September 20, 2023



Before the Build: Two Critical Questions to Ask

Build Around the Patient Experience

Finding Solutions to Build and Grow Your ASC - Sponsored Content

UR Medicine Ortho ASC Offers a Series of Firsts

New Ortho ASC Comes to Hospital’s Rescue


Before the Build: Two Critical Questions to Ask

Whether you’re planning to break ground or expand, due diligence in these areas is a must.

Ortho consultTOUCH OF GRAY As a growing number of Baby Boomers advance in age and the market for orthopedic surgery grows, the nature of local competition and payor contracts will determine success or failure for many outpatient facilities.

Given Medicare’s addition of several orthopedic procedures to its fee schedule, an increasingly graying population and a post-COVID effect that has predisposed a sizable number of patients to stay as far away from hospitals as possible, the stage is set for leaders in the ortho space to capitalize by establishing or further growing this surging outpatient service line.

However, leaders need to do their homework first. Here are two critical questions whose answers will give you a better idea about whether building a new ortho facility or expanding an existing service line is a potentially profitable idea.

How saturated is your local market? David Uba, CEO of Excelsior Orthopedics in Buffalo, N.Y., says that if your local market is loaded with hospitals or larger ASC companies that own a vast majority of your region’s orthopedic surgeons, you could face an uphill battle to secure reimbursement rates sufficient enough to make your project profitable. Additionally, heavy competition can make it difficult to secure necessary patient volume. On the flip side, if your local market has room and opportunity to secure orthopedic surgeons and the patients they can bring, you could be sitting on a veritable goldmine.

As is often the case, market research is key. Gregory DeConciliis, PA-C, CASC, administrator of Boston Out-Patient Surgical Suites in Waltham, Mass., urges stakeholders to speak with local surgeons in the community to better understand what they are experiencing in terms of volume and reimbursement, as well get feedback regarding whether the area truly needs an additional orthopedic surgery facility.

How likely will payors be to negotiate? Of course, this question is a loaded one. Payors are far more likely to negotiate with savvy leaders who understand the importance of building strategic relationships. “You must know your payors and develop relationships with them if you are going to negotiate profitable reimbursement rates,” says Mr. Uba.

Additionally, reimbursements can differ significantly based on the specific procedures involved. For example, total joints procedures are currently quite profitable because the case costs are so much lower at ASCs than at hospitals. “But that is not generally the case for carpal tunnel procedures, which typically secure lower reimbursements, yet have the potential for higher volume,” says Mr. Uba. He says profitability often comes down to your ability to negotiate suitable reimbursement rates with payors for less costly ortho procedures.

Realistic, well-researched answers to these two questions will go a long way toward dictating whether or not you should make a move.

Build Around the Patient Experience

The “one-stop-shop” concept is becoming the gold standard for comprehensive outpatient orthopedic care.

TCO-EaganTHE WATER’S FINE Twin Cities Orthopedics’ Eagan ASC also houses physical therapy services, including a small swimming pool.

Convenience is a crucial component for success in outpatient surgery, particularly in terms of patient satisfaction. That’s leading to a growing movement toward patient-centered facility design.

Chris Bailey, PT, DPT, OCS, chief development officer for Revo Health in Golden Valley, Minn., believes everything about the surgical experience should be viewed from the patients’ perspective, starting with the actual physical design of the facility. When Dr. Bailey and his team opened the 76,000-square-foot Twin Cities Orthopedics Full-Service Orthopedic Center in Eagan, Minn., five years ago, the goal was to provide an all-in-one approach to orthopedic care by locating a surgery center, advanced imaging, PT and more, all under one roof.

The center has thrived as a result, leading Revo to use it as a conceptual blueprint for a brand-new project slated for a tiered opening starting this fall. It’s a three-story, 70,000-square-foot facility that will house virtually every service an orthopedic services patient may need, including a surgery center scheduled to open in early 2024, urgent care, physical therapy, advanced MRI imaging scanners and private care suites.

“Having a one-stop shop is important to the consumer because of the ease of access to high-quality health care,” says Dr. Bailey. “We see having the surgery center attached to the clinic, the care suites and all the postoperative therapy in one spot as a real driver of convenience for patients.”

Location also plays a pivotal role in the convenience equation. Dr. Bailey says all Revo facility locations are carefully chosen to meet procedural demand and increase patient comfort, and the new center is no exception. Located in a thriving Minneapolis suburb, patients can access it via familiar roads without needing to drive into the city. He says that not only makes the experience better for patients, but also logistically easier for family caregivers who transport patients to and from the facility.

Revo also focuses on the providers and staff who work at its new buildings during the planning and design process, from the locations to the design of the operating rooms and procedure rooms, as well as colocation of complementary services. “We know we cannot deliver the highest level of patient care without a highly engaged staff,” says Dr. Bailey. To that end, the building was designed with wider hallways, brighter corridors, more windows in the staff break areas and even access to employee-only outdoor areas where staffers can take a breather during a busy day.

“These things all add up to a more satisfied staff, and the patient is the one who benefits,” says Dr. Bailey. “I also think that competition in the market is important. As we build new facilities, the bar is raised for competitors’ new facilities, and when the bar is raised, ultimately, the patient wins.”


Finding Solutions to Build and Grow Your ASC
Sponsored Content

As ambulatory facilities across the country continue their evolutionary path, OR leaders look for partners and solutions that will help them on their unique journeys into the future.

OutpatientCredit: Stryker
Whether you’re growing your ASC or building from scratch, Stryker’s ASC business delivers tailored solutions for where you are today and want to be in the future.

