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Fall 2011



Inside Source
What ASC Professionals Know


The Benefits of
Outsourcing Your
ASC’s Billing
IT Talk:
Cloud Computing –
A Nebulous Concept Made Simple

Meaningful Use and its Impact on
Ambulatory Surgery Centers

Improving ASC Performance
Through Data Analysis




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  Brought to you by
Inside Source
 What ASC Professionals Know

 in this issue:                                                                                                   WELCOME
 WELCOME
 An ASC Perspective ....................................1                                                         An ASC Perspective
 IT TALK
 Cloud Computing – A Nebulous Concept
                                                                                                                  Patrick Doyle, VP of Sales
 Made Simple ...............................................2                                                     SourceMedical Surgery Division
 BUSINESS
 The Benefits of Outsourcing Your ASC’s
 Billing ..........................................................3

 Meaningful Use and its Impact on
 Ambulatory Surgery Centers ......................8

 TECHNOLOGY
                                                                       I n many instances, compromising is not only necessary but proper. In the summer
                                                                         of 2011, the President and Congressional leaders compromised on matters
                                                                       regarding national fiscal policy to achieve a more stable economic environment.
 Improving ASC Performance Through Data
 Analysis .......................................................9     Additionally, National Football League owners and players came to a compromise
                                                                       in their labor dispute to ensure that football would be played on Sundays beginning
2011 UPCoMINg EvENTS SCHEDULE                                          in September. In both instances, a compromise was at once predictable and
10/3      PASA Annual Meeting                                          necessary to achieve the long-term objectives of all parties involved. Question:
          Radisson Hotel Harrisburg-Hershey,                           When is compromising neither necessary nor appropriate? Answer: When
          Camp Hill, PA
                                                                       setting a standard of excellence. This ideal should be applied to most, if not all,
10/3      NYSAASC
          Desmond Hotel & Conference Center,                           professional endeavors, and we ask surgery centers considering an IT system to
          Albany, NY                                                   consider this as they conduct system evaluations.
10/5      OR Excellence
          Manchester Hyatt, San Diego, CA
10/13     WASCA Annual Education Conference                            With roughly 6,000 surgery centers nationwide, more than half of these centers
          Tulalip Resort & Spa, Tulalip, WA                            implement clinical and business information systems not designed to handle the
10/15     IAASC Annual Conference                                      unique aspects of a surgery center. Medical billing systems not designed with an
          Marriott, West Des Moines, IA
                                                                       ASC’s unique requirements in mind cannot handle electronic preference cards or
10/27     18th Annual ASC Conference
          Westin Michigan Avenue, Chicago, IL                          provide case costing information and compromise a facility’s ability to maximize
11/2      KAASC Annual Education Conference                            revenue and reduce costs. Similarly, clinical applications not designed for a surgical
          Capitol Plaza Hotel, Topeka, KS                              environment or applications which cannot handle multiple specialties compromise
11/10     TASCS Annual Conference
          Westin Riverwalk, San Antonio, TX                            the most significant and important aspect of any surgery center: patient care.
11/10     MASA Education Day
          Grand Traverse Resort, Traverse City, MI                     As the leading provider of clinical and business systems to surgical facilities,
11/14     AASA Annual Ambulatory Surgery                               SourceMedical offers affordable IT solutions to surgery centers not willing to
          Conference
          Gilbreath Conference Center –                                compromise. By fulfilling our commitment to leverage evolving technology and
          Baptist Medical Center, Little Rock, AR                      web platforms, our more than 2,200 surgical facilities experience higher system
                                                                       satisfaction and faster return on investment than can be experienced with any
2012 UPCoMINg EvENTS SCHEDULE                                          other vendor’s solutions. We have flexible purchase options that avoid large
2/24      McDermott’s ASC Symposium                                    upfront investments and allow facilities to immediately realize the benefits of
          NJAASC Quarterly Meeting, Miami, FL
4/25      CASCA Annual Spring Conference
                                                                       ASC software. I invite you to contact me and join your many colleagues that are
5/9       ASCs 2012                                                    experiencing these benefits firsthand.
          Gaylord Texan, Dallas, TX
6/14      Annual Orthopedic, Spine and Pain
          Management-Driven ASC Conference
          Westin Michigan Avenue, Chicago, IL
                                                                       Patrick Doyle
                                                                       VP of Sales




                                                                           SourceMedical is the largest provider of outpatient information solutions and services for outpatient ambulatory
                                                                           surgery centers, specialty hospitals, and rehabilitation clinics nationwide. With 30 years of real-world
                                                                           experience, more than 5,000 satisfied customers, and the confidence of more than 250 consultants and
                                                                           management companies, SourceMedical offers the broadest range of solutions and enhancements available to
                                                                           the industry. The company’s unique end-to-end systems improve operational efficiency and cash flow while
                                                                           enabling healthcare facilities to capture, exchange, and analyze data to deliver a higher standard of patient care.
                                                                           For more information, please visit www.sourcemed.net.
IT TALK

Cloud Computing – A Nebulous Concept Made Simple
Scott Palmer, President and COO, Surgery Division




