Dan Beuerlein, regional vice president of operations at Symbion Healthcare, discusses some of the benefits and challenges of adding outpatient spine surgery to your ambulatory surgery center.
Benefits
1. Position your ASC as a market leader. Since spine surgery is relatively new in the outpatient setting, marketing these services gives the ASC a strategic advantage in the community. "Depending on the market you're in, if you're looking to be on the forefront of technology as it develops, advertising your outpatient spine capabilities can help solidify your reputation as a market leader," says Mr. Beuerlein. Sometimes, people might be weary of undergoing spine surgery at an ASC, so listing complimentary specialties, such as pain management and orthopedic surgery, in the marketing literature earns credibility among potential patients. "You are showing the ASC is capable of handing this complex specialty," says Mr. Beuerlein.
2. Increased access to patient volumes. Adding another specialty to the mix means the surgery center can provide services to a wider range of patients. Volume and referrals are driven by the surgeon, but an increased number of patients in other specialties could be a by-product of adding the subspecialty. For example, the addition of a spine practice to the ASC will often increase the referrals among complimentary groups in your center like Pain Management and Orthopedics.
3. Higher revenues for your OR time. One of the key advantages to adding spine surgery is that it has the potential to increase ASC revenue. Spine procedures are reimbursed at higher rates than many other procedures, which can have a substantial impact on the center's profitability. "In most facilities, on average, a spine case can bring anywhere from 3-5 times the revenue generated by general surgery and orthopedic cases," says Mr. Beuerlein. "If you maximize available OR time, adding spine cases sometimes can be as profitable as adding five other cases."
Challenges
4. Insurance contracts. Make sure your existing insurance contracts are solid and structured to encompass spine surgery cases because of the high cost of implants associated with the procedures, says Mr. Beuerlein. "You've got the potential for more risk with spine," he says. "It's not uncommon that a procedure might be preapproved by the insurance carrier, so you buy the equipment and do the surgery, and then the payor decides to deny that claim."
5. Strong managed care resources. If you're going to add spine, you need strong resources in managed care for contract negotiations and claims processing. "You must make sure you have an educated managed care department where the individuals know the contracts backward and forward," says Mr. Beuerlein. "You also need to have strong legal advice because sometimes you will have to fight for reimbursement." Surgery centers often struggle with receiving compensation from payors, claims adjusters and the workers' compensation board for the services rendered. When these problems arise, having a dedicated team to fight for compensation is necessary to the success of spine in the ASC.
Learn more about Symbion Healthcare.
Benefits
1. Position your ASC as a market leader. Since spine surgery is relatively new in the outpatient setting, marketing these services gives the ASC a strategic advantage in the community. "Depending on the market you're in, if you're looking to be on the forefront of technology as it develops, advertising your outpatient spine capabilities can help solidify your reputation as a market leader," says Mr. Beuerlein. Sometimes, people might be weary of undergoing spine surgery at an ASC, so listing complimentary specialties, such as pain management and orthopedic surgery, in the marketing literature earns credibility among potential patients. "You are showing the ASC is capable of handing this complex specialty," says Mr. Beuerlein.
2. Increased access to patient volumes. Adding another specialty to the mix means the surgery center can provide services to a wider range of patients. Volume and referrals are driven by the surgeon, but an increased number of patients in other specialties could be a by-product of adding the subspecialty. For example, the addition of a spine practice to the ASC will often increase the referrals among complimentary groups in your center like Pain Management and Orthopedics.
3. Higher revenues for your OR time. One of the key advantages to adding spine surgery is that it has the potential to increase ASC revenue. Spine procedures are reimbursed at higher rates than many other procedures, which can have a substantial impact on the center's profitability. "In most facilities, on average, a spine case can bring anywhere from 3-5 times the revenue generated by general surgery and orthopedic cases," says Mr. Beuerlein. "If you maximize available OR time, adding spine cases sometimes can be as profitable as adding five other cases."
Challenges
4. Insurance contracts. Make sure your existing insurance contracts are solid and structured to encompass spine surgery cases because of the high cost of implants associated with the procedures, says Mr. Beuerlein. "You've got the potential for more risk with spine," he says. "It's not uncommon that a procedure might be preapproved by the insurance carrier, so you buy the equipment and do the surgery, and then the payor decides to deny that claim."
5. Strong managed care resources. If you're going to add spine, you need strong resources in managed care for contract negotiations and claims processing. "You must make sure you have an educated managed care department where the individuals know the contracts backward and forward," says Mr. Beuerlein. "You also need to have strong legal advice because sometimes you will have to fight for reimbursement." Surgery centers often struggle with receiving compensation from payors, claims adjusters and the workers' compensation board for the services rendered. When these problems arise, having a dedicated team to fight for compensation is necessary to the success of spine in the ASC.
Learn more about Symbion Healthcare.