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2018 ASC Industry Trends Archives - Pinnacle III

Oct 16
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ASC Business Strategy: Peering Through a Looking Glass into Your Organization

ASC Business Strategy: Peering Through a Looking Glass into Your Organization

By ASC Management, Leadership No Comments

I have often told groups who are interested in developing a surgery center, or who already have one, that seeking “professional help” to assist them with ASC business strategy is a smart move. Outside consultation can provide an organization with a fresh, yet experienced, point of view. This year I decided to practice what I preach.

Over the last year, Pinnacle III has been diving deep internally to refine our systems, processes, and strategy. After several months of self-assessment, we decided to seek outside professional help to realize the true benefits of our strategic planning process. We selected a consultation firm that specializes in small businesses experiencing growth. Their task? Provide us with operational, organizational, and cultural input and guidance throughout that growth process. The process of internal review and change has been challenging and rewarding.

I now double down on my original stance – organizations, especially developing or growing businesses such as ASCs, should seek outside professional consultation to assist in building and implementing business strategy.

Taking the Steps

To help you visualize how this process might work in your organization, I’ve listed the steps I took when seeking outside professional consultation.

  • First, we made an initial determination of the strategic initiatives we wanted to accomplish. This gave us an idea of the organizational goals we might need outside help to accomplish.
  • Next, we chose a strategic consulting firm. To obtain a list of the consultants serving businesses like our own, I reached out to people I respected in the business community for recommendations. I discussed with my contacts what I was trying to accomplish. After combining input from trusted colleagues and business associates with my own research, I narrowed my scope to three potential consultants.
  • Third, I interviewed each firm. The first firm operated under proven, academic-based structure, with a great deal of experience working with institutional organizations. The second firm was experienced in strategy, but typically worked with companies larger than Pinnacle III. And the third firm, the one I ultimately chose, was a group run by an individual who had started and run several companies and whose experience was geared more towards mid-sized companies. I felt this was the best fit for us.

What I Learned

Since making the decision to go down this road and choosing someone to work with, I have learned several things.

  • You must be ready for transparency. Unless you are willing to pull back the curtain on how your business is run and managed, don’t take this step. We opened our books and gave our consultant access to our management team, as well as other key members of our organization. We made it clear to our entire team no topic was off the table and all comments would be confidential.
  • You must be ready to put your ego aside. If you can’t “handle the truth” (remember Jack Nicholson in “A Few Good Men”), don’t embark on this journey. Each management team member – especially my partner, Rick DeHart and I – were provided feedback that resulted in small to moderate ego bruising. We were reminded the feedback received, both from the consultant and the team, was meant to improve our organization and meet our established goals.
  • Getting a diagnosis is worthless unless your organization is committed to the treatment plan. We went into this exercise committed to addressing the problem areas and taking the time to make changes to ensure our continued success. If you, as the leader, or members of your team are not committed to doing what is necessary to achieve the goals initially identified when the process began, you will only end up wasting valuable time and money.
  • Keep the fire burning. We are experiencing what we expected to experience. None of the initiatives are a quick fix – if they were, we would probably already have implemented them. Instead, as an organization, we have had to stay committed to our original goals and the long-term benefits we will receive from this initiative. It is up to each leader in our organization to keep us moving forward to reach our goal.

Regardless of how your business measures success, strategic initiatives need to be in place to accomplish your organization’s goals. Evaluating your organization’s current business strategy and environment relative to where you want to be is the first step toward creating those strategic initiatives. Then, when appropriate, business leaders should have the courage to seek outside consultation to structure the implementation and execution of plans designed to achieve the desired goals. Building a team capable of accomplishing the initiatives and recommendations to move the company forward is an equally important step. Working with an outside consultant can also bring clarity on how to strategically build and refine your team at a rate on pace with your company’s growth.

As established leaders, it may be difficult to admit things could be better managed, or that you may not have all the answers. A business that overcomes the ego of its leaders, incorporates input from trusted resources including outside consultants, and grows through internal process review and refinement, is a sign of a truly strong and humble leader.

Robert Carrera, President & CEO

Aug 09
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ASCs: Marketing for Your Small Businesses

ASCs: Marketing for Your Small Business

By ASC Management, Leadership No Comments

Most businesses understand some type of marketing is imperative to compete in today’s economy. Some businesses, especially small businesses like ambulatory surgery centers (ASCs), shy away from venturing into new digital platforms due to lack of time, financial resources, or both. However, there are strategic steps small businesses can take to engage in time- and cost-effective digital marketing initiatives.

First, identify your target audience. Begin by collecting appropriate and available customer data, such as age, gender, household income, etc. Ensure the data collected adheres to guidelines established under the Health Insurance Portability and Accountability Act (HIPAA).

Next, identify your marketing goal – the ultimate action you want your customers to take. Because surgery centers do not sell products online, an example of a marketing goal might be to increase the ASC’s web page views.