          L   et’s assume you are an administrator of an
              ambulatory surgery center. You focus on
          providing outstanding patient care and meeting
                                                                  Companies like SourceMedical have partnered with
                                                                  leading hosting companies to make their services
                                                                  available. ASCs can securely access Vision and
          the needs of your surgeons and staff. Part of your      Vision EHR for a reasonable monthly fee that covers
          staff commitment is providing the right hardware        all equipment and software costs. Your software
          and software for your staff to manage the daily         vendor is responsible for performing upgrades,
          operational needs of the facility while providing       monitoring the applications and servers, performing
          you with the right information to make informed         daily backups, and providing 100% of the server
          decisions and provide accurate and timely               side support. Just as importantly in a clinical
          information to your Board.                              environment, the applications are available at all
                                                                  times (99.9% uptime) through redundant hardware
          You understand basic computing concepts and have        and software that is transparent to the end-user in
          become adept at using office productivity software,     the event of a failure.
          but by no means do you consider yourself an IT
          expert. You worry about maintaining the hardware        To connect to the Cloud, facilities are responsible
          and software that exists on your staff’s desktops,      for accessing the Internet, providing PC
          performing backups, installing upgrades, security and   workstations, tablet devices, printers, and scanners.
          HIPAA, periodically replacing hardware, repairs, and    Thin client workstations which have no moving
          more. However, you cannot afford to pay a full-time     parts and can be purchased for as little as $250 are
          IT resource so you use a third party to help with       replacing the traditional PC workstation. Users may
          these activities. And while there are many great        also use software to connect devices such as the
          companies to choose from, this can become an            iPad to the Cloud as well.
          expensive proposition.
                                                                  If you access Google applications or email via AOL
          What’s the Solution?                                    or Yahoo via a browser, then you are already Cloud
                                                                                                                              Fall 2011




          There has been tremendous advancement in                computing. We have learned through experience to
          communication capabilities over the Internet and        trust these applications so companies are shifting
          rapid growth in the number of companies serving up      more intensive applications to the same model. We
          applications that are remotely housed and managed.      see a shift to off-premises computing as a trend that
          Cloud computing and its counterpart “software           will benefit ASCs in the years ahead.
          as a service” describes the ability to replace the
          classic client-server model with the ability to         For more information on Cloud Computing
          access software without having any locally installed    using Vision, please contact us at 866-675-3546
          applications.                                           or email us at info@sourcemed.net.
                                                                                                                          2
BUSINESS

                The Benefits of outsourcing Your ASC’s Billing
                Scott Stone, COO & President, Revenue Cycle Solutions Division


                            F     rom a financial standpoint, outsourcing your billing, coding, and collections can have a dramatic effect on your
                                  bottom line. Utilizing the services of highly experienced back office staff, your facility can expect to:

                                     w Receive the maximum reimbursement for all procedures
                                     w Ensure claims are being submitted error-free, reducing denials and delays in reimbursement
                                     w Improve A/R days which will provide faster access to your cash
                                     w Receive assistance with managed care contracting negotiations
                                     w Decrease internal costs associated with salaries, benefits, and training

                             Beyond the financial benefits, there are many other reasons outsourcing your billing makes sense. Finding and
                             retaining qualified coders, billers, and collectors isn’t easy. By outsourcing your billing, disruption caused by
                             staff turnover and training is avoided. Utilizing a billing service provider also helps ensure your operations are
                             compliant with all current regulatory requirements including OIC, HIPAA, and state and federal requirements.

                             When looking for a provider, a proven track record in the ASC market and certified coders should be a top
                             priority. Make sure the provider has the ability to seamlessly integrate their billing services with your existing
                             clinical and management software system. Seamless integration provides complete visibility into your accounts
                             and allows progress to be monitored real-time. Additionally, the provider should offer a toll-free number for
                             your patients. Having a service that answers all billing questions will free your staff to spend more time on what
                             matters most: patient care. To fully understand the many benefits associated with outsourcing your billing,
                             coding, and collections, please see the case study below.




                                CASE STUDY
                             CASE STUDY
                             How One ASC Improved Compliance, Cash Collection, and Revenue
                             This ASC ONE ASC IMPROVED COMPLIANCE,
                                 HOW is a freestanding, joint-ventured multi-                                            Observations:
                             specialty center that handles AND REVENUE
                                 CASH COLLECTIONS 350 cases a month.                                                     Inconsistent Fee Schedule – A fee schedule
                                 (ABBREVIATED VERSION)
                             The Medicare-certified center is owned by seven                                             evaluation revealed most fees were lower than
                             physicians and the local hospital which owns 51%.                                           Medicare/BCBS allowances for the ASC’s geographic
                        Surgery Center is a freestanding, joint-ventured multi-specialty center that handles 350 cases
                        a month.is self-managed by ENT, GI, Ophthalmology, Orthopedics, Podiatry and
                             It The specialties served include the governing body.                                       locality. The fee schedule was based on physician
                        Pain Management. The Medicare-certified center is owned by seven physicians and the local
                        hospital, which owns 51%. It is self-managed by the governing body.
                                                                                                                         DRGs rather than Medicare allowances or cost per
                             During its first 14 months in operation, the                                                case. There was no consistency in fees.
                        During its first 14 months in operation, the center had experienced a negative cash flow.
                              surgery center experienced a negative cash flow.
                        SourceMedical’s Revenue Cycle Solutions (RCS) team was brought onboard to evaluate and aid
                        in resolving business office inefficiencies related to the billing process and to(RCS) if the
                              SourceMedical’s Revenue Cycle Solutions determine                                          Low Managed Care Rates – The surgery
                        center met billing compliance guidelines.
                             team was brought onboard to evaluate and aid                                                center’s managed care contracts had low rates and
                        A full in resolving business office inefficiencies team to assess the
                               financial and business office evaluation was performed by the RCS related                 unfavorable terms for an area with little managed
                        revenue cycle and determine any billing compliance issues. Initial findings were obtained
Fall 2011




