7 Best Practices for Increasing Spine Center Profitability

Written by Kathleen Roney | March 27, 2012 | Print  |
How do you increase profits at a spine center? It might seem basic — bring in a higher volume of patients. However, reaching patients is not always easy. Additionally, there are other ways to increase a spine center's profitability such as decreasing costs and widening the specialties and services offered. Dr. John Caruso discusses 7 best practices for spine center profitabilityAccording to John Caruso, MD, a neurosurgeon with Parkway Neuroscience & Spine Institute, a private multi-specialty group in Hagerstown, Md., spine has the largest potential for growth in the outpatient and ambulatory surgery center market. By changing physician mentality, utilizing current innovations and welcoming changes in the healthcare market, spine centers can improve profitability and offer more cost-efficient, evidence-based care.

Here are seven best practices for increasing spine center profits:

1. Take ownership of healthcare dollars.
A huge "don't" on improving spine center profits is allowing physicians to ignore efficiency as a benchmark of great care. A spine center cannot have physicians that want the latest and greatest — who want to spend healthcare dollars frivolously, says Dr. Caruso. Thinking of healthcare expenses as coming out of their pockets will help curb costs. Physicians should claim ownership of patients in two ways: in the treatment they prescribe and in the cost of that treatment.

When you look at old methods for healthcare, most actions came from a physician's pen. It is still that way. Most healthcare costs come from medications or treatments physicians prescribe or recommend to "There are some physicians who are not as conscientious of costs associated with treatment, therefore, placing a high financial burden on the healthcare system," says Dr. Caruso. A surgical center makes physicians acutely aware of healthcare costs because they have ownership in the facility. This concept changes the approach to healthcare delivery and has the potential to lower costs on a grand scale. Those who claim ownership of healthcare dollars will become more informed physicians, and will improve the healthcare system, says Dr. Caruso.

2. Adopt a cost-container mentality. According to Dr. Caruso, a cost-container mentality is a key to success for any surgical or spine center. A cost-container mentality encourages physicians to consider methods for better, cost-efficient care. When nurses, medical staff and physicians open packages for OR cases or procedures and do not end up using the device, equipment or the implant, that expense goes to waste. Right in that moment, money is lost.

Each aspect of cost-containment and cost-wasting needs to be considered. Physicians who engage in that mentality are a benefit to a spine center or ASC. "Look at every single case to see how and where money is wasted. It boils down to each suture, each package," says Dr. Caruso. "If you want to increase profits by decreasing costs, you want physicians with the cost-container mindset at your spine center."

3. Make smart purchase decisions. According to Dr. Caruso, another great way to improve profits is to understand the implant market. "Do not purchase a certain implant or device because a friend or acquaintance sells it," says Dr. Caruso. "Evaluate and test the products, standardize and consolidate decisions."

Solid business decisions are made when multiple individuals have an input. The old mantra "two heads are better than one" is applicable when considering devices and implants because testing among the physicians is key. "You want the device and implant to be efficacious," says Dr. Caruso. "Aim for the best results at the best costs, and avoid redundancy."

4. Offer a great patient experience.
Receiving healthcare service, whether it is a routine procedure or a life-threatening surgery, can be anxiety inducing and stress ridden for patients. According to Dr. Caruso, spine and surgical centers should provide great customer service to patients to help alleviate the tension and unease associated with healthcare treatment.

"It is all about the patient. The entire flow [of the experience] should be pleasant," says Dr. Caruso. "The goal should be to have a patient feel as if their time in the spine center was exceptional and that medical staff was warm and personable."

According to Dr. Caruso, spine centers can excel in this area and provide a better product than hospitals. "The ASC encounter should be a pleasant and continuous experience — from when a patient makes initial contact, through their pre-operative work-up, all the way to their release," says Dr. Caruso. "Administrators should think of the little details such as where visitors can park and how families will find their loved ones." If patients enjoy their treatment as much as is possible and have their anxieties mitigated, they will return and thus drive profits.

5. Collaborate and expand services. You improve profitability of a spine center by bringing in more cases. If you widen the specialties offered, there will be more reason for more patients to visit. Spine on its own is a profitable venue and according to Dr. Caruso, there will be more shifts pushing spine into outpatient arenas as time goes on. Expanding services and introducing more specialists could capitalize on future trends. While orthopedics and neurosurgeons may compete over spine services, a spine center that expands services to include collaboration between orthopedics and neurosurgery could see increased patient volume and increased profits. "For instance, a great expansion area is neuromuscular care, which inherently combines these great subspecialties" says Dr. Caruso.

Look to other spine centers or surgery centers for answers. Dr. Caruso recommends finding examples with similar provider mixes or similar practice dynamics. What have they done, how are they increasing profits? Additionally, look for surgical centers to partner or affiliate with. A spine center can complement larger ASCs or surgery centers. According to Dr. Caruso, spine, orthopedics and neurosurgery need to embrace a collaborative approach because collegial relationships build a competitive advantage and foster cost control.  

6. Hire talented administrators and managers. In the face of current healthcare changes, spine centers need sharp administrators who can keep physicians and employees fiscally astute and who understand the bigger picture, says Dr. Caruso. As stated previously, the bigger picture is a focus on the patient and their care experience.

"There are a lot of talented individuals available but the key is to get an individual who aligns himself or herself with the business and understands the future of that business," says Dr. Caruso. "Historically physicians have wanted to make business decisions but they may not have all the information. That is why an administrator or business manager is essential."

Again, hiring a friend is not a best practice. Spine centers need someone with evidence-based experience and knowledge to run the operations and increase profits. "You have to have the right people who understand that right now is truly a unique opportunity to offer high quality care," says Dr. Caruso.

7. Engage in social media.
Before social media, health information flow came only from physicians and healthcare groups. Physicians could, to an extent, dictate disease and treatment perceptions, says Dr. Caruso. Social media offers a wide-open arena and it is giving patients a voice in the healthcare information flow — they can engage in a dialogue about their aliments with other patients, with physicians and with healthcare organizations. According to Dr. Caruso, social media will push physicians towards better outcomes and more transparency, not just for the cost but the quality of the care.

Additionally, the social media community can help patients assuage their concern about diagnoses. For instance, breast cancer is a diagnosis that has seen a lot of social media activity. Jay Harness, MD, a breast cancer surgeon in California, launched a website to answer questions from breast cancer patients. The website now features over 200 YouTube videos from physicians who answer questions to frequently asked questions as well as questions patients submit online. The website now launches content via YouTube, Facebook, Twitter and Google+. 

Although different from spine related diagnoses, physicians can still apply some of the techniques. Spine surgeons, neurosurgeons and orthopedic surgeons could maintain a social media presence and answer patient questions.

Social media is going to revolutionize how medicine is viewed in the country so spine centers need to be involved, says Dr. Caruso. Both physicians and spine centers should have social media outlets. A spine center will need to hire someone to coordinate the flow of information, says Dr. Caruso. "It is important for physicians to be a part of the information dissemination," says Dr. Caruso.

There are many strategies for improving spine center profitability. Overall, increasing patient flow and reducing costs are pillars in the best practice arena for profitability. Utilizing new technology, embracing different healthcare perspectives and hiring individuals that have the mindset and drive for success among healthcare reform are best practices that may guide a spine center to a better tomorrow.

More Articles on Improving Profits:

7 Best Practices for Driving Spine Center Profitability With Marketing
15 of the Most Profitable Orthopedic & Spine Device Companies in 2011
10 Steps to Improve ASC Profitability With Benchmarking: Thoughts From Samaritan North Surgery Center Administrator David Kelly

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