Now, identify the best platform to engage your patients. Then track the results. This is typically where small businesses need guidance. Although most platforms mentioned below are “free,” they will cost you hours in content creation and maintenance. And, if not managed properly, your customer engagement initiative could fail.[1] However, our goal is to provide tips that boost your confidence, not instill fear!

Let’s start with the basics: managing your ASC’s online profiles (e.g., Google, Yelp, Healthgrades). A 2017 consumer report indicated 97% of consumers use the internet to find a local business and 85% of these consumers trust an online review as much as personal recommendations.[2] The expectation for business to consumer interaction is also high, with nearly 52% of customers expecting a response in seven days or less, especially if the review is negative.[3] Therefore, proactively managing patient reviews and capitalizing on positive patient experience is vital. Checking on these platforms at least once a week will help you stay on top of reviews and show your customers you are listening.

Once your profiles are properly created and managed, look at other free social platforms with a creative eye. Because social media is very interactive, it takes time and dedication to maintain. YouTube can be a great platform to showcase your brand by posting “how-to” videos that display industry expertise. Healthcare entities have used this platform to provide pre/post-operative educational videos for patients, eliminating webinars or in-person classes. Small businesses can also collaborate with their partners. For example, consider working with a device company to produce medical equipment demonstrations or provide patient education with affiliated hospitals.

Most people research medical information online before consulting with a provider. This could be a path that leads information seekers to your service. Instagram is the third largest social media platform. It is estimated to have 700 million active users each month.[4] The age group utilizing it is also diverse, with 18% of users in the 50-64 age group.[5] However, the best way to engage with your audience is to have them do the marketing for you. Social media reviews are the digital equivalent to the good old word-of-mouth. Obtaining referrals from a trusted source goes a long way.

If you are inspired to explore the possibilities of a social media business account, ensure you have proper disclaimers and/or permissions to post customer reviews. The last thing your ASC needs is a lawsuit triggered by a poorly managed marketing initiative.[6]

Marketing automation tools such as GetResponse, Emma, and Marketo are great ways to follow up on successful patient engagement. Not all marketing automation tools are free, but they can help small businesses know when a lead lands on their website, requests information, and participates in other engagement behaviors. The data provided can be used for strategic follow-up through email, short messaging service (SMS), or direct mailers.

Marketing automation may not be for you just yet, but that doesn’t mean your business can’t gather data on marketing efforts. Ensure all marketing campaigns have a call to action that is trackable. Although this is simple advice, many small businesses forget about post-impression behavior tracking. This is voluntary forfeiture of customer data that could benefit your future marketing efforts. The adage, “if it can’t be measured, it can’t be improved,” is applicable here.

In summary, marketing should not be a shot in the dark. Increase your chances of hitting your target by incorporating marketing into your business’s strategic plan. In today’s fast-paced, noisy, and competitive market, small businesses do not have the luxury of bypassing customer engagement and loyalty. Customer engagement should be focused, analyzed, and personalized for the best long-term results.

Alice Beech, Physician Liaison

[1] https://www.forbes.com/sites/johnrampton/2014/04/22/why-most-social-media-strategies-fail/#648185f43a9b

[2] https://www.brightlocal.com/learn/local-consumer-review-survey

[3] https://www.reviewtrackers.com/customers-expect-responses-negative-reviews

[4] https://www.linkedin.com/pulse/instagram-fastest-growing-social-media-platform-2018-sonila-begu

[5] https://www.linkedin.com/pulse/instagram-fastest-growing-social-media-platform-2018-sonila-begu

[6] https://www.hhs.gov/hipaa/for-professionals/compliance-enforcement/agreements/complete-pt/index.html

Jul 18
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ASC Marketing and Sales: Keeping Up in an Evolving Industry

ASC Marketing and Sales: Keeping Up in an Evolving Industry

By ASC Development, ASC Management, Leadership No Comments

Marketing your business isn’t easy. Having a comprehensive marketing strategy is especially important in dynamic markets where change is the norm. In health care, and especially in the ASC industry, effective leaders tend to focus on concrete operational and administrative items that keep the doors open for business. Surgery centers often operate with a precise number of staff designed to support the current client base. An all hands-on deck culture leaves limited time to consider, let alone implement, a robust ASC marketing and sales strategy. Some stakeholders may argue a robust ASC marketing and sales strategy is not vital – after all, physician practices drive business to the site of care. While this is true, environments change. Those who are committed to tactics that have worked well in the past may soon find they have been left behind.

What is an effective way to go about marketing an ASC? Here are some strategies to consider.

Selling – Manipulation v. Persuasion

It is said, “Any successful business sells well.” What does that mean exactly and how does it apply to surgery centers?