                               to the billing process and to determine if the
                        during the on-site evaluation, while the improvements were achieved after 12 months of
                                                                                                                         care penetration. Market standard in the area
                        reimbursement management. met time of the compliance guidelines.
                               surgery center At the billing evaluation the center was facing numerous                   revealed rates based on percentage of billed charges;
                        challenges. Each problem affecting revenue was addressed separately, with the following
                               A full financial and business office evaluation was
                        recommendations for correction.
                                                                                                                         however, most of the center’s managed care
                             performed. Initial findings were obtained during                                            reimbursement was based on Medicare groupers.
                        Observation: Fee schedule was inconsistent
                              the on-site evaluation while the improvements
                        Fee schedule evaluation revealed that most fees were lower than Medicare/BCBS allowances
                        for the ASC’s geographic locality. Fee schedule was basedof physician DRGs rather than
                              were achieved after 12 months on reimbursement                                             Non-compliant Coding – Coding was being
                        Medicare allowances or cost per case. There was no consistency in fees.
                             management. Revenue-affecting issues were                                                   performed by an inexperienced coder; multiple
                        The RCS team recommended a complete review following observations.a copy
                             resolved as a result of the of the fees, provided the center with                           coding errors resulted in both over- and under-
                        of Medicare allowances, showed them how to do a mark-up based on these fees, and provided
                        information about case costing.
                                                                                                                         charging of claims.

            3           Observation: Low Managed Care Rates
                        The ASC’s managed care contracts had low rates and unfavorable terms for an area with little
                        managed care penetration. Market standard in the area revealed rates based on percentage
                        of billed charges. However, most of the ASC’s managed care reimbursement was based on
Figure 1.
                                                                                                   COMPARISON GROSS AND NET CHARGES BEFORE /DURING/AFTER RCS BILLING
                                                                                                  $14,000,000.00
                                                                                                                                                         $13,224,387

                                                                                                  $12,000,000.00


                                                                                                  $10,000,000.00                     $9,413,284


                                                                                                   $8,000,000.00                                                              Gross Charges
                                                                                                                                                                              Net Charges
                                                                                                   $6,000,000.00
                                                                                                                    $4,680,781                                   $4,597,145
                                                                                                   $4,000,000.00                          $3,905,406


          Past Due Billing – The coder also handled billing                                    Eighteen Months Later
                                                                                                  $2,000,000.00
                                                                                                                      $2,067,246

          and often fell behind. All claims were submitted on                                  Under the direction of the RCS team with
                                                                                                          $0.00
          paper – no electronic filing and no cross-checking                                   assistance from surgery center staff, the following
                                                                                                                  Year 1 - No    Year 2 - Part Yr  Year 3 - Full Yr
                                                                                                                RCS Involvement  RCS Involvement  RCS Involvement
          was done to ensure all claims were filed.                                            achievements resulted:

          No claim follow-up – There was not a single                                                                                Figure 2.
          collector or follow-up on submitted claims. The                                                    COMPARISON CASH COLLECTIONS BEFORE AND DURING RCS BILLING
          payment poster did not have a copy of the insurance                                   $6,000,000

          contracts, and payments were accepted as correct.
                                                                                                $5,000,000
                                                                                                                                                                               $4,768,328
          There was a large amount of unbilled revenue due
          to coding errors, and multiple procedures were                                        $4,000,000
          often unbilled. Claims receiving no payment or
          incorrect payment were not revisited. Thirty-seven                                                                                        $3,115,526
               About SourceMedical                                                              $3,000,000
          percent of total accounts receivable were greater
          than SourceMedical is the premier provider of outpatient information
               150 days old.
                                                                                                $2,000,000
                  solutions and revenue cycle management services for ambulatory
                                                                                                                            $1,549,008
          Insufficient Insurance Information – The clinics
              surgery centers, speciality hospitals, and rehabilitation

          scheduler was With a 30-year trackof Medicare ASC- 5,000
              nationwide. not using a list record and more than                                 $1,000,000

          allowed proceduresSourceMedical is the trusted source for unique,
               satisfied customer,
                                   nor did they have insurance                                                       Year 1 - No
                                                                                                                   RCS Involvement
                                                                                                                                             Year 2 - Part Yr
                                                                                                                                            RCS Involvement
                                                                                                                                                                     Year 3 - Full Yr
                                                                                                                                                                    RCS Involvement
               end-to-end systems improve operational efficiency and cash flow
          information on the center’s contracts.                                                       $-
                  while enabling healthcare facilities to deliver a higher quality of
                  patient care.
          Patient Responsibility Communicated – Patients                                       w Increase in gross revenue – Within 18 months,
          were not notified in advance about deductibles                                         the annual gross revenue increased from
          and co-pays. Medicare requires that patients are                                       $4,680,781 to $ 13,224,387 indicating a 182%
          apprised of their financial responsibilities prior to                                  increase in annual gross revenue.
          the day of surgery and need to acknowledge that
          they have been informed with a written signature.                                    w Increase in net revenue – During this same time
                                                                                                 period, the annual net revenue increased from
          Following the Evaluation:                                                              $2,067,246 to $4,597,145 which indicates a 122%
          The RCS team provided the governing body with a                                      4 increase in annual net revenue.                                                        05/11
          detailed list of recommendations; the surgery center
          made the necessary changes including outsourcing                                     w Increase in cash collections – During this same
          their coding and billing to the RCS team.                                              time period, the increase in annual cash collections
                                                                                                 increased from $1,549,008 to $4,768,328 - a
           Changes in Revenue – Within the first 90 days of                                      208% increase in annual cash collections.
           RCS involvement, the surgery center was operating
           in the black for the first time. Gross charges tripled,                             w Elimination of billing backlog – All billing was
Following are charts which reflect the improvements made in the Center’s results after
           average gross charges per case doubled, collections
partnering with Source Medical Revenue Cycle Solutions and utilizing Revenue Cycle
                                                                                                 audited for errors, and refunds were issued
           increased more than 250%, and profits increased
Management :
                                                                                                 for overpayments along with submission of a
           more than 400%.                                                                       corrected claim. Claims were resubmitted for
                                                                                                 underpayments. If timely filing was an issue, appeals
                                        Figure 1.
      COMPARISON GROSS AND NET CHARGES BEFORE /DURING/AFTER RCS BILLING
                                                                                                 were filed to collect the claim citing new center
     $14,000,000.00
                                                                                                 problems. All claims were followed up on by
                                                           $13,224,387
                                                                                                 collectors and resubmitted when the payer did not
                                                                                                                                                                                                    Fall 2011




