OR Manager - April 2020 - 10

OR Business Management Conference
Continued from page 9
The top-of-mind trend is regionalization
and the growth of ambulatory surgery-with
80% of today's procedures
being performed on an outpatient basis,
Peters told attendees. " To capture the
perioperative market, you not only have
to develop and operate a competitive
ambulatory surgery service, you have to
have a network because payers want to
contract on a regional basis, " he said.
Things to consider, he said, are:
* What businesses and specialties
should we focus on?
* What is our ambulatory strategy?
* How do we succeed under valuebased
care?
* How do we offer surgeons and their
patients the best experience?
* How do we use information to drive
change in organizational performance?
*
What is our competitive advantage,
and how will our competitors respond?
Jeffry
Peters,
MBA
Peters noted that hospital
outpatient departments
(HOPDs) receive
higher Medicare and
Medicaid reimbursement
than do freestanding
ambulatory surgery
centers (ASCs)-but
surgeons often receive
higher professional fees at ASCs. To
compete with freestanding ASCs, he
advised providing integrated healthcare
networks with primary care offices, diagnostics,
and follow-up.
" We need to be involved in the care
provided to patients from the moment
they're scheduled through preadmission,
surgery, and recovery. And recovery
is 6 months, " he stressed. " We
need to make sure patients are pain
free and able to do activities of daily living
that they couldn't do preoperatively.
We can't ignore the impact of our work
on patient outcomes. That's what valuebased
care is. Are we making their lives
10
OR Manager | April 2020
Sample scoring criteria for portfolio evaluation
Financial health
➤ How has the program or service
performed the previous 2 years?
➤ Is it achieving the target internal rate
of return?
➤ Are free cash flows positive and
sustainable?
Organizational alignment
➤ Is the program or service aligned with
the organization's mission, vision, and
core values?
➤ Does it support the current strategic
plan?
➤ Does it create any redundancy within
the system?
Positioning and perception
➤ What is the current market share, and
how has it trended over the previous
2 years?
➤ Is the market as a whole growing or
shrinking?
➤ Is public perception positive, negative,
or nonexistent?
better, and what are we doing during
the perioperative process to ensure that
they're better? "
Health systems that are not tracking
value-based metrics are losing millions
of dollars yearly on surgical site infections
and readmissions, Peters said.
" You can change behavior by providing
information from multiple sources
in such a way that it's easy to understand
and to use, " he added. Predictive
analytics and sophisticated information
technology systems are making such
information increasingly accessible.
He also believes case time is a better
performance metric than turnover
time or even first case on-time starts.
" The best opportunity for reducing case
time is patient in to anesthesia ready,
close to patient out. It varies greatly by
anesthesia providers. If you use this
Cultural climate
➤ Is the internal attitude toward the
program or service generally favorable
or unfavorable?
➤ How agile and receptive to change are
the staff and managers?
Regulatory and reimbursement
➤ How volatile is the regulatory
environment surrounding this product
or service?
➤ Are there significant policy changes
coming or potentially coming that
could impact financial performance?
Resources
➤ How resource-intensive is the program
or service compared to the rest of the
organization (this includes workforce,
capital, physical space, and operating
expenses)?
Source: David Wildebrandt, MHA, Berkeley
Research Group, LLC. Used with permission.
metric, you can reduce a total joint case
by 25 minutes per case, " he noted.
" You're being evaluated on whether
you generate more money this year
than last year, " Peters said. Demonstrating
improvements in operational
and financial performance, and providing
a clear vision of how the perioperative
service line can compete with
surgeon-owned freestanding ASCs are
the keys to success.
Peters added that he has seen many
chief financial officers who started as
business managers 20 years ago. " The
system saw their business acumen and
respected their leadership skills, " he
said. " What you're working with is giving
you the tools to rise within your health
system, and your knowledge is what
health systems need in the future to be
successful. "
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OR Manager - April 2020

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