At the 10th Annual Orthopedic, Spine and Pain Management-Review ASC Conference in Chicago, Stephen Rosenbaum, CEO, and Robin Fowler, MD, chairman and medical director of Interventional Spine & Pain Management, gave a presentation titled “Keys to Successfully Establishing and Growing a Premier Pain Center.” Here, Mr. Rosenbaum and Dr. Fowler discussed the six keys to success at their pain centers.
1. Physicians should have the right attitude. Physicians who are owners and performing cases at ASCs should have the right attitude for success. “These need to be docs that get it; they can’t just clock in and out,” said Dr. Fowler. “There is the idea that physicians aren’t good at business, but they can be great businessmen if they get it. They have to be involved and drive their case volume and profits.”
Dr. Fowler said older physicians should act as mentors to younger physicians and younger physicians should bring new energy into the practice, which will spread across the practice. “When a surgery center has a range of ages, it is more effective,” he said. The patient should also have a good work ethic, have skin in the game and be high achievers.
2. Have strong clinical leaders. Strong clinical leaders are essential to drive the practice. “Don’t be thrifty with their salaries or resources,” said Dr. Fowler. “You want a partnership with led administrators and clinical staff.”
To harmonize the center, Dr. Fowler suggests rotating he front office staff and the clinical operating room staff so they can appreciate the work their colleagues do every day. Additionally, staff should be awarded for their contributions and successes. “We put incentives in place and donate to charities that are important to the staff,” said Dr. Fowler. “This really helps everyone from work ethics to their loyalty. Reward structures include performance bonuses for everyone from the orderlies through the receptionist through our head staff and administrative teams.”
The surgery center also caters in lunch often for the staff. “We believe that our staff are fundamental to our success,” said Mr. Rosenbaum. “You want loyal employees and we want to be loyal to our employees. We want people to know we respect them and we want to bring them along and mentor them. The people who work in the centers are no less incented to make a living and come to work every day, the same as the physicians. Everyone is growing together.”
3. Don’t accept every payor contract offered to you. When establishing your practice, Dr. Fowler advises against accepting every contract sent your way in attempt to rush in-network. “We were out-of-network with a payor for years, and their numbers climbed so when it came time to readdress the issue, we came to a good agreement that resulted in a greater revenue stream for us,” said Dr. Fowler. “We are looking for good contracts we can appreciate long term.”
Accepting low contracted rate could spell disaster for the surgery center. “I don’t think it’s a good idea for pain physicians to go in-network just to bring in more business,” said Dr. Fowler. “If you want to provide quality healthcare, you need to be financially successful there.”
4. Let vendors compete for contracts. Vendor contracts should be considered every two years, and the vendors should compete for your business. “It doesn’t hurt to be selective, even when you first begin,” said Dr. Fowler. “As a pain physician and surgery center owner, the insurance company is trying to pay us less and vendors want us to pay more, so let vendors compete.”
5. Don’t cut corners with legal representation. Work with a good healthcare law firm to establish a strong practice. “You need to use a firm that has a good reputation but also someone who has accountability to you,” said Dr. Fowler. “Have long term, binding representation there and talk to all the physicians about it. I don’t want our legal side to be something the other physicians in the group don’t know about. The more involved all physicians are, the better the contracts will turn out.”
He said physicians often want to feel included, which turns them into businessmen. “Physicians can learn about reimbursement and protocols, which makes them more compliant,” said Dr. Folwer. “At board meetings, we have time for education so they can see what is involved in our contracts and we discuss what is coming up.”
6. Build the right governance. The physicians should be in control of their environment and have input on decisions made about the center. “At our board meetings, we really ramp up our information,” said Mr. Rosenbaum. “We show average charge and collection for procedures, payor mix and monthly volume. We let the physicians compare their numbers at the meeting and if they see someone else is doing better than them, they work hard to grow their business because they are competitive with their peers.”
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Dr. Fowler said older physicians should act as mentors to younger physicians and younger physicians should bring new energy into the practice, which will spread across the practice. “When a surgery center has a range of ages, it is more effective,” he said. The patient should also have a good work ethic, have skin in the game and be high achievers.
2. Have strong clinical leaders. Strong clinical leaders are essential to drive the practice. “Don’t be thrifty with their salaries or resources,” said Dr. Fowler. “You want a partnership with led administrators and clinical staff.”
To harmonize the center, Dr. Fowler suggests rotating he front office staff and the clinical operating room staff so they can appreciate the work their colleagues do every day. Additionally, staff should be awarded for their contributions and successes. “We put incentives in place and donate to charities that are important to the staff,” said Dr. Fowler. “This really helps everyone from work ethics to their loyalty. Reward structures include performance bonuses for everyone from the orderlies through the receptionist through our head staff and administrative teams.”
The surgery center also caters in lunch often for the staff. “We believe that our staff are fundamental to our success,” said Mr. Rosenbaum. “You want loyal employees and we want to be loyal to our employees. We want people to know we respect them and we want to bring them along and mentor them. The people who work in the centers are no less incented to make a living and come to work every day, the same as the physicians. Everyone is growing together.”
3. Don’t accept every payor contract offered to you. When establishing your practice, Dr. Fowler advises against accepting every contract sent your way in attempt to rush in-network. “We were out-of-network with a payor for years, and their numbers climbed so when it came time to readdress the issue, we came to a good agreement that resulted in a greater revenue stream for us,” said Dr. Fowler. “We are looking for good contracts we can appreciate long term.”
Accepting low contracted rate could spell disaster for the surgery center. “I don’t think it’s a good idea for pain physicians to go in-network just to bring in more business,” said Dr. Fowler. “If you want to provide quality healthcare, you need to be financially successful there.”
4. Let vendors compete for contracts. Vendor contracts should be considered every two years, and the vendors should compete for your business. “It doesn’t hurt to be selective, even when you first begin,” said Dr. Fowler. “As a pain physician and surgery center owner, the insurance company is trying to pay us less and vendors want us to pay more, so let vendors compete.”
5. Don’t cut corners with legal representation. Work with a good healthcare law firm to establish a strong practice. “You need to use a firm that has a good reputation but also someone who has accountability to you,” said Dr. Fowler. “Have long term, binding representation there and talk to all the physicians about it. I don’t want our legal side to be something the other physicians in the group don’t know about. The more involved all physicians are, the better the contracts will turn out.”
He said physicians often want to feel included, which turns them into businessmen. “Physicians can learn about reimbursement and protocols, which makes them more compliant,” said Dr. Folwer. “At board meetings, we have time for education so they can see what is involved in our contracts and we discuss what is coming up.”
6. Build the right governance. The physicians should be in control of their environment and have input on decisions made about the center. “At our board meetings, we really ramp up our information,” said Mr. Rosenbaum. “We show average charge and collection for procedures, payor mix and monthly volume. We let the physicians compare their numbers at the meeting and if they see someone else is doing better than them, they work hard to grow their business because they are competitive with their peers.”
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