     $12,000,000.00
                                                                                                 have a record of receipt. Accounts receivable was
     $10,000,000.00                     $9,413,284                                               brought up to date. Going forward, all claims were
      $8,000,000.00                                                            Gross Charges
                                                                                                 submitted and followed up on in a timely basis.
                                                                               Net Charges
      $6,000,000.00
                       $4,680,781                                 $4,597,145                   w Compliance in billing – The RCS team’s certified
                                             $3,905,406
      $4,000,000.00
                                                                                                 coders and experienced billing staff reviewed all
      $2,000,000.00
                           $2,067,246
                                                                                                 questionable claims and payments; the necessary
             $0.00
                                                                                                 corrections were made; and payers and patients
                        Year 1 - No     Year 2 - Part Yr    Year 3 - Full Yr                     were notified.
                      RCS Involvement   RCS Involvement    RCS Involvement
                                                                                                                                                                                                4
The Benefits of outsourcing Your ASC’s Billing
                                (continued from page 4)




                 “                                                                                                                       ”
                          Gross charges tripled, average gross charges per case doubled, collections
                          increased more than 250%, and profits increased more than 400%.


                               Making the decision to outsource your Revenue                To learn more about RCS and how we can
                               Cycle Management is one which can have a profound            impact your center’s financial performance,
                               impact upon your ASC’s results. As such, it should           call us at 866-889-7722, email us at
                               be trusted only to someone with a proven track               revenuecyclesolutions@sourcemed.net, or visit
                               record who truly understands your business.                  http://sourcemed.net/revenue-cycle/.
                               Achieving results as shown above requires deep
                               domain expertise, highly trained and dedicated
                               professionals, well-defined and proven processes,
                               and a real focus on results. SourceMedical’s RCS
                               team embodies just that - “ASC Billing Done Right”.




                Improve your Financial Results
                and Eliminate your Billing Concerns
                ASC Billing Done Right
                Deep ASC billing domain expertise means that your
                surgery center receives maximum reimbursement for all
                procedures. Whether “in network” or “out of network”,
                we are focused on quality processes and positive
                outcomes for every client.

                Complete Revenue Cycle Management
                by a Proven Leader
                Insurance verification, coding, collections, appeals and       “Business is all about trusted relationships, and we have forged such
                denials management, and customized reporting – all             a relationship with SourceMedical. They are reliable, professional,
                from the industry leader in ASC Software and ASC               courteous, and have helped us navigate some very complex waters over
                Billing Services. We provide each client a dedicated           the years. Without hesitation, I would recommend their ASC Billing
                                                                               Services to anyone – particularly if you are seeking to improve your top
Fall 2011




                team of functional experts, ensuring continuity and
                                                                               and bottom line.”
                eliminating disruptions in your revenue stream.
                                                                                                       - Mark E. Smith, Chief Administrative Officer
                                                                                                         Orthopedic Associates of Wisconsin


                To Learn More:
                   w 866-889-7722
                   w revenuecyclesolutions@sourcemed.net                                         is now
                   w www.sourcemed.net/revenue-cycle

            5
fEEdBACK

           The Sounding Board
           A Source for Voicing Your ASC Insights

The Sounding Board’s mission is to gather feedback, insights and opinions from you, the ASC experts, on the latest
news, trends and outlook facing our industry today, and to publish the best of your insights to help benefit our peers.

We’d like to hear from you. Selected feedback/insights will be recognized in SourceMedical’s newsletter, magazine
or website, as well as submitted for publication. To show our appreciation, authors will be awarded a $500 gift card.
Deadline for submissions is April 30, 2012.


What are your thoughts on the healthcare reform?




What impact do you believe it will have on the ASC Industry?




What top 3 operational concerns do you have for the future of ASCs?
1.


2.


3.




Your Name: ______________________________________________________________________________

Your Title: _______________________________________________________________________________

Your Phone: ______________________________________________________________________________

Best Date/Time to Reach You? _______________________________________________________________
                                                                                                                              Fall 2011




Facility Name: ____________________________________________________________________________

Facility Address: __________________________________________________________________________

City: ______________________________________ State: ________________ Zip: _____________________


         Please fold your completed feedback form on the dotted line, tape the bottom and mail.
           No need for postage. You may also fax back to 205-278-1416 or go to our website
      at http://sourcemed.net/surgery/sounding-board-feedback.php to complete the form on-line.                           6
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 Special care mustSpecial care ensure FIM and POSTNET barcode are actual size AND placed properly on the mail piece on the mail pie
                   be taken to must be taken to ensure FIM and POSTNET barcode are actual size AND placed properly
 to meet both USPS regulationsUSPS regulations and automation compatibility standards.
                  to meet both and automation compatibility standards.



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BUSINESS

Meaningful Use and its Impact on
Ambulatory Surgery Centers
Gary Clark, Regional Vice President of Sales, Surgery Division


           E  very day I speak with ambulatory surgery
              center (ASC) clients and prospects regarding
           the American Recovery and Reinvestment Act of
           2009. These conversations typically focus on the
           almost $26 billion available for health information
           technology (HIT) and how it impacts their facilities
           and physicians.

