Here are four challenges of managing an orthopedic surgery center and solutions for overcoming them.
1. Increasing equipment costs eating away the budget. After bringing on a new spine physician in late 2009, Midlands Orthopaedics faced the challenge of researching and buying new equipment and supplies the new physician would need in order to perform spine procedures. Belinda Rutledge, administrator, of Midlands Orthopaedics Surgery Center in Columbia, S.C., says she worked closely with the physician for several months before he officially joined the surgery center so they could jointly agree on the least expensive options without compromising on the quality of the instruments.
"We didn't want to spend a lot of money on a spine table, and it took about eight months just to find a quality used spine table because a brand new one will cost you around $160,000," she says. "We finally purchased a used spine table for half that price after working with three vendors and working out the best deal. The key is that we worked with that surgeon to develop and bring in all the equipment he would need to build his practice."
2. Inefficient OR scheduling. Block time and scheduling of ORs should be managed to allow for the most contiguous use of case times, Ross Alexander, MBA, the administrator of The Surgery Center of Fort Collins (Colo.), an ASC owned and managed by a group of surgeons, Poudre Valley Health System and Surgical Care Affiliates, says, "The more contiguous your schedule, the better." In the course of preparing for and receiving AAAHC accreditation, Mr. Alexander's surgery center did extensive benchmarking of its OR use. While the center ultimately increased OR use rate and block utilization rate, it had to balance efficiency against physicians' desire to have operating room time available when they wanted it, which Mr. Alexander concedes can be a delicate balancing act.
Measuring utilization rates is necessary to improve efficiency. "It is something we now track on a quarterly basis," Mr. Alexander says. Measurement, however, is only the starting point. The goal is maintaining and continually improving upon what has been measured.
3. Collecting payroll data. It shouldn't feel like pulling teeth when management requests reports and other information needed to evaluate performance, nor should it feel that way when the payroll function needs the hours for the pay period in order to prepare the payroll. Everyone has a job to do and each side will need to keep up its end of the bargain, says Edward J. Gorz, CPA, accounting manager for MedHQ. Procedures and tools should be developed to make information exchanges simple and pain free.
4. Incorrectly filed claims. Incorrectly filed claims and faulty coding can incur heavy costs on orthopedic practices, especially in today's rapidly changing medical environment, says Jay Nussbaum, CEO of Healthcare Watchdog, a medical billing and advocacy group with offices in New Jersey and California. If the practice keeps in-house billing, the coders should receive consistent recertification in order to remain informed on the latest coding techniques. Practices that outsource billing responsibilities need confidence in the billing company's knowledge and certification requirements. "In 2012, ICD-10 will contain some 15,000 additional codes. That’s why keeping our coders on the cutting edge of knowledge is essential to our business."
1. Increasing equipment costs eating away the budget. After bringing on a new spine physician in late 2009, Midlands Orthopaedics faced the challenge of researching and buying new equipment and supplies the new physician would need in order to perform spine procedures. Belinda Rutledge, administrator, of Midlands Orthopaedics Surgery Center in Columbia, S.C., says she worked closely with the physician for several months before he officially joined the surgery center so they could jointly agree on the least expensive options without compromising on the quality of the instruments.
"We didn't want to spend a lot of money on a spine table, and it took about eight months just to find a quality used spine table because a brand new one will cost you around $160,000," she says. "We finally purchased a used spine table for half that price after working with three vendors and working out the best deal. The key is that we worked with that surgeon to develop and bring in all the equipment he would need to build his practice."
2. Inefficient OR scheduling. Block time and scheduling of ORs should be managed to allow for the most contiguous use of case times, Ross Alexander, MBA, the administrator of The Surgery Center of Fort Collins (Colo.), an ASC owned and managed by a group of surgeons, Poudre Valley Health System and Surgical Care Affiliates, says, "The more contiguous your schedule, the better." In the course of preparing for and receiving AAAHC accreditation, Mr. Alexander's surgery center did extensive benchmarking of its OR use. While the center ultimately increased OR use rate and block utilization rate, it had to balance efficiency against physicians' desire to have operating room time available when they wanted it, which Mr. Alexander concedes can be a delicate balancing act.
Measuring utilization rates is necessary to improve efficiency. "It is something we now track on a quarterly basis," Mr. Alexander says. Measurement, however, is only the starting point. The goal is maintaining and continually improving upon what has been measured.
3. Collecting payroll data. It shouldn't feel like pulling teeth when management requests reports and other information needed to evaluate performance, nor should it feel that way when the payroll function needs the hours for the pay period in order to prepare the payroll. Everyone has a job to do and each side will need to keep up its end of the bargain, says Edward J. Gorz, CPA, accounting manager for MedHQ. Procedures and tools should be developed to make information exchanges simple and pain free.
4. Incorrectly filed claims. Incorrectly filed claims and faulty coding can incur heavy costs on orthopedic practices, especially in today's rapidly changing medical environment, says Jay Nussbaum, CEO of Healthcare Watchdog, a medical billing and advocacy group with offices in New Jersey and California. If the practice keeps in-house billing, the coders should receive consistent recertification in order to remain informed on the latest coding techniques. Practices that outsource billing responsibilities need confidence in the billing company's knowledge and certification requirements. "In 2012, ICD-10 will contain some 15,000 additional codes. That’s why keeping our coders on the cutting edge of knowledge is essential to our business."