Using Orthopedics and Spine to Turn Around an ASC

Using
Orthopedics
and Spine to
Turn Around an
ASC
Jeff Simmons, President, Western Region
Michael McKevitt, Senior Vice President, Business Development
ASC Communications Conference, June 11-13, 2009
The Regent Model

High-quality, efficient surgery centers

Patient focused, physician-driven

Minority ownership with physicians holding majority
ownership and governance

Turnaround underperforming centers and de novo
centers in select markets across the country
ASC Communications Conference
June 11-13, 2009
Regent Centers
ASC Communications Conference
June 11-13, 2009
Creatively Recruiting New Physicians

There are more ASC’s now than there are hospitals

Fewer new projects with fewer number of physicians
available for recruitment

Each market is different but physician behavior (needs) is
consistent when it comes to recruitment

Collaborative strategies will yield a larger opportunity

Challenge your own perceptions
ASC Communications Conference
June 11-13, 2009
Repositioning an ASC
Adding New Services that are Conducive to Outpatient
Environment is Key





Offers increased reimbursement levels
Often improves quality of care
Enables the surgery center to expand and diversify both the
case mix and the partnership itself
Improves profitability
Makes for a stronger and more cohesive medical staff
ASC Communications Conference
June 11-13, 2009
Keys to Successfully Adding Orthopedics

Leading orthopedic surgeons in the community join as
partners

Best equipment in the community

Best techs and circulating nurses in the community

Negotiating carve outs for implants in key contracts

Out-of-networks strategy for a percentage of patients
ASC Communications Conference
June 11-13, 2009
The Patient Population Is Segmented In
Orthopedics
Patient Groups
Sports Medicine
Younger
ASC Communications Conference
June 11-13, 2009
Older
Degenerative Diseases
Costs to Developing an Orthopedic Program
EQUIPMENT
ESTIMATED COSTS
Arthroscopy Tower
(Camera box, Shaver box, Light
source, Computer)
$100,000 - $150,000
Pnuematic Tourniquets
$3,000 - $8,000
Arthroscopy Tray
$4,000 - $6,000
Beach Chair System
$2,500 - $4,000
Surgeon Headlight
$12,000 - $15,000 each
C-arms
$75,000 - $140,000
Power Equipment
$8,000 - $12,000
ASC Communications Conference
June 11-13, 2009
Net Revenue
Orthopedic Services versus Other Specialties
Pain, $915
Orthopedics, $2,435
Urology, $1,802
Opthalmology,
$1,276
General Surgery,
$1,572
ENT, $1,776
ASC Communications Conference
June 11-13, 2009
Keys To Developing A Successful Spine
Program

The A Team: Spine surgeon trained in minimally invasive
surgical techniques

A dedicated team of nurses, techs and recovery care staff
that exceeds the quality available at the local hospital

Marketing materials to educate patients on the benefits of
outpatient spine programs

Overnight capability

A dedicated anesthesiologist at the facility to complement
the nursing staff
ASC Communications Conference
June 11-13, 2009
Keys To Developing A Successful Spine
Program, continued

The right equipment: Proper equipment will allow you to
execute more complex cases and offer higher quality care
to patients

The right patients and procedures

Stay within the realm of safety and economics
ASC Communications Conference
June 11-13, 2009
Adding New Spine Services Conducive to
Outpatient Environment
A small percent of volume can translate into a large percentage
of revenue
Volume
3.69%
ASC Communications Conference
June 11-13, 2009
22.5%
Revenue
Costs to Setting up a Successful Spine
Program: Six Equipment Essentials
EQUIPMENT
ESTIMATED COSTS
Operating Table
(Allen Frame + OSI Jackson Table)
$170,000
Surgical Microscope
$100,000
Intraoperative Imaging
$180,000 - $200,000
Instrumentation Trays
$10,000 - $20,000 each
Surgeon Headlight
$12,000 - $15,000 each
Surgical Drill
$15,000 each for standard pneumatic drills
ASC Communications Conference
June 11-13, 2009
Overnight Capability = Higher Acuity Cases

Anterior Cervical Discectomy

Anterior Cervical Discectomy and Fusion

Foraminotomy (Cervical Posterior and Lumbar)

Lumbar Microdiscectomy

Lumbar Laminectomy
ASC Communications Conference
June 11-13, 2009
Spine Services in the Outpatient Environment
Projected Growth
These spine services are
expected to grow substantially
in the outpatient setting in the
next few years.
ASC Communications Conference
June 11-13, 2009
300%
to
400%
Net Revenue
Spine Services versus Other Specialties
ASC Communications Conference
June 11-13, 2009
Conclusion

Adding more complex cases can significantly
increase revenue

Motivated and committed physicians and staff are
critical to the success of the center

Manage for profitability and work to improve not only
the quality of care, but also the business of care
ASC Communications Conference
June 11-13, 2009
Thank You.
Contact Information

Mike McKevitt, Senior Vice President
p: 312.848.5301
e: mmckevitt@regentsurgicalhealth.com

Jeff Simmons, President, Western Region
p: 707.396.0138
e: jsimmons@regentsurgicalhealth.com
ASC Communications Conference
June 11-13, 2009