As an administrator in a health care entity, it may be difficult to imagine yourself selling as one does, let’s say, in a retail store. When we think of health care in a typical clinical environment, we picture sick patients, caring providers, medical equipment, medicines, and other related items. It can be difficult to imagine selling in the health care arena. In fact, it almost feels wrong – perhaps because most health care isn’t elective. However, I would venture to say this is true only if you consider the old school perception of selling. What do I mean? The old mindset of selling embodies characteristics of manipulation which, by definition, entails, “artful, unfair, or insidious means.” There is a much stronger ethical consideration in health care than in many other industries. Artful, unfair, and insidious means go against the ethics of medical practice.

Shifts towards globalization and mainstream use of technology have allowed for greater sharing of consumer insights. Consumers in turn have become more savvy. Selling now focuses more on persuasion. Persuasion means to move by “argument, entreaty, or expostulation to a belief, position or course of action.” Selling deals with intent, purpose, and an end goal. If the end goal is to rip people off, then, yes, selling feels terrible. That is manipulation. However, health care leaders can expect to feel something different when their selling mindset moves toward persuasion.

The Norwegian word for sell is “selje,” which directly translates to, “to serve.” As a business operator, if you believe you are there to serve the marketplace, customers will find ways to buy your services because you are serving them. With this shift in perspective, selling becomes more palatable for our surgery centers, right?

Understand Your Customer

The best way to attract customers – new patients or physicians – is to understand your prospects. Health care providers ask leading questions to understand the root cause of a health problem. The same practice holds true with your customers.

Let’s say you want to recruit a spine surgeon who just moved into your market. What are your next steps?

How about a visit to the surgeon’s practice, bringing his or her favorite lunch and dessert, to entice the surgeon to stick around while you rave about how great your surgery center is for his/her cases? This represents the old way of selling. And many physician recruiters would feel good about this method because you walked in with intent, purpose, and an end goal. But you would be doing yourself, the physician, and the surgery center a huge disservice if you didn’t take the time to understand the real needs of the physician. The favorite lunch and dessert will only satisfy for a short while. The positive statements in favor of the surgery center will only maintain impact until the physician experiences a negative event that doesn’t measure up to these claims. Even though this sales approach may provide immediate success, it is wiser to invest more effort in understanding the physician’s needs.

Taking time to get to know the physician and asking the right questions will create and sustain a longer-term relationship with them, which should be the real end goal. Another reason to ask the right questions is to assist customers articulate their needs. Your exercise may help get them to a place where they feel better about taking a step forward with you. Conversely, you may encounter a physician who has his or her defenses up because they have run into someone who sold, manipulated, and ripped them off in the past.

How can you engage physician recruitment prospects in deeper conversations about their needs? Here are some examples of focused questions to get you started in better understanding your customer.

  1. “I understand you just moved into the area. Where would you like to see your practice go in the next 3-5-years?” or “What are your goals for you and your practice in the next 3-5 years?”
  2. “What are your current patient demographics? Are there any additional cases or services you would like to start performing?”
  3. “Are there any special equipment needs for your surgical cases?”
  4. “Have you worked in an ASC before?” If yes, “What are some of the best or worst things that have shaped your ASC experiences? What things do you wish you could have changed? What things have you enjoyed?”

To accurately gauge if you are asking the right questions, determine if you are simply selling to your customer or truly servicing them. Servicing your customer entails understanding their needs first, rather than presenting to them what you think they want.

When you ask better questions of your customer, you get better responses about pain points and aspects your customer expects from your service. These answers can help you pinpoint how your ASC stands out from competitors. Sometimes your ASC is a better site of care for a physician; sometimes it’s not. Not being able to serve every client’s needs is okay. Develop your strategy, then focus on servicing your clients if it makes sense for you, your staff, and the business. Avoid being stagnant. Communication about your customers’ needs allows you to uncover hidden opportunities for business growth which can yield untapped profit.

Understand Customers’ Preferred Channels of Communication

Once you obtain the answers you need from your customers, work to understand how your customers want to receive future information and communication. Do they prefer phone calls, texts, emails, or paper communication? Do preferences change depending on the content? Identify when it is appropriate to send out a mass form of communication to all clients and when to communicate with clients on an individual basis. When you communicate with clients one-on-one, tailor your messaging and communication channel to fit their communication preferences. The best way to find out is to ask!

Making Every Sale Count

The last tip in marketing your surgery center is to make every sale count. Air Force veteran and “sales whisperer” Wes Schaeffer claims, “To make any sale, you must make every sale.” He goes on to explain: “Suppose you are going on a date. You would brush your teeth, dress up nice, approach with a smile, and perhaps pay for dinner. All these little gestures are viewed as little sales along the way, contributing to a larger sale.”

