As a new nurse, going from the hospital environment into an ambulatory surgery center was an eye-opening experience. I remember one of my fellow nurses laughing when I asked where to get a saline flush. I quickly realized why that was so funny and the differences working in a facility that bills globally, as opposed to itemized billing. In my career, I have worked for two large ambulatory surgery management groups. When it came to increasing revenue, they had different approaches, but the ultimate goals were the same. Control the things you can control – supply costs, labor costs, and billing.
What I learned so long ago, is that supplies are something we can control. Here are some considerations when evaluating opportunities to reduce supply costs:
- Is the size of your inventory appropriate for your case volume?
- Is your stock being rotated to prevent items from expiring and having to be discarded? This one really made me batty. It is literally like throwing money away.
- Are there suitable alternatives for supplies that cost less than the item you have always ordered?
- Look for buy-in from your partners to agree on supplies for cost-savings instead of catering to individual preferences. Show them data that supports your position.
Right in line with supply costs are labor costs. There are so many repetitive processes in an ASC or surgery department in a hospital. I know how difficult it can be to stop and really evaluate workflows to look for inefficiencies, but it is so important. One way of doing this is with job shadowing. Calendar some time with each of the departments in the ASC to walk through their processes. When you have a complete picture of the inner workings at your facility, you will gain insightful information that can help eliminate unnecessary steps that will save a minute here and a minute there. That might not seem like much. When you add it up across a day, a week, a month, and a year those minutes add up to dollars and lots of them.
Last but not least, is billing. I don’t mean that you send a bill and hope it gets paid. Here are some items to consider when trying to increase payments at your facility:
- How can you increase billing? Perform more cases by attracting more physicians? Better utilization of block time? Bring on more specialized and higher reimbursing service lines?
- What about your policies for collecting the amount due from the patient? Are your patients being notified in a timely manner of their financial responsibility and given their payment options prior to the day of the procedure? Are you getting all the information you need from the office scheduler when the case is booked?
- Are claims being submitted in a timely manner? What about other correspondence with insurance companies? Are they being addressed before the clock runs out?
While these initiatives are straight-forward, it can seem daunting to get started. I recommend getting the team involved to evaluate what items are most pressing for your facility and then divide and conquer.
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