Making the business decision to change the footprint of your ambulatory surgery center (ASC) for planned expansion of surgical services is a big one. Just as big is the vision to launch a brand-new ASC in a community that has demonstrated a need for more surgical services in the region. Both require collaboration and teamwork to encompass the requirements of multiple stakeholders.

Procedures have been migrating from the hospital outpatient department to ASCs for many years, but that evolution has accelerated. With the potential to provide more than $55 billion annual healthcare cost savings, this shift in site of care is expected to continue beyond the post-pandemic environment. In fact, today’s ambulatory surgery market is booming with leaders of ASCs taking on the challenges of expanding their businesses, adding service lines, or building a new facility from the ground up.

Those ambulatory leaders and owners who choose to go on these exciting journeys know that multiple layers of planning are necessary – and the choice of partners is critical in the complex process. Stryker has deep experience in this evolving market, understands the challenges of ASCs and has delivered tailored solutions to hundreds of centers.

Every ASC is unique, and in fact, each center has its own unique blend of clinical, operational, and financial circumstances. Stryker offers a customized partnership with a dedicated team who starts by listening and learning about each individual ASC’s situation and future needs. Instead of selling a pre-determined solution, Stryker tailors a unique solution that will deliver an exceptional experience for ASC owners and ultimately patients who will be coming through the doors for their surgical procedures.

The process involves not only the logistics of creating a new space or center, but also the capital equipment requirements and analyses of the workflow needs that will spell success for the facility. Stryker’s customizable agreements allow facilities to acquire the capital equipment when it is needed.

Whether planning an expansion, transitioning ownership, or adding a sub-specialty, Stryker can help navigate all of these changes with a comprehensive solution to allow for strategic growth. It’s all about increasing efficiency in a new or renovated space with an eye on continued future growth as the ASC specialty surgical markets continue to expand.

Note: for more information go to Ambulatory Surgery Center (ASC) | Stryker


UR Medicine Ortho ASC Offers a Series of Firsts

Patient safety and infection control are a particular focus of the massive new facility.

When University of Rochester (UR) Medicine’s Orthopaedics & Physical Performance Surgery Center opened in Henrietta, N.Y., earlier this year, patients were treated to more than just another outpatient surgical facility for individuals with bone and joint conditions.

UR Medicine touts its surgery center as the first in Western New York to be designed specifically for patients with mobility problems who need outpatient orthopedic procedures. It’s also the region’s first ASC to offer services such as diagnostic imaging, physical therapy, physical performance training and gait analysis in the same building. The health system claims this setup brings an unprecedented level of integrated care and convenience to patients in the area.

The innovation doesn’t stop there, with infection control serving as a key area of focus. One of the ASC’s eight ORs is outfitted with an advanced laminar airflow system that provides superior whole-room disinfection, according to UR officials. Another OR is a modular, prefabricated space built as a “clean room” to promote the highest level of infection prevention, including a novel air distribution system. A third OR was constructed with glass walls to make for easier cleaning and increased sterility.

The center is being built in multiple phases at a total expected cost of $227 million, and UR anticipates upon completion that it will host 6,000 surgeries each year. Currently, the site operates three procedure rooms in addition to the eight ORs, along with multiple single-bed rooms that offer 23-hour care for recovering patients. Up to six additional ORs could be built in the future. UR says 330 providers and staff currently work at the site each day: 150 in administrative offices, 30 in the procedure rooms, 120 in ambulatory surgery and 30 in advanced imaging.

The location was also carefully considered. With community access in mind, the center is located near the busy New York State Thruway and local bus routes. The patient experience is enhanced as well, with a covered entrance for patient drop-offs and post-procedure pick-ups along with valet parking available to enable easier access for patients with mobility issues.


New Ortho ASC Comes to Hospital’s Rescue

With a health system’s inpatient facility struggling to support enormous surgical demand, thousands of orthopedic procedures per year will shift to its outpatient center.

Bronson Orthopedic Surgery Center recently opened its doors in Kalamazoo, Mich. The 18,000-square-foot, state-of-the-art surgery center, jointly owned and operated by Bronson Healthcare and a group of Bronson orthopedic surgeons, is part of a 52-acre freeway-adjacent site that Bronson Healthcare is developing into a Health Village.

The facility’s four operating suites are equipped to handle numerous outpatient surgical procedures, including sports medicine, joint replacement surgery, hand surgery, fracture repair, foot and ankle surgery and general orthopedic surgery.

Construction of the surgery center began in late 2021 in response to a significant uptick in patients seeking surgical care at Bronson Methodist Hospital. The addition of the four operating suites for orthopedics and sports medicine is expected to significantly reduce overall wait times for patients scheduling other procedures at the hospital. It is estimated that the new surgery center will accommodate more than 5,000 orthopedic cases each year.

The center is staffed by experienced board-certified Bronson surgeons who also perform orthopedic surgery at other Bronson sites, plus a team of anesthesiologists and surgical and support staff. Postoperative care is provided on-site, and patients are discharged home for recovery on the same day as their surgery.

The new center exemplifies a growing realization among many health systems that outpatient surgery is a safe, proven and valid alternative that can enable them to offload elective procedures to free up hospital resources for more acute and immediate care.

“With the majority of orthopedic surgeries now performed safely and efficiently on an outpatient basis, our new surgery center is the perfect option for many patients,” says Administrative Director Ken Hammer. “This setting offers an ease and efficiency for certain procedures that will be a nice complement to Bronson’s hospital-based surgical services in Kalamazoo County.” OSM


Related Articles

December 6, 2023

Renovating a facility to accommodate the many spine procedures that can now be performed in outpatient settings often involves a digital makeover in the form of...