The same holds true for your surgery center. Some of the little sales to consider as part of your larger ASC marketing and sales strategy are:

  1. Is your pre-registration pamphlet easy for patients to read and understand?
  2. Can patients easily navigate your website? Is your website enticing to patients? Do they get a good feel for the care they will receive at your facility?
  3. Do patients receive any form of communication prior to their procedure to ensure they are ready?
  4. Do front desk personnel warmly greet patients and/or friends and family when they arrive?
  5. Do your nurses and providers explain all necessary steps and set up expectations throughout each patient’s episode of care?

This is just an example of some of the mini-sales opportunities that occur when providing service to patients. There are many more touch-points in the patient journey. Each of these touch-points allow an opportunity to complete a mini-sale.

What works for your surgery center today, may not work for your surgery center tomorrow. Opportunities to improve customer experience occur with technology updates and patron preferences. The customer experience should be monitored, updated, and modified over time. The best way to identify the quality of your customers’ experiences is through patient satisfaction surveys and online reviews. Identifying how your customers navigate through your supply chain, including all the mini-sales touch-points, lends itself to better customer experiences and opportunities to retain customers long-term.

Effective ASC Marketing and Sales Drives Business

ASC marketing and sales requires an unceasing commitment. Customer needs are your number one priority in providing services, whether that customer is a physician or patient. Ensure you prominently address those needs in your strategic plan.

Effective ASC marketing and sales expresses your story. Never forget, your sales pitch should reveal your passion – to provide the highest quality service to consumers. As every consumer and every industry is different, so too is every business and every sales pitch. When you embrace the unique direction your customer base is encouraging you to move in, customer loyalty and unique service offerings will drive your business growth.

Trista Sandoval, VP of Business Development & Physician Relations

Jul 12
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Welcome Aboard: Â Great Reasons to Become an ASC Nurse

Welcome Aboard: Great Reasons to Become an ASC Nurse

By ASC Management, Leadership No Comments

Nursing jobs are aplenty and there are no signs of this changing any time soon. According to data from the U.S. Bureau of Labor Statistics, employment of registered nurses is projected to grow 15% from 2016 to 2026 – much faster than the average for all occupations.[1] Factors contributing to this rosy job outlook include employment growth in the health care sector and the need to replace retiring nurses.

With ample nursing job openings, qualified nurses can be selective about their work environment. A question nurses must answer is: “In what type of care environment do I want to work?” One of the more rewarding and enjoyable opportunities is serving as an ASC nurse.

Advantages of Working as an ASC Nurse

Here are some of the most compelling arguments for why nurses may want to set their sights on landing a position in an ASC.

  1. Better work-life balance. ASC staff do not typically work weekends or holiday hours. Weekday shifts tend to end at a reasonable time – usually, there’s no burning the midnight oil. If you want evenings, weekends, and holidays free, these are typical perks of being an ASC nurse.

There is a trend of ASCs opening on an occasional Saturday to help meet patient scheduling needs. Some ASC nurses jump at the opportunity to work this shift as it often frees up a weekday. An open weekday is a great time to take care of appointments and errands while most people are working. Depending upon your interests, that weekday may be the prime time to pursue recreational activities.

  1. Opportunity for cross-training. Are you interested in expanding your skill set while on the job? The ASC setting is the place for you. ASCs run a lean staff, with team members expected to wear many hats. For an ASC nurse, this may entail assuming roles such as risk manager, quality improvement director, or infection control specialist. Some ASCs ask clinical staff if they are interested in cross-training in what may seem like unusual areas. These can include patient registration, sterile processing, and materials management.

Cross-training affords nurses opportunities to expand their education and skills while still focusing on patient care. Cross-training may also provide an opportunity for nurses to work more hours, if the need arises.

  1. Strong team cohesion. Hospitals, due to their physical and staff sizes, tend to be departmentalized, experience greater staff turnover, and rely upon more temporary staff. ASCs, with their small, cross-trained staff, naturally lend themselves to stronger team cohesiveness and efficiency. It doesn’t take long for a new ASC nurse to meet all coworkers and understand their job roles. By working with the same people day in and out, ASC staff develop powerful, often family-like bonds.

This familiarity helps develop comfort with and confidence in one another. It also improves communication and interaction between team members. The results: greater staff, patient and physician satisfaction; stronger workflow; reduced risks and, typically, better outcomes.

  1. Closer relationships with patients. Patients who seek treatment at an ASC are in generally good health. They lack severe comorbidities. Undergoing surgery in an ASC tends to be less stressful compared to requiring emergent hospital care.

These factors allow ASC nurses to get to know their patients on a more personal level. There’s time for conversations with patients and family members. It’s not unusual for one or more staff members to discover a social connection with patients. As these bonds develop, patients move beyond being a medical record number and diagnosis. It is a rewarding experience to deliver care to someone you know on a more personal level.

  1. Bonus program. In many ASCs, once the facility achieves profitability, leadership will implement a bonus program. This allows staff to take greater ownership of how well the entire business performs. For an ASC nurse, this may include influencing patient satisfaction, room turnover rate, survey performance, and cost containment.
  2. Faster decision-making. In a hospital, change tends to be slow. For example, if clinical staff are unhappy with a type of surgical glove, changing brands usually requires a lengthy approval process. This can include multiple trials and levels of leadership approval, potentially taking many weeks.