           I find that most of the surgeons, medical directors,
           and administrators I speak with understand that the
           Medicare and Medicaid EHR incentive programs
           provide incentive payments to eligible professionals
           (EPs), hospitals, and critical access hospitals (CAHs)
           that demonstrate meaningful use (MU) of certified
           EHR technology. They are also painfully aware that
           ambulatory surgery centers themselves are not
           eligible for these incentive payments. The one thing I
           disclose, which most people are not aware of, is that
           patient encounters in an ambulatory surgery center       As you review this complete list, you will see that
           can be included when calculating an EP’s meaningful      a certified EHR can easily accommodate these 25
           use attestation.                                         measures in your ambulatory surgery center. Some
                                                                    examples include:
           According to the CMS website, “EPs who practice          w A computerized provider order entry (CPOE)
           in multiple locations must have 50 percent or more         module allowing EPs to meet meaningful use when
           of their patient encounters during the reporting           ordering medications; maintaining a list of active
           period at a practice/location equipped with certified      medications and medication allergies;
           EHR technology. Every patient encounter in all           w An embedded drug-drug/drug-allergy interactions
           Places of Service (POS), except a hospital inpatient       module;
           department (POS 21) or a hospital emergency              w And the ability for EPs to maintain an up-to-date
           department (POS 23), should be included in the             problem list.
           denominator of the calculation, which would include
           patient encounters in an ambulatory surgical center      In conclusion, though it is true that ambulatory
           (POS 24).”                                               surgery centers are not directly eligible to receive
                                                                    incentive payments through the Medicare and
           So what does this mean for your ambulatory surgery       Medicaid EHR incentive programs, they can still
           center? If you have a certified EHR, you can help        positively contribute to their EPs’ attainment of MU
           your EPs achieve their meaningful use attestation        by having a certified EHR deployed at their facility.
                                                                                                                                Fall 2011




           which, in turn, will allow them to be eligible for
           incentive payments. There are a total of 25 MU           For more information about HITECH-EHR,
           objectives for EPs. A certified EHR must meet all 25     please visit our website at http://sourcemed.
           measures, and EPs must attest to a minimum of 20 of      net/hitech-surgery/. If you would like to learn
           these measures to qualify for an incentive payment.      more about SourceMedical’s certified EHR
           For a complete list of all MU core measures, please      solution, please visit http://sourcemed.net/
           visit www.cms.gov/EHRIncentivePrograms.                  vision/.


                                                                                                                            8
TECHNOLOGY

                Improving ASC Performance Through Data Analysis
                Tyler Strain, Senior Account Executive, Surgery Division




                          O      ver the course of eight years I have worked
                                 with over 600 ASCs, both independently-
                           owned and corporate-managed, in establishing,
                                                                                    SourcePlus Business Intelligence and SourcePlus
                                                                                    EdgeSurvey available through SourceMedical.

                           executing, and maintaining data analytic strategies      So the question becomes what specific data points
                           with the single goal of improving performance.           are relevant to my ASC’s operations?

                           The term ‘data analysis’ can be defined as the           Based on our experience in working with the leading
                           process of gathering, inspecting, cleansing,             independent facilities, consultants, and over 200
                           transforming, and modeling data with the goal of         management companies, here are some suggested
                           highlighting useful information to support effective     key data points to analyze to help with improving
                           decision making. Paramount to this process is            performance:
                           ensuring both proper data collection standards are
                           in place and an ability to extract the data in a way     w Scheduling: Identify any gaps in the schedule and
                           which allows a center to measure the critical areas        ensure block times are being used appropriately.
                           within its ASC.                                            The center may be able to consolidate cases or
                                                                                      release staff early. Emphasis should also be placed
                           The key to proper data analysis is ensuring the data       on cases that are profitable (based on procedure
                           is relevant and actionable. Well-run centers need          and payer).
                           to clearly establish performance goals in all areas of
                           operations and implement data collection strategies      w Supply Management: Management software
Fall 2011




                           which measure a facility’s outcomes. Fundamental           in your ASC should be able to track supply costs
                           to this process is empowering your staff with the          and confirm pricing against your supply contracts.
                           proper tools to both collect and extract these             Additionally, point-of-care documentation should
                           performance metrics. There are powerful business           include the status of each supply item scheduled
                           analytic, reporting, and benchmarking products that        to be used on the pick list. The ability to track
                           work in conjunction with your ASC management               supplies that have been used, returned, or wasted
                           software to enhance the data collection and                is paramount to controlling your inventory
                           extracting process. Examples of these products are         overhead.


            9
w Cost per Case: Point-of-care supply tracking                    of the variances are identified, best practices can
                 will enable your facility to track the total costs of           be identified and implemented.
                 a case. With declining reimbursements, well-run
                 centers are looking at costing analytics as a way to          w Case Volume: Analyze case volume by physician
                 combat shrinking revenues.                                      to identify any trends in caseloads. This allows the
                                                                                 center to identify key physicians that are driving
               w A/R Days: Ensure a baseline goal for days in A/R                the business and those that are not performing up
                 has been established and monitor for any outliers               to expectations.
                 or identification of any negative trends.
                                                                               These are just a few examples of the relevant data
               w Clinical Times: Time is money; accurately record              points that need to be analyzed on a regular basis.
                 clinical times and analyze the efficiency of the              There is a wealth of information residing in your
                 clinical staff/physicians by OR.                              ASC management software that your staff collects
                                                                               on a daily basis. Take action now and leverage this
               w Net Revenue: Analyze and trend variances in                   information through the available data analytic tools
                 revenue by specialty and physician. Variances                 to drive better performance in your center.
                 may be occurring with the same specialty when
                 performing the same procedures. Once the causes

               To learn more about SourceMedical’s business analytics and reporting tools, please visit our website at
               http://sourcemed.net/vision/sourceplus/sourceplus-business-intelligence-bi/ and
               http://sourcemed.net/sourceplus/sourceplus-edgesurvey/.




