"Successful people do what unsuccessful people are not willing to do. Don't wish it were easier; wish you were better." -- Jim Rohn

Running a surgery center draws upon a broad yet diverse set of clinical, technical, operational and organizational skills. It sounds overwhelming! And at times it probably feels that way too. The good news: you don’t necessarily need to be a master of each branch or go it alone. On the topic of success, recently-minted billionaire and Bumble founder & CEO, Whitney Wolfe Herd says, “Don’t be scared of the ‘what ifs,’ because the truth is, the only failure is not trying. Trying and having it not work out isn’t failure.”

The road to success is paved with many “failures”

Having spent many years in service of the ASC industry, I often get asked what differentiates a successful ASC from one that is struggling. I can tell you emphatically that the ASCs that flourish in any business climate are the centers committed to the concept of continuous improvement. Focusing on specific areas where your center may have deficiencies and taking steps to correct them will push you in the right direction. Hopefully, some of these suggestions will help you take stock of areas that are already working for you and others that need attention.

1. Commitment to Quality

Surgery centers must prioritize QAPI studies and physician involvement in quality initiatives. ASC leadership needs to stay current with new and potential quality reporting rules from the Centers for Medicare and Medicaid Services (CMS) or risk being penalized. Compliance with CMS standards, while considered a necessary component of quality, should be regarded as the bare minimum. Spending time on effective QAPI studies can demonstrate opportunities for improvement and can shore up infection prevention practices and improve patient outcomes. These studies can often be done using data already available in the clinical record or within the center's practice management system, thus saving time and money.

2. Financial Accountability

Like it or not, financial discipline matters. We are all aware (or should be) of metrics that make ASCs hum – A/R days, net revenue per case, cash collections – the list goes on. Ask yourself the question, “What am I not doing?” and create an accountability plan to help make time to follow through with the necessary activities. Are you testing to ensure payors are paying you the maximum amount according to your contract? Do you have a handle on coding accuracy? How long does it take to get bills out? Are you leveraging technology to automate or enforce tedious yet critical processes (see #9)? If you commit to blocking your already busy calendar to focus on financial discipline, you will see results. Remember, you can’t manage what you don’t measure.

3. Well-Organized Leadership

They say it all starts at the top. And they are right! An outstanding administrator who is well-organized, reliable, and communicative (someone who anticipates issues and isn't afraid to face them head-on) can make all the difference. Successful ASC leaders empower staff to make their views heard, even if the decision reached isn't the employees' preferred choice. Leaders lead by example and show that they empathize with everyone on the team, and they expect the team to do the same towards one another. In an ASC's intensely collaborative environment, the organization won’t function with brisk efficiency if leadership begins to view staff as resources or interchangeable assets; a workplace is healthier when everyone feels valued for their unique contribution.

4. Follow Through from Leadership

A high-performing center usually has a great administrator (see above) who also follows through with plans. If the ASC plans to recruit a new physician, the administrator follows through and works with the practice to bring new cases to the center. If the administrator has promised employees a coffee machine for the break room, he or she promptly provides one.

5. Active Case Recruitment

Speaking of new cases… physician recruitment both internal and external is a critical on-going effort that can pay dividends, literally. It is often easy to look externally for growth, but the reality is that most outpatient surgery centers have opportunity to drive growth internally. Examine your physician case volume and specialty mix to see whether your center is maximizing utilization. Cultivate relationships with the schedulers at the clinics to reinforce referrals.

6. Physicians That "Get It"

Physician involvement is one of the easiest ways to improve an ASC’s profitability. A top-notch leader can accomplish a lot without much support but it doesn’t hurt to have an internal champion. The champion can act as a bridge between the center and the board and can advocate for important initiatives that may face resistance from other physicians or board members. Ideally, a physician champion understands the business of running a surgery center, communicates well with staff, and is a respected board member.

7. Paying Attention to Benchmarks

The most successful centers consistently compare their supply and staffing costs, efficiency, and volume to industry benchmarks. ASC administrators should have a keen awareness of how their center compares to other surgery centers, both locally and nationally.

8. Close Contact with Vendor/Payor Representatives

Your partner reps should be your best friend. Outside your physician practice, these are the people you are dealing with most frequently who aren’t directly on your team. But these resources are an extension of your team and should be working with you to accomplish your goals. Maintaining good relations with your vendors can equate to better response times as well as better rates. Don’t be afraid to ask them for help.

9. Take Advantage of Technology

ASC Management Platform Guide

Technology should help you work smarter, not harder. Do you feel stuck or frustrated with what you have installed? If yes, then you are not taking advantage of software to improve both your work flow and cash flow. Do you live with manual workarounds and sticky notes? Are you frequently concerned about the accuracy of reports? Are you case costing? Are you allowing patients to check-in and pay with their phones? Are you still paper charting? If these questions resonate with you, you need to assess your software choices contributing to lower productivity at your ASC. In today’s post-pandemic digital world, you are at a disadvantage if you don't fully embrace your software.

Don't be afraid to ask for help

Continuously reviewing your center practices and committing to incremental improvement where necessary will deliver the success you seek. It will take time, so don’t get discouraged. Being open-minded to seek outside assistance in the areas where you need it isn’t something to be ashamed of. Simplify’s mission and reason for being is to accelerate productivity and success for surgery centers through a combination of technology, services, and operational understanding. And we work with hundreds of centers around the country. Change is not easy, but with the right resources, attitude and focus, you’ll be on your way. We love hearing from you. Did we miss something on this list? Feel free to email me directly with your feedback: dhowerton@simplifyasc.com

"If you really look closely, most overnight successes took a long time." -- Steve Jobs


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