In the ASC, the decision-making process is usually linear and quick. Unhappy with a product? It may only take a day or two to switch.

Answer These Questions Before Pursuing an ASC Nurse Job

The pros listed above represent just a portion of the many reasons why serving as an ASC nurse is rewarding. However, working in the ASC environment may not be for everyone. Before you begin applying to ASC job openings, consider these questions:

  • Do you need a guaranteed shift? ASCs tend to staff for the cases on their schedule. When there is not a full schedule, staff are often sent home. At times, there may be opportunities to fill some open schedule time with special projects. Even then, flexible scheduling tends to be a fact of life for an ASC nurse.
  • Are you looking for a rush? ASCs perform scheduled, elective procedures. Surprises are unwanted. If they happen, it usually indicates something has gone wrong, potentially jeopardizing safety. Want the adrenaline surge of coming into work not knowing what will happen or what you will need to do? You won’t find that in a well-run ASC.
  • Do you want to move up the leadership ladder quickly? There are few management roles within an ASC. If your desire is to rapidly advance into a management role, the ASC setting likely won’t lend itself to quick upward mobility. It is important to note, however, if you work in an ASC managed by a larger company, there may be more opportunities for advancement – assuming you’re willing to relocate.
  • Do you work best independently? ASCs thrive on teamwork. Most projects require it. If you tend to work most effectively on your own, an ASC probably isn’t a good fit.

Still unsure about whether you want to work as an ASC nurse? Consider reaching out to a local ASC and speak with its clinical director or director of nursing. Ask this person to tell you what they love about working in a surgery center. Find out if you can visit, tour the facility, and speak with other members of the nursing staff. There’s a good chance that working as an ASC nurse will check many of the boxes on your desired job qualities list.

Lisa Austin, VP of Facility Development

[1] https://www.bls.gov/ooh/healthcare/registered-nurses.htm

May 15
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Effective Health Care Marketing Goes Beyond Driving Business

Effective Health Care Marketing Goes Beyond Driving Business

By ASC Management No Comments

Health care regulations and policies are constantly changing, which makes health care marketing dynamic and challenging. Most marketing focuses heavily on targeting the right audience and delivering a tailored message to that audience. If the message is successfully transmitted, it drives demand for the health care service and consequently increases business and revenue. However, more nuanced effort is required to effectively market your surgery center and drive revenue growth.

Although patients may arrive at the specialist’s or ASC’s doorsteps through effective advertisements or physician referrals, there is no guarantee patients will stay to receive treatment for the same reasons.

For effective long-term business growth and retention, patients need to view your ASC as a reliable, trustworthy, and competent place to receive care. This is not fulfilled through marketing alone; it requires commitment from your entire organization.

Building Trust with Patients

Health care fits into the service industry category, where trust is translated into currency. Patients seeking care are already experiencing some vulnerability and stress related to their health. From the moment your patients walk through the door, and even before this point, they are assessing how your ASC responds to their needs and the quality of service they can expect to receive. In other words, can they expect your ASC to live up to the expectations set forth by your marketing campaign?

Long gone are the days when companies were able to unilaterally control their marketing message. Nowadays, patients are doing the marketing for providers, whether the providers agree or not. Technology has provided a platform for consumers to express their feelings and experiences online about the businesses with which they interact.

One study by the Local Consumer Review has indicated positive online reviews make 73% of consumers trust a local business more.[1] It is crucial to understand how patient experience and brand reputation go hand-in-hand in an increasingly digital world.

Focusing on Patient Experience

Strong marketing strategies focus on optimizing patient engagement to enhance positive brand reputation. That engagement starts with the initial marketing, but it solidifies through the patient’s experience at the ASC.

Here are some ways to improve patient experience:

  1. Set expectations through patient education.

Offer patient education through different platforms to establish patients’ expectations for their care. Patients get frustrated when there is a lack of information about their procedure, which sets the stage for unintended miscommunication. By being proactive in creating simple, relevant guides, you will contribute to your patients’ overall perception and experience.

  1. Invest in customer service education for your staff.

Your staff is the “face” of your organization. Patients tend to care more about how they are treated than the facility’s appearance. Educate your staff on how to engage with patients in positive ways, and how to ask patients to provide feedback about their experience. You may also consider giving staff a simple flyer or cut sheet to hand to patients which outlines how to leave an online review for your ASC. Evidence shows that 70% of consumers will leave a review for your business when asked.[1]

  1. Invest time in communicating with your customers.

Technology has changed consumers’ expectations about how businesses communicate with them. Be aware of what patients are saying about your organization and be proactive in responding to what they are relaying. Let your patients know you are open to feedback, whether it’s good or bad.

