. Lessons Learned: Don’t Self manage and Don’t Assume it’s Getting Done!
Ronald A. Duperroir, Principal Clarity
Why is your ASC or Hospital not profitable? Why is the partnership frustrated? Why are there no distributions? Nine times out of ten it is for one of two reasons, sometimes both: The founding physician (s), with good intent, attempted to manage the operations absent of the tools and time to make it successful; and/or 2) The management team, while perhaps proficient in their field, is spread too thin and no one monitors the outcomes or holds them or the staff operationally accountable – the partnership assumes if they do cases (volume) the rest will fall in line as agreed upon.
We have seen this scenario over and over again and we often wonder why some groups of physicians firmly believe they have the time and energy to design, build, operate, and manage a successful ambulatory surgery center (ASC)? Certainly we all want to have the best intentions in mind during the onset and money (management fees) are a driver in this decision. But it goes without saying that ASC management isn’t easy and seasoned administrators/managers know they have their work cut out for them from the start of conception. Be it from the start of the design process, monitoring construction costs, licensing, accreditation, selecting properly written managed care contracts, the price paid for supplies and equipment and successful daily operations. From clinical and financial operations, to customer (patient) relationship management (CRM), staffing and human resource (HR) issues, operating room management (ORM) turnover times, pick list management, equipment maintenance and procurement …. All of which can be leave a team swirling in an abyss of what priorities need to be accomplished in their never-ending list of duties and demands.
Lessons learned – Lessons Shared:
1. The best operating companies don’t do it alone regardless how tempting 6 percents looks; paying six percent to a good partner is better than a cash call
2. Choose a strong management team to partner with; physicians don’t have the time to run a successful practice, render and sustain quality surgical care, maintain strong professional referral networks, and manage a personal life. Add the responsibility of managing an ASC or Hospital and something will break somewhere in the chain
3. Choose your management team wisely; bigger is not always better – knowledge is the foundation, but also look at personality fits.
4. Examine all your contracts line by line and not just managed care contracts; don’t be afraid to say NO!
5. Don’t over build and over equipment your space; you’ll have a huge monthly debt for items you don’t need and will regret for years to come
6. You are in a manufacturing business with a mission to produce a successfully performed procedure (surgeries); in the big picture your are a healthcare manufacture. Think process, product flow, use of resources, and raw materials needed or on hand.
7. Watch the Expense line on your Profit and Loss Statements; monitor, monitor, monitor … then make continuous improvement (adjustments) – remember the feedback loop in all successful manufacturing models
8. Have the ability to know the cost of inventory on hand; if you don’t watch this closely, you will see items stacking up in some of the most bizarre places
9. Understand what a procedure cost from beginning to end; how much does it cost to produce a procedure, what’s your return?
10. Watch those contractual adjustments and daily cash operations; who has authority to adjust, at what amount and when?
11. Understand your accounts receivable (AR); what does it really mean? Do you match your AR with denials, short pays, etc..
12. Ensure there is a process for insurance verification, authorization and collection of deductibles and copayments.
13. Keep your chargemaster current and accurate; this is so very important and so very misunderstood
14. Choose your partners wisely; don’t spread yourself too thin with multiple specialties with a depth of one
15. Choose the right clinical leadership and team; if the clinical environment goes south a chain of negative affects will occur
16. Keep an eye out on working capital; if it is not there challenges begin and evidentially snow ball into operations and the pockets of others
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Clinical Operations and Management
Nov 11th
Healthcare Management Services
Clinical Operations and Management
Clarity Health manages all aspects of your Hospital and Ambulatory Surgery Center. Whether you are a hospital, physician/hospital joint venture or physician owned surgery center, the Clarity Health leadership team will delivers and executes proven success strategies gained via the experience of managing hospitals, single and multi specialty ASCs throughout the country. Services Include:
• Insures compliance with system efficiencies, policies and procedures
• Assists ongoing hiring, education, and training
• Negotiating and reviewing third party payor contracting annually
• Participating on Governing Board to ensure fiscally responsible decision making
• Assisting with implementation of a comprehensive budget and marketing plan
• Providing risk management and human resource support
• Implementing and monitoring monthly/quarterly financial and statistical reports
• Preparing annual operating agreements and capital budgets
• Implementing and managing key indicators
• Monitoring clinical, financial and operations benchmarking against national standards
• Maximizing scheduling efficiencies
• Establishing and monitoring surgeon utilization reports
• Maintaining clinical and operational compliance
• Enhancing revenues and supporting future center development
• Designing inventory control mechanisms
• Purchasing capital equipment while maintaining a focus on controlling capital expenses
• Monitoring patient satisfaction reports
• Providing updated information on legislative and regulatory issues
• Maintaining accreditation requirements and supporting agency surveys
What Makes Clarity Different?
• Offering equity and non equity models
• Offering participation in real estate, operations, and management
• Providing full turnkey development with no outsourcing for equipment procurement or managed care contracting. Our services take you from financial development through State Licensure and Medicare certification.
• Offering Central Business Office: A centralized billing office providing you with streamlined billing and collections, ability to minimize administrative overhead, and allocate every square foot of your medical space to revenue producing ventures. This is a separate service agreement.
• Extending flexibility and innovation to individualize our services to meet the needs of your group and the community in which you practice.
• Providing Capital expenditures and supply discounts below standard Group Purchasing Organization (GPO) pricing to both the facility and individual physician offices.
• Offering savings on liability, property and casualty insurance.
• Assisting with JCAHO, AAAHC and Centers of Excellence preparation.
• Providing Net Learning curriculum for all clinical staff
• Providing strategic growth planning for your ASC and physician practices.
• Implementing electronic file management systems.
• Delivering success in revitalizing existing centers.
• IT specialists with national ASC/MOB experience priced below market rates.
• Access to other physicians through specialty diversified networks.
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