Written by Debbie Weinstein Tuesday, 19 October 2010 00:00

Today’s healthcare environment is unpredictable. Costs are rising, reimbursements are declining, and payers have decided that ASC’s are the devil incarnate. So, what can an ASC do to stay competitive, and profitable?    

Here are some tips for managing costs:

Inventory Management – Whether your center has a materials manager or various staff responsible for the ordering of supplies, there are several techniques that they can utilize to keep costs down in their center. First, is that it is good to have relationships with multiple vendors. This is helpful when one vendor is not able to fulfill an order when needed at the center. Second, don’t be afraid to negotiate special pricing or payment terms. In this economy, it is easy to play “let’s make a deal”.  Finally, taking a physical inventory count several times a year is an important task that every center should undertake. This will not only bring to your attention items that have become expired, but it will make you aware of items that are not used on a regular basis or that you do not use at all, that you can return to your vendor for an item that you use on a more frequent basis.

Staff salaries – Next to inventory, the second highest cost in your center is payroll. Managing this aspect of the ASC is challenging at best, but it is worth consideration. First, try to stagger your nursing staff so that you have an early shift and a late shift. This should alleviate any overtime that staff may incur. Also, make sure that you are staffing according to the centers case load. If you have part time staff, bring them in to cover short shifts, four hour minimums are the standard on light case days. 

Scheduling – Scheduling cases in an ASC efficiently is often times a difficult task. Physician offices don’t always book their cases weeks in advance or days in advance. Sometimes, they will send a booking sheet to the center the night before a case, leaving the receptionist and the clinical staff to scramble around at the 11th hour to insure that they have the equipment, implants, supplies, and anesthesiologist available for the case. In addition, they need to verify patient insurance benefits. The other inefficient scheduling dilemma is dealing with gaps in the schedule. This may require utilizing one operating room full time instead of two part-time, and condensing the schedule so that there are little time gaps between procedures. This may take some coercion on the part of the board, however, inefficiencies mean less profitability, so they may agree to a change in scheduling tactics.

Whether you are the administrator or the director of nursing, staying intimately involved with the financial and operational aspect of your center is crucial to be able to manage in this environment. Understanding your costs in evaluating any contracts you may have with payors now or in the future is the key to the negotiation process. We will address the idea of case cost analysis in my next blog.