Also, it is important to understand where to communicate with your patients. Although a recent study shows Yelp & Facebook are local consumers’ most trusted review sites,[1] other platforms are being used for consumer reviews. One of the services Pinnacle III provides to its facilities is managing each ASC’s online reputation. We foresee demand for patient interaction expanding, not decreasing.

  1. Have a service recovery plan.

This applies to both patients and referring physicians. As a physician, you value your relationship with your patient. As a surgeon, you value the trust other physicians place in you when they refer their patients to you. What if a mishap occurs that could potentially tarnish those sacred relationships?

It is wise to prepare your staff members to handle an unhappy patient or referring physician partner. By focusing on customer loyalty versus attempting to gain new ones, you may realize more positive benefits in the long run. Frederick Reichheld, author of the Loyalty Effect, stated that a five-percentage point increase in customer retention increases profits by more than 25 percent.[2]

Better Business at Your ASC

Targeting potential consumers with tailored marketing messages can help lead patients to your health care door, but their arrival is only half the battle. Comprehensive and results-driven health care marketing also incorporates the patient experience when they seek treatment at your physician office and/or ASC. Stay in-touch with the ever-changing health care market to make sure you are providing the best possible service for your patients’ needs. Seek to build trust with patients and you will be rewarded for your efforts. Recognizing and prioritizing each patient’s overall experience ensures health care marketing results in long-lasting, loyal relationships.

Alice Beech, Physician Liaison

[1] https://www.brightlocal.com/learn/local-consumer-review-survey/

[2] Reichheld, Frederick F., and Thomas Teal. The loyalty effect: the hidden force behind growth, profits, and lasting value. Harvard Business School Press, 2008.

 

Apr 11
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How ASC Data Analytics Can Benefit Your Facility: Part 2 of 3

How ASC Data Analytics Can Benefit Your Facility: Part 2 of 3

By ASC Management No Comments

(Part 1 introduces the topic as it applies to ASCs, Part 2 provides examples of how analytics can be beneficial in the ASC arena, and Part 3 will walk through the evaluation process to determine when analytics is a good fit for an organization)

In this second installment of our ASC data analytics blog, we will examine specific ways an analytics program can benefit an ASC. While not every type of report mentioned here may be applicable or beneficial to every facility, the following examples will provide a broad base for understanding the potential benefits an ASC analytics program can provide.

ASC Data Analytics Report #1: Case Cost Analysis

The first category of essential ASC data analytics is case cost analysis. Simply put, case cost analysis determines the cost to complete an individual case. With this number determined, the cost of a case can be subtracted from the revenue generated by that case to obtain the associated profit (or loss). Though determining the profit/loss margin of a single case rarely tells a complete story, logically grouping cases into different “pools” can begin to reveal performance of different segments within an ASC. Grouping cases by procedure type, specialty, surgeon, or payor can reveal performance trends.

Although most ASCs likely know their cost per case at a high level already – total operating expenses divided by number of cases – the true value of adding a formal analytics component comes from the ability to drill down into the data. Going beneath the surface allows ASC leadership to identify specific, meaningful areas of concern that can be improved upon to enhance the overall performance of the facility.

Components of a Case Cost Analysis: Supply Cost

An analytics-led case costing report is driven by details. Our initial definition of case cost analysis mentioned “determining the cost to complete an individual case.” Merely examining the expenses identified on an income statement or general ledger will reveal facility-wide trends. However, that will not stratify the data to provide the level of detail needed to make a valid comparison between case types (the “pools” we noted previously). For example, a basic pain procedure shouldn’t be assigned the same case cost as a complex orthopaedic procedure. For true case costing insight, expenses need to be directly tied to individual cases.

To obtain specificity in a case cost analysis, one would typically rely on the ASC’s inventory management system to determine the per-case supply cost. Reviewing surgeon preference cards by procedure type may also be used if the inventory management process at a facility lacks per-case specificity. This should provide an accurate accounting of the various supplies used for each procedure, as well as, the total supply cost per case. Supply cost differences between surgeons or procedure types are immensely important in providing analysis points when reviewing differences in total profitability later in the process.

Components of a Case Cost Analysis: Staff Cost

In addition to supplies, staff time is an important consideration in detailed case cost analysis. Most facilities use a case log to track time individual staff members spend on a specific case. By totaling individual employee costs associated with the episode of care, direct staff cost per case can be identified.

Components of a Case Cost Analysis: Overhead Allocation

While supplies and staffing make up most of the direct costs for a case, facilities should also assess the impact overhead expenses have on their overall profitability. Overhead allocation can also be completed at the case level. This can be done by determining the total amount of fixed costs for a given period and assigning a portion of these costs to each case. Some facilities may choose to assign an equal overhead value for each case. Other facilities may choose to allocate overhead based on a formula representing the relative utilization of a fixed expense (e.g. allocation of overhead based on OR time, total case time, etc.). Using this methodology, a complex orthopaedic case is assigned a higher overhead expense per case than a quick pain procedure. This makes sense when one considers that an orthopaedic case uses relatively more of the rent, utilities, etc., than a pain case. When an ASC desires to understand the true total costs of each of their cases, providing a logical overhead value assignment is a necessary component.