The right product, for the right procedure
at the right time
At Cardinal Health, we focus on making healthcare more cost-effective so                 We’re a full-service provider of:
our customers can focus on delivering exceptional care to their patients.                •	 Medical-surgical	products
Renowned	for	our	exceptional	quality,	value	and	service,	we’re	proud	to	                 •	 Pharmaceuticals
have	a	presence	in	one	of	every	four	surgery	centers	across	the	country.	We	             •	 Presource	procedure	packs
owe	our	track	record	to	a	simple	philosophy	 delivering	on	our	customers’	
                                            —                                            •	 Technology	solutions
immediate	needs	and	being	supportive	of	their	long-term	success.                         •	 Customized	services                              Fall 2011




   Lit. No. 2AMB5041 (06/2010)                                                                      cardinalhealth.com



                                                                                                                                        10
Don’t compromise when making your EHR decision.
 Partner with the company ASCs choose more often than all others combined.

                   Top Ten Reasons Why Now May Be the
                   Right Time to Implement Vision EHR™
w Vision EHR is certified as a Full Inpatient EHR system and validates our
	
  commitment to meeting the highest industry standards for an EHR application
	Is fully integrated into the workflow, security, and reporting of your management system
w
	Has specialty-driven chart templates and is customizable
w
	Promotes best practices for workflow and achieves high user acceptance
w
w Ensures consistent and thorough clinical documentation
	
	Eliminates costly document storage
w
	Helps facilities achieve and maintain compliance with regulatory requirements
w
	Has flexible payment options and can fully pay for itself in as little as 15 months
w
	Supports inventory management and cost analysis
w
	Is backed by our Meaningful Use Compliance Guarantee for ASCs
w


        “Vision EHR’s on-demand access to patient charts has simultaneously proven very beneficial to [our] staff and eliminates chart hunting.
        Anesthesiologists, PACU nurses, and billing staff have instant access to patient charts as needed which improves information workflows and creates
        more efficient processes. Additionally, enabling insight into multiple areas allows for faster identification and resolution of problems.”
                                                                                                    - Ed O’Byrne, Administrator, Stratham Surgery Center


           For an assessment on how Vision EHR can help your facility lower costs and improve care,
         please call Patrick Doyle at 866-675-3546, or visit us at sourcemed.net/sourceplus/vision-ehr/.
  SourceMedical is the premier provider of clinical and management software solutions.                                                                              TM



Our innovative solutions currently assist over 2,200 ASCs and specialty hospitals improve
        operational efficiency and cash flow while facilitating improved service and care.




                                                                                                                                           www.sourcemed.net
                                                                                                                                     Wallingford, CT 06492
                                                                                                                                     866 North Main St. Extension


                                                                                                                       TM




                                                                                                                                                                         SC6400

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Inside Source Fall 2011 Magazine

