5/23/2013

1

Evergreen Surgery Center, LLC

ASC > HOPD Transition

Presented by: Neil Johnson, RN, COO Kenneth Faw, MD, Director

(Bersen, 2008)

• 1983 Physician Owned ASC - 4 OR

History

5/23/2013

2

• 1983 Physician Owned ASC - 4 OR

• 1986 Hospital Owned ASC - 4 OR

History

• 1983 Physician Owned ASC - 4 OR

• 1986 Hospital Owned ASC - 4 OR

• 2003 Hospital/Physician JV - 51/49, 9 OR

History

Floor Plan

5/23/2013

3

• 1983 Physician Owned ASC - 4 OR

• 1986 Hospital Owned ASC - 4 OR

• 2003 Hospital/Physician JV - 51/49, 9 OR

• 2012 Hospital Owned HOPD

History

• Large Facility – 9 ORs

Drivers for Change

• Large Facility – 9 ORs

• Staff- Through Hospital HR

Drivers for Change

5/23/2013

4

• Large Facility – 9 ORs

• Staff- Through Hospital HR

• Dual Loyalties- Orthopedics/Plastics

Drivers for Change

• Large Facility – 9 ORs

• Staff- Through Hospital HR

• Dual Loyalties- Orthopedics/Plastics

• Competing ASCs

Drivers for Change

• Large Facility – 9 ORs

• Staff- Through Hospital HR

• Dual Loyalties- Orthopedics/Plastics

• Competing ASCs

• Passive Investors (Anesthesia, Plastics)

Drivers for Change

5/23/2013

5

• Large Facility – 9 ORs

• Staff- Through Hospital HR

• Dual Loyalties- Orthopedics/Plastics

• Competing ASCs

• Passive Investors (Anesthesia, Plastics)

• Aging Owner Physicians

Drivers for Change

• Large Facility – 9 ORs

• Staff- Through Hospital HR

• Dual Loyalties- Orthopedics/Plastics

• Competing ASCs

• Passive Investors (Anesthesia, Plastics)

• Aging Owner Physicians

• Few Young Physicians with Investment Capital

Drivers for Change

• Large Facility – 9 ORs

• Staff- Through Hospital HR

• Dual Loyalties- Orthopedics/Plastics

• Competing ASCs

• Passive Investors (Anesthesia, Plastics)

• Aging Owner Physicians

• Few Young Physicians with Investment Capital

• Increasing Physician Employment

Drivers for Change

5/23/2013

6

• Large Facility – 9 ORs

• Staff- Through Hospital HR

• Dual Loyalties- Orthopedics/Plastics

• Competing ASCs

• Passive Investors (Anesthesia, Plastics)

• Aging Owner Physicians

• Few Young Physicians with Investment Capital

• Increasing Physician Employment

• OR demand at the hospital

Drivers for Change

• Orthopedics

A few service line stories:

• Orthopedics

• Bariatrics

A few service line stories:

5/23/2013

7

• Orthopedics

• Bariatrics

• Ophthalmology

A few service line stories:

• Orthopedics

• Bariatrics

• Ophthalmology

• Urology

A few service line stories:

• Orthopedics

• Bariatrics

• Ophthalmology

• Urology

• Pain

A few service line stories:

5/23/2013

8

• Orthopedics

• Bariatrics

• Ophthalmology

• Urology

• Pain

• Plastics

A few service line stories:

• Orthopedics

• Bariatrics

• Ophthalmology

• Urology

• Pain

• Plastics

• Gynecology

A few service line stories:

A Comparison

ENT 25%

General 8%

Gynecology 27%

Orthopedics 25%

Pain 3%

Plastics 2%

Podiatry 8%

Urology 2%

2002 Specialty Report

ENT 7%

General* 3%

Gynecology 10%

Hand 3%

Ophthalmology 17%

Orthopedics 12%

Pain 41%

Plastics 2%

Podiatry 5%

All Others 0%

1st Half of 2012

5/23/2013

9

0

10

20

30

40

50

60

70

80

2004 2005 2006 2007 2008 2009 2010 2011 2012

FTE's Per Case

5/23/2013

10

• Sale Price

Transition Issues

• Sale Price

• Union vs. Non-Union Staff

Transition Issues

• Sale Price

• Union vs. Non-Union Staff

• ASC Culture

Transition Issues

5/23/2013

11

• Sale Price

• Union vs. Non-Union Staff

• ASC Culture

• Certificate of Need

Transition Issues

• Sale Price

• Union vs. Non-Union Staff

• ASC Culture

• Certificate of Need

• Contracts

Transition Issues

• Sale Price

• Union vs. Non-Union Staff

• ASC Culture

• Certificate of Need

• Contracts

• Billing

Transition Issues

5/23/2013

12

• Sale Price

• Union vs. Non-Union Staff

• ASC Culture

• Certificate of Need

• Contracts

• Billing

• Pricing

Transition Issues

• Sale Price

• Union vs. Non-Union Staff

• ASC Culture

• Certificate of Need

• Contracts

• Billing

• Pricing

• Insurance Migration to High Deductible

Transition Issues

• Point B Management Consulting

Transition Workgroups

5/23/2013

13

• Point B Management Consulting

• Finance and Revenue

• Billing System and Revenue Cycle

• Pricing and Reimbursement

• Information Technology

• Materials Management/Purchasing

• Clinical Operations

• Regulatory/Compliance/Legal/Credentialing

• Communications

• Surgical Services Leadership

Transition Workgroups

• Deductibles, Out-of-Pocket Costs

• Triggered Joint Commission and Dept. of Health Reviews (even though had just completed surveys)

• IT Considerations

Final Thoughts

Open Discussion

5/23/2013

14

Bersen, J. (2008, July 31). [Web log message]. Retrieved from http://joshbersin.com/2008/07/31/make-learning-part-of-your-business-strategy/

References