For most facilities, it isn’t possible to track every staff minute and supply back to every patient with 100% accuracy. Typically, the total direct costs (supplies, staff) that can be tied back to an individual case are lower than the direct costs shown on an income statement. The difference in the two amounts is the unallocated variable expense. Unallocated variable expenses often arise from the aggregation of small expenses (pens, tissues, hand soap, etc.) that are difficult to track and attribute to individual cases. These expenses can be distributed on the case level using the same methodology as the overhead distribution.

Interpreting the Case Cost Data

At this point, all the expenses for the facility – clinical supplies, staff, overhead, and unallocated variable expenses – are now linked back to individual cases. Instead of one generic cost per case, each case has its own unique, true cost. When the costs per case are subtracted from the revenue generated by each case, the actual profitability of that case is revealed.

All this data can be sorted, grouped, and filtered in a myriad of ways. With each new view of the data, analytical insights begin to jump off the page.

Cases previously thought to be highly profitably may prove the opposite due to high supply, staff, or overhead costs. Physicians who have been historically viewed as producers of low revenue per case may actually be contributing significantly to the facility’s profit due to lower-than-expected expenses. Entire specialties and payors may be viewed in a new light. The data may reveal that improvement in just a few key procedure types could have a dramatic impact on the overall profitability of a center. The list of potential findings is limitless.

ASC Data Analytics Report #2: Facility Financial Analysis

An ASC data analytics program should be able to provide a routine, comprehensive analysis of a facility’s financial performance. This should include not only reporting current financial metrics, but also comparisons to the same period during the previous year(s), the most recent periods (often called “trailing reports”), and to ASC-specific regional and national benchmarks.

Often, the facility financial analysis can be tied to case cost data. Case cost data can be reported in a combined suite of reports (a dashboard) that provides quick insight into the ASC’s performance. For example, a decrease in overall facility profit may be identified as the result of an increase in lower-profit types of procedures over the same period. Likewise, a decrease in revenue per case but an increase in total ASC profitability – which could be perplexing – may be identified as an increase in procedures with low revenue per case (which dilute the overall facility revenue per case) but a strong profit margin. Adding a data analytics component to standard ASC financial analysis should increase awareness and understanding of the factors influencing an ASC’s financial performance.

ASC Data Analytics Report #3: Clinical Analysis

Adding an ASC data analytics program can also provide benefits to clinical efficiency and patient safety efforts. Case time log data can help paint a picture of efficiency within the OR, as well as provide a workflow analysis of the activities in registration, pre-op, and PACU. An example is a block-utilization report, which details how well a specific surgeon or specialty fills their allotted OR block time. Identifying trends and tweaking block time allocation as necessary can lead to a more efficient, profitable center.

Patient safety data can be gleaned to identify trends that can prevent a bad outcome before it happens. Staffing data is a wonderful resource an analytics program can use to ensure optimal levels of staffing are being utilized. Medication log data is another database that can be tapped into to add to the clinical safety reporting tapestry. For example, analysis of the medication log data may reveal cases where drugs are being prescribed at different stages in the delivery of care that may create unsafe conditions, such as hazardous drug interactions or over-prescription of narcotics. A dedicated analytics program should be able to drive facility profitability, efficiency, and patient safety through enhanced analysis and amalgamation of clinical data.

Investing in an ASC Data Analytics Program

Attaining highly detailed case cost, financial, and clinical efficiency/patient safety insights is a lot of work. Parsing out valuable insights from scattered databases, case logs, and financial reports requires a specialized skillset and experience tailored to the ASC setting for maximum return on investment. The available data often needs to be “scrubbed” (a time-consuming process) to avoid the dreaded “garbage in-garbage out” phenomenon.

As discussed in Part 1 of this series, dedicated analytics programs and personnel are not currently common in many ASCs. Committing the resources necessary to obtain a quality ASC data analytics program must be carefully weighed against the potential benefits. The next part of this series will discuss strategies to help make this determination. As the ASC industry becomes more competitive and pressures from payors continue to rise, the decision to invest in an analytics program is increasingly becoming the correct choice for many ASCs.

Cody Carlin, Director of Data Analytics

Apr 03
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Implementing a Patient Texting Program at Your ASC

Implementing a Patient Texting Program at Your ASC

By ASC Development, ASC Management No Comments

Over the last two decades, texting has grown into one of the world’s most effective and accessible communication methods. However, there are still some professional service sectors where more traditional communication (e.g. phone, mail) is more common. It may be surprising to know that some health care entities are beginning to offer patient texting programs, sending important reminders to patients. For those in the ASC industry, this is an exciting opportunity to demonstrate to patients you care about modernizing and updating their delivery of care as well as your interactions with them. Is your ASC poised to take advantage of this chance to show you provide the best and most convenient options?