  • 1. Fall 2011 Inside Source What ASC Professionals Know The Benefits of Outsourcing Your ASC’s Billing IT Talk: Cloud Computing – A Nebulous Concept Made Simple Meaningful Use and its Impact on Ambulatory Surgery Centers Improving ASC Performance Through Data Analysis Follow us on: Brought to you by
  • 2. Inside Source What ASC Professionals Know in this issue: WELCOME WELCOME An ASC Perspective ....................................1 An ASC Perspective IT TALK Cloud Computing – A Nebulous Concept Patrick Doyle, VP of Sales Made Simple ...............................................2 SourceMedical Surgery Division BUSINESS The Benefits of Outsourcing Your ASC’s Billing ..........................................................3 Meaningful Use and its Impact on Ambulatory Surgery Centers ......................8 TECHNOLOGY I n many instances, compromising is not only necessary but proper. In the summer of 2011, the President and Congressional leaders compromised on matters regarding national fiscal policy to achieve a more stable economic environment. Improving ASC Performance Through Data Analysis .......................................................9 Additionally, National Football League owners and players came to a compromise in their labor dispute to ensure that football would be played on Sundays beginning 2011 UPCoMINg EvENTS SCHEDULE in September. In both instances, a compromise was at once predictable and 10/3 PASA Annual Meeting necessary to achieve the long-term objectives of all parties involved. Question: Radisson Hotel Harrisburg-Hershey, When is compromising neither necessary nor appropriate? Answer: When Camp Hill, PA setting a standard of excellence. This ideal should be applied to most, if not all, 10/3 NYSAASC Desmond Hotel & Conference Center, professional endeavors, and we ask surgery centers considering an IT system to Albany, NY consider this as they conduct system evaluations. 10/5 OR Excellence Manchester Hyatt, San Diego, CA 10/13 WASCA Annual Education Conference With roughly 6,000 surgery centers nationwide, more than half of these centers Tulalip Resort & Spa, Tulalip, WA implement clinical and business information systems not designed to handle the 10/15 IAASC Annual Conference unique aspects of a surgery center. Medical billing systems not designed with an Marriott, West Des Moines, IA ASC’s unique requirements in mind cannot handle electronic preference cards or 10/27 18th Annual ASC Conference Westin Michigan Avenue, Chicago, IL provide case costing information and compromise a facility’s ability to maximize 11/2 KAASC Annual Education Conference revenue and reduce costs. Similarly, clinical applications not designed for a surgical Capitol Plaza Hotel, Topeka, KS environment or applications which cannot handle multiple specialties compromise 11/10 TASCS Annual Conference Westin Riverwalk, San Antonio, TX the most significant and important aspect of any surgery center: patient care. 11/10 MASA Education Day Grand Traverse Resort, Traverse City, MI As the leading provider of clinical and business systems to surgical facilities, 11/14 AASA Annual Ambulatory Surgery SourceMedical offers affordable IT solutions to surgery centers not willing to Conference Gilbreath Conference Center – compromise. By fulfilling our commitment to leverage evolving technology and Baptist Medical Center, Little Rock, AR web platforms, our more than 2,200 surgical facilities experience higher system satisfaction and faster return on investment than can be experienced with any 2012 UPCoMINg EvENTS SCHEDULE other vendor’s solutions. We have flexible purchase options that avoid large 2/24 McDermott’s ASC Symposium upfront investments and allow facilities to immediately realize the benefits of NJAASC Quarterly Meeting, Miami, FL 4/25 CASCA Annual Spring Conference ASC software. I invite you to contact me and join your many colleagues that are 5/9 ASCs 2012 experiencing these benefits firsthand. Gaylord Texan, Dallas, TX 6/14 Annual Orthopedic, Spine and Pain Management-Driven ASC Conference Westin Michigan Avenue, Chicago, IL Patrick Doyle VP of Sales SourceMedical is the largest provider of outpatient information solutions and services for outpatient ambulatory surgery centers, specialty hospitals, and rehabilitation clinics nationwide. With 30 years of real-world experience, more than 5,000 satisfied customers, and the confidence of more than 250 consultants and management companies, SourceMedical offers the broadest range of solutions and enhancements available to the industry. The company’s unique end-to-end systems improve operational efficiency and cash flow while enabling healthcare facilities to capture, exchange, and analyze data to deliver a higher standard of patient care. For more information, please visit www.sourcemed.net.
  • 3. IT TALK Cloud Computing – A Nebulous Concept Made Simple Scott Palmer, President and COO, Surgery Division L et’s assume you are an administrator of an ambulatory surgery center. You focus on providing outstanding patient care and meeting Companies like SourceMedical have partnered with leading hosting companies to make their services available. ASCs can securely access Vision and the needs of your surgeons and staff. Part of your Vision EHR for a reasonable monthly fee that covers staff commitment is providing the right hardware all equipment and software costs. Your software and software for your staff to manage the daily vendor is responsible for performing upgrades, operational needs of the facility while providing monitoring the applications and servers, performing you with the right information to make informed daily backups, and providing 100% of the server decisions and provide accurate and timely side support. Just as importantly in a clinical information to your Board. environment, the applications are available at all times (99.9% uptime) through redundant hardware You understand basic computing concepts and have and software that is transparent to the end-user in become adept at using office productivity software, the event of a failure. but by no means do you consider yourself an IT expert. You worry about maintaining the hardware To connect to the Cloud, facilities are responsible and software that exists on your staff’s desktops, for accessing the Internet, providing PC performing backups, installing upgrades, security and workstations, tablet devices, printers, and scanners. HIPAA, periodically replacing hardware, repairs, and Thin client workstations which have no moving more. However, you cannot afford to pay a full-time parts and can be purchased for as little as $250 are IT resource so you use a third party to help with replacing the traditional PC workstation. Users may these activities. And while there are many great also use software to connect devices such as the companies to choose from, this can become an iPad to the Cloud as well. expensive proposition. If you access Google applications or email via AOL What’s the Solution? or Yahoo via a browser, then you are already Cloud Fall 2011 There has been tremendous advancement in computing. We have learned through experience to communication capabilities over the Internet and trust these applications so companies are shifting rapid growth in the number of companies serving up more intensive applications to the same model. We applications that are remotely housed and managed. see a shift to off-premises computing as a trend that Cloud computing and its counterpart “software will benefit ASCs in the years ahead. as a service” describes the ability to replace the classic client-server model with the ability to For more information on Cloud Computing access software without having any locally installed using Vision, please contact us at 866-675-3546 applications. or email us at info@sourcemed.net. 2
