As ophthalmologists continue to get less and less reimbursement forbread-and-butter cataract procedures, their motivation to offer new servicesto make up for lost revenue increases. Experts believe that it may be agreat time to tap into this spirit of entrepreneurship by staying open tonew possibilities and investing in some new equipment.

"We are always adding something new because there is always something new ineye surgery," notes Andrea Hyatt, Administrator for Dulaney Eye Institute,Towson, Md. "The doctors appreciate that we have the newest technology, sothey don't have to purchase it for their practices."

Ms. Hyatt and others say there's a wide array of services to consider. Hereare some of their suggestions.

YAG/Argon laser. If you don't already provide a YAG laser for cataractsurgeons, now may be the best time to invest.

"This is a no-brainer," says New York ophthalmologist Eric Donnenfeld, MD."You can eliminate redundancy in the community by providing one centrallaser for surgeons. For a hospital or ASC, facility fees will quickly payfor the investment." According to Stephen Sheppard, CPA, C.O.E. of MedicalConsulting Group, Springfield, Mo., the facility fee is about $400 perprocedure.

Ms. Hyatt's ASC invested in the latest YAG laser for about $30,000 (plus$3,000 a year for maintenance), and she says it's been well worth it.

"The doctors really like this because they don't have to go out and buy anew YAG laser. They like to do all their cases, surgery and laser, in oneday," she notes.

Mr. Sheppard cautions facilities to make sure physicians will bring patientsto your facility before investing in YAG laser: "If the physician is notalso an owner, he or she might be reluctant to bring YAG cases due toinconvenience to the patient and the reduction in the physician fee."

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