In the ever-evolving landscape of healthcare, Ambulatory Surgery Centers (ASCs) face unique challenges that can significantly impact their profitability. As the industry grapples with rising practice costs and increased consolidation, independent ASCs must navigate several pitfalls to remain viable. During the 21st Annual Spine, Orthopedic & Pain Management-Driven ASC + The Future of Spine Conference, leaders gathered to discuss these obstacles. Here are five critical factors affecting the future profitability of independent ASCs, drawn from the insights shared at the panel:
1. Sticking with Outdated Staffing Strategies
One of the most pressing issues for ASCs is recruiting and retaining skilled staff. Unlike hospitals, ASCs often struggle to compete with higher salaries and benefits offered by larger institutions. Jene’ Becerra, Director of Nursing at Crown Point Surgical Suites, highlighted the staffing challenges faced by her team.
“It’s hard to find staff that have been trained in surgery,” Becerra explained. “Nursing schools don’t often focus on surgical training, making experienced circulators and techs hard to find. We frequently share staff with other centers to maintain efficiency, but training new hires can take months, impacting our operations.”
To address this, ASCs should consider innovative recruitment strategies, competitive compensation packages, and partnerships with educational institutions to develop a pipeline of skilled professionals.
2. Allowing Surgeons to Have Idle Block Time
Efficiency is crucial for the profitability of independent ASCs, given their smaller scale of operations. Curtis Mayse, CEO of Steamboat Orthopaedic and Spine Institute, emphasized the importance of optimal block time utilization.
“To contain costs, it’s essential to have a structured schedule, such as dedicated spine or pain days,” Mayse stated. “Idle block time is costly, and having a flexible staff that can adapt to various roles is challenging but necessary for maintaining efficiency.”
Implementing advanced scheduling software and real-time analytics can help ASCs optimize block time, ensuring that every minute in the operating room is utilized effectively.
3. Selecting the Wrong Implant Vendor and Allowing Reps to Upsell in the OR
Rising implant costs are another significant concern for ASCs. Curtis Mayse noted the impact of these costs on overall profitability.
“Implant costs are increasing at double-digit rates,” Mayse said. Choosing the right vendor and consolidating purchases is crucial, but even then, costs often outpace reimbursement rates.”
To mitigate this, ASCs should negotiate favorable contracts with vendors, establish strict guidelines for implant selection, and monitor usage closely to avoid unnecessary upselling in the OR.
4. Performing Unprofitable Cases Where Costs Exceed Reimbursement
With more procedures shifting to the ASC setting, leaders must carefully evaluate which service lines to add. Mayse pointed out the challenges of managing complex cases that might not be cost-effective.
“We’re bringing as much volume as possible, but some spine cases, like three-level fusions, require careful pricing analysis because reimbursement doesn’t always cover costs,” Mayse explained. “Understanding the margin is essential.”
Becerra echoed this sentiment, adding, “Sometimes the hardest decision is determining which cases should be performed at a hospital versus an ASC. Surgeons might prefer the ASC for convenience, but it may not be cost-effective.”
ASCs should develop a robust case selection process, guided by comprehensive financial analyses, to ensure they are performing profitable procedures.
5. Not Challenging Prior Authorization Denials
Prior authorizations are a significant hurdle for independent ASCs, often leading to delays and denials in reimbursement. According to the Medical Group Management Association’s 2023 “Regulatory Burden Report,” nearly 97% of providers experience delays due to prior authorization requirements.
“We constantly battle with medical necessity reviews and prior authorization paperwork,” Dr. Sev Hrywnak said. “It’s a significant burden, especially on the billing side.”
To combat this, ASCs need a dedicated team to handle prior authorizations, equipped with the necessary tools and training to efficiently manage and challenge denials.
Conclusion: Embrace Solutions for a Brighter Future
Independent ASCs face numerous challenges that can impact their profitability. However, by addressing outdated staffing strategies, optimizing block time, selecting the right implant vendors, carefully choosing cases, and effectively managing prior authorizations, ASCs can navigate these obstacles and thrive. Embracing innovative solutions, like HUB Healthcare, can streamline operations, improve efficiency, and ultimately enhance profitability.
How HUB Healthcare Can Help
HUB Healthcare offers a comprehensive solution designed to enhance communication in healthcare, streamline care coordination, and improve overall workflow efficiency. Our platform includes features such as medical case management software, healthcare document management, and healthcare analytics to ensure that all aspects of patient care are optimized. By leveraging HUB Healthcare’s robust tools, organizations can reduce workflow bottlenecks, automate repetitive tasks, and facilitate better collaboration among healthcare providers. This not only improves work quality but also enhances patient outcomes, making HUB Healthcare an essential partner in achieving healthcare excellence.
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