许多医院和bet8网站备用意识到他们需要制定和实施ASC计划. But knowing at the outset of the process how an ASC will fit into your broader organizational vision will make for better decision-making later on.
这意味着理解为什么你的医院或bet8网站备用需要一个ASC计划, 决定你需要多少ASC手术室和手术室, 并理解ASCs将为您的组织带来的价值
Hospital executives need to reflect on the following questions as they consider their ASC strategy:
- 你们医院的手术室和手术室是满负荷还是未充分利用?
- 手术已经从医院转移到竞争的ASCs了吗?
- Will you be cannibalizing existing surgery 和 procedural volume that is in the hospital by developing an ASC?
- 你的bet8网站备用是一致的吗?? Are you having difficulty recruiting 和 retaining surgeons because you do not have an ASC site-of-service or partnership opportunity?
- 有bet8网站备用因为没有ASC而离开吗?
- Are payers denying benefits to patients who need outpatient surgery that can be performed in an ASC?
- 付款人会把你的病例转给有ASC权限的外科bet8网站备用吗?
- Does an ASC strategy allow you to enter into secondary markets 和 create opportunity for accretive value?
- Does an ASC strategy in your primary market require decanting surgery 和 procedural volume that cannot be replaced due to the absence of backfill volume
While there are many components that will contribute to the success of your ASC plan (see figure 1), 遵循下面的六个步骤可以让你的组织走向成功.
图1:ASC开发的关键步骤
步骤1:确定可以迁移的案例
Start by conducting a site-of-service case volume analysis to evaluate the surgical 和 procedural case volume that is ASC eligible 和 performed in the hospital setting. 应该考虑许多因素, 例如CMS和商业付款人承保程序清单(cpl), ASC的规章制度, 患者选择标准, 并发症, 以及市场状况. 通过确定符合asc条件的病例, you can proceed with the process of optimizing the cases’ site of service 和 existing hospital assets.
这需要时间和复杂性,特别是在规划过程中没有ASC的专业知识. 在评估中必须考虑付款人批准的cpl以外的关键考虑因素和因素, 比如共病因素, 停留时间, 获得设备(e).g.(机器人),可能需要执行案件. 医院 和 health systems that do not have ASC expertise often work with an outside subject matter expert to facilitate this analysis.
除了确定在ASC环境中通常执行的病例外, proactive organizations identify 和 plan for cases most likely to be performed in an ASC in the future (see figure 2).
图2:手术迁移趋势
步骤2:确定应该迁移的用例
仅仅因为有资格移民并不一定意味着他们应该移民. This piece of the ASC planning process requires identifying key stakeholders 和 bet8网站备用 champions who will provide input from both a business 和 clinical st和point. 例如, 外科bet8网站备用在ASC环境下进行某些手术可能会感到不舒服, 或者,访问设备可能受到限制,从而限制了迁移的机会. Another key consideration is the broader financial impact of moving profitable cases out of a hospital OR 和 into an ASC.
Evaluating ASC-eligible cases starts with performing a thorough site-of-service assessment (with input from surgeons). This will an allow an organization to ultimately determine the feasibility 和 financial impact of cases that will 和/or should migrate to an ASC.
步骤3:尽早吸引玩家
通常, 商业付款人合同费率将对自动结算系统的财务可行性产生重大影响. 因此确定的机会,合理和适当的报销, 并确保ASC拥有最佳的管理医疗费率, 要求付款人尽职调查,并在ASC开发过程的早期启动付款人讨论.
经常, organizations invest time 和 money planning for their new ASC without being proactive with the payers. 评估在医院或bet8网站备用的商业付款人合同中增加asc的机会, 为降低医疗总成本建立商业案例. Being proactive with the payer is critical; hospitals 和 health systems that aren’t soon discover that the rates they receive from payers do not support developing their ASC.
It is also important to consider ASC partnership structure 和 how equity position 和 certain aspects of management control can impact the hospital’s position with the payer with respect to ASC rates. Being proactive 和 engaging with payers early on is a key component of the ASC strategy 和 planning, 并可能对ASC的可行性产生重大影响.
Successful organizations prepare for success with ASC managed care contracting 和 strategy 9 to 12 months before the ASC is expected to open (or sooner). 医院或bet8网站备用评估移徙的影响至关重要, 开发商业案例, 并建立一个业务结构,允许成功的付款.
第四步:了解财务影响
Developing an ASC 和 underst和ing the projected financial impact is more than just identifying the up-front capital requirements 和 projecting EBITDA. A mistake many hospitals 和 health systems make is to invest time underst和ing the financial performance of the ASC without also evaluating the financial impact.
Moving cases out of a hospital into an ASC will inevitably impact a hospital’s financial performance if there is no opportunity to backfill cases. 如果医院或bet8网站备用有机会回填, it will be important to consider the impact on the payer mix 和 the types of cases that will be performed that replace the procedures that are anticipated to migrate. 这也是管理式护理计划和战略的关键组成部分, 和 should also be considered with respect to the equity position the hospital 和 or health system has in an ASC joint venture.
第五步:制定时间表和工作计划
A solid ASC plan builds in enough lead time to perform the analyses necessary to deliberate 和 make critical decisions, 以及考虑意外延误的灵活性. 通常, organizations should plan on the development process taking 12 to 18 months; this is highly dependent on whether the ASC is a buildout of an existing space or if the ASC requires the development of a new building from the ground up.
There are many components 和 milestones that can impact the timeline 和 ultimately the pro forma 和 operating work plan. 解释延迟是很重要的,例如:
- 入住证、州调查和认证/医疗保险调查之间的时间间隔.
- 付款人认证和合同.
- ASC领导和人员的招聘.
图3提供了一个从头开始的ASC的ASC开发时间表的示例, 还有一些重要的里程碑.
图3:ASC开发时间表
第六步:接受并培养ASC哲学
One reason ASCs typically operate more efficiently than hospitals is the ASC’s operational philosophy, 文化, 还有“我能行”的态度. 在制定bet8网站备用的ASC计划和策略时, it is important that this philosophy is present at all phases of development to ensure operational efficiency 和 excellence 和 care delivery that meets 和 exceeds ASC st和ards while achieving high levels of patient, bet8网站备用, 以及员工满意度. Involving ASC experts in both the planning 和 execution stage of your ASC strategy will increase the likelihood of your strategy’s success.
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2023年8月21日出版