Here are a few interesting statistics about smartphone and text messaging use:

  • Ninety-five percent of Americans own a cellphone of some kind.[1]
  • Texting is the most widely used smartphone feature, with 97% of Americans using it at least once a day.[2]
  • Ninety percent of all text messages are read within three minutes of their delivery.[3]
  • It takes the average person 90 seconds to respond to a text message.[4]
  • Texting is for everyone. Ninety-four percent of smartphone users 70 and older use text messaging on a weekly basis.[5]

Statistics like these helped inspire our ASC to implement a patient texting program in November 2017. Before launching the program, many of our patients were receptive to the idea of receiving text messages from our ASC. As part of our program, patients are asked if they want to receive text messages from us when providing their medical history through our online portal. An average of about 80 percent of our patients opt in.

We hoped that by leveraging the power of texting, we could improve the experience of our patients and staff.

Developing the Texting Program

Our texting program is managed through an online patient portal vendor. Working with this company, we customized a series of automatic text messages which are sent to patients preoperatively and on the day of surgery. We carefully crafted our messaging and determined the most appropriate time for message transmissions. This “automated clinical pathway” provides instructions and prompts patients to complete important steps in their procedure preparation. Personal health information is never transmitted to maintain HIPAA compliance.

Here is a summary of our text messages:

Two days before surgery, morning. Our first message asks patients to confirm the date and time of their procedure.

If patients are unable to make their appointment, the message advises patients how to reschedule.

If patients confirm their appointment, they receive another automated message reminding them to review their physician’s preoperative instructions.

Two days before surgery, evening. This message provides instructions about what patients need to bring with them on their day of surgery. We also remind them to bring a method of payment and ensure they arrange for transportation.

Day after surgery, morning. Our final automated message thanks patients for allowing our ASC to provide care during their surgery. It also expresses our hope that they are recovering well. If there is a problem with their recovery, the text message instructs patients to call the ASC and ask to speak to a nurse.

Note: Patients can opt out of receiving texts from the ASC at any time. For patients who choose to do so, and those who do not opt in to receiving texts when providing their medical history, we communicate via phone and/or email.

Texting Program Benefits

Due to the widespread use of text messaging, patient texting programs are primed for success. During the first three months of this program at our ASC (November 2017-January 2018), all patients who opted to receive text messages responded to the automated messages. Most confirmed their appointment through the text message; the remaining called the ASC.

Here are some of the tangible improvements your ASC may experience after implementing an ASC patient texting program:

  • Decrease in number and duration of nurse calls to patients (savings of about 10 minutes per call)
  • Decrease in staff hours per case
  • Increase in staff efficiency and satisfaction
  • Increase in patient compliance with physician and ASC instructions
  • Decrease in patient no-shows and cancellations
  • Increase in patients paying for care prior to day of surgery (an unexpected benefit)

Growing the Patient Texting Program

After experiencing the success of a patient texting program, ASCs may consider exploring ways to expand the use of texting. One idea is to incorporate front office staff into the patient texting program. For example, after verifying benefits, front office staff may choose to send an automated text message to patients. The message could indicate patient financial responsibility after verified insurance deductions, and prompt the patient to arrange for payment.

Another solution is sending a one-time text message to patients. This would come in handy if, for example, there was a significant snow storm or catastrophic event and the ASC needed to close. The ASC could send a text to all affected patients on the surgical schedule.

One other area to grow a patient texting program is sending text updates to family members in the waiting area. These would provide an update on the status of loved ones in surgery.

The Importance of a Patient Texting Program

An ASC patient texting program demonstrates to patients your ASC cares about consistently modernizing and updating your health care services with a focus on what works best for patients. This is a powerful message to send to your customers in the ASC industry. Studies show 64 percent of consumers prefer texting versus a phone call for customer service needs and 77 percent of consumers are likely to have a positive perception of companies that use text messaging.[6] In the ever-changing health care market, texting is expected to become an even more valuable communication tool going forward. You can bookmark this as a 2018 ASC industry trend.

Michaela Halcomb, Director of Operations

[1] http://www.pewinternet.org/fact-sheet/mobile/

[2] http://www.pewinternet.org/2015/04/01/us-smartphone-use-in-2015/

[3] http://connectmogul.com/2013/03/texting-statistics/

[4] https://www.ctia.org/

[5] https://www.tatango.com/blog/94-of-seniors-are-sending-text-messages-weekly/

[6] https://www.openmarket.com/blog/infographic-consumers-favor-sms-messaging-yet-online-retailers-are-missing-the-massive-opportunity-to-engage/