  • 4. BUSINESS The Benefits of outsourcing Your ASC’s Billing Scott Stone, COO & President, Revenue Cycle Solutions Division F rom a financial standpoint, outsourcing your billing, coding, and collections can have a dramatic effect on your bottom line. Utilizing the services of highly experienced back office staff, your facility can expect to: w Receive the maximum reimbursement for all procedures w Ensure claims are being submitted error-free, reducing denials and delays in reimbursement w Improve A/R days which will provide faster access to your cash w Receive assistance with managed care contracting negotiations w Decrease internal costs associated with salaries, benefits, and training Beyond the financial benefits, there are many other reasons outsourcing your billing makes sense. Finding and retaining qualified coders, billers, and collectors isn’t easy. By outsourcing your billing, disruption caused by staff turnover and training is avoided. Utilizing a billing service provider also helps ensure your operations are compliant with all current regulatory requirements including OIC, HIPAA, and state and federal requirements. When looking for a provider, a proven track record in the ASC market and certified coders should be a top priority. Make sure the provider has the ability to seamlessly integrate their billing services with your existing clinical and management software system. Seamless integration provides complete visibility into your accounts and allows progress to be monitored real-time. Additionally, the provider should offer a toll-free number for your patients. Having a service that answers all billing questions will free your staff to spend more time on what matters most: patient care. To fully understand the many benefits associated with outsourcing your billing, coding, and collections, please see the case study below. CASE STUDY CASE STUDY How One ASC Improved Compliance, Cash Collection, and Revenue This ASC ONE ASC IMPROVED COMPLIANCE, HOW is a freestanding, joint-ventured multi- Observations: specialty center that handles AND REVENUE CASH COLLECTIONS 350 cases a month. Inconsistent Fee Schedule – A fee schedule (ABBREVIATED VERSION) The Medicare-certified center is owned by seven evaluation revealed most fees were lower than physicians and the local hospital which owns 51%. Medicare/BCBS allowances for the ASC’s geographic Surgery Center is a freestanding, joint-ventured multi-specialty center that handles 350 cases a month.is self-managed by ENT, GI, Ophthalmology, Orthopedics, Podiatry and It The specialties served include the governing body. locality. The fee schedule was based on physician Pain Management. The Medicare-certified center is owned by seven physicians and the local hospital, which owns 51%. It is self-managed by the governing body. DRGs rather than Medicare allowances or cost per During its first 14 months in operation, the case. There was no consistency in fees. During its first 14 months in operation, the center had experienced a negative cash flow. surgery center experienced a negative cash flow. SourceMedical’s Revenue Cycle Solutions (RCS) team was brought onboard to evaluate and aid in resolving business office inefficiencies related to the billing process and to(RCS) if the SourceMedical’s Revenue Cycle Solutions determine Low Managed Care Rates – The surgery center met billing compliance guidelines. team was brought onboard to evaluate and aid center’s managed care contracts had low rates and A full in resolving business office inefficiencies team to assess the financial and business office evaluation was performed by the RCS related unfavorable terms for an area with little managed revenue cycle and determine any billing compliance issues. Initial findings were obtained Fall 2011 to the billing process and to determine if the during the on-site evaluation, while the improvements were achieved after 12 months of care penetration. Market standard in the area reimbursement management. met time of the compliance guidelines. surgery center At the billing evaluation the center was facing numerous revealed rates based on percentage of billed charges; challenges. Each problem affecting revenue was addressed separately, with the following A full financial and business office evaluation was recommendations for correction. however, most of the center’s managed care performed. Initial findings were obtained during reimbursement was based on Medicare groupers. Observation: Fee schedule was inconsistent the on-site evaluation while the improvements Fee schedule evaluation revealed that most fees were lower than Medicare/BCBS allowances for the ASC’s geographic locality. Fee schedule was basedof physician DRGs rather than were achieved after 12 months on reimbursement Non-compliant Coding – Coding was being Medicare allowances or cost per case. There was no consistency in fees. management. Revenue-affecting issues were performed by an inexperienced coder; multiple The RCS team recommended a complete review following observations.a copy resolved as a result of the of the fees, provided the center with coding errors resulted in both over- and under- of Medicare allowances, showed them how to do a mark-up based on these fees, and provided information about case costing. charging of claims. 3 Observation: Low Managed Care Rates The ASC’s managed care contracts had low rates and unfavorable terms for an area with little managed care penetration. Market standard in the area revealed rates based on percentage of billed charges. However, most of the ASC’s managed care reimbursement was based on
  • 5. Figure 1. COMPARISON GROSS AND NET CHARGES BEFORE /DURING/AFTER RCS BILLING $14,000,000.00 $13,224,387 $12,000,000.00 $10,000,000.00 $9,413,284 $8,000,000.00 Gross Charges Net Charges $6,000,000.00 $4,680,781 $4,597,145 $4,000,000.00 $3,905,406 Past Due Billing – The coder also handled billing Eighteen Months Later $2,000,000.00 $2,067,246 and often fell behind. All claims were submitted on Under the direction of the RCS team with $0.00 paper – no electronic filing and no cross-checking assistance from surgery center staff, the following Year 1 - No Year 2 - Part Yr Year 3 - Full Yr RCS Involvement RCS Involvement RCS Involvement was done to ensure all claims were filed. achievements resulted: No claim follow-up – There was not a single Figure 2. collector or follow-up on submitted claims. The COMPARISON CASH COLLECTIONS BEFORE AND DURING RCS BILLING payment poster did not have a copy of the insurance $6,000,000 contracts, and payments were accepted as correct. $5,000,000 $4,768,328 There was a large amount of unbilled revenue due to coding errors, and multiple procedures were $4,000,000 often unbilled. Claims receiving no payment or incorrect payment were not revisited. Thirty-seven $3,115,526 About SourceMedical $3,000,000 percent of total accounts receivable were greater than SourceMedical is the premier provider of outpatient information 150 days old. $2,000,000 solutions and revenue cycle management services for ambulatory $1,549,008 Insufficient Insurance Information – The clinics surgery centers, speciality hospitals, and rehabilitation scheduler was With a 30-year trackof Medicare ASC- 5,000 nationwide. not using a list record and more than $1,000,000 allowed proceduresSourceMedical is the trusted source for unique, satisfied customer, nor did they have insurance Year 1 - No RCS Involvement Year 2 - Part Yr RCS Involvement Year 3 - Full Yr RCS Involvement end-to-end systems improve operational efficiency and cash flow information on the center’s contracts. $- while enabling healthcare facilities to deliver a higher quality of patient care. Patient Responsibility Communicated – Patients w Increase in gross revenue – Within 18 months, were not notified in advance about deductibles the annual gross revenue increased from and co-pays. Medicare requires that patients are $4,680,781 to $ 13,224,387 indicating a 182% apprised of their financial responsibilities prior to increase in annual gross revenue. the day of surgery and need to acknowledge that they have been informed with a written signature. w Increase in net revenue – During this same time period, the annual net revenue increased from Following the Evaluation: $2,067,246 to $4,597,145 which indicates a 122% The RCS team provided the governing body with a 4 increase in annual net revenue. 05/11 detailed list of recommendations; the surgery center made the necessary changes including outsourcing w Increase in cash collections – During this same their coding and billing to the RCS team. time period, the increase in annual cash collections increased from $1,549,008 to $4,768,328 - a Changes in Revenue – Within the first 90 days of 208% increase in annual cash collections. RCS involvement, the surgery center was operating in the black for the first time. Gross charges tripled, w Elimination of billing backlog – All billing was Following are charts which reflect the improvements made in the Center’s results after average gross charges per case doubled, collections partnering with Source Medical Revenue Cycle Solutions and utilizing Revenue Cycle audited for errors, and refunds were issued increased more than 250%, and profits increased Management : for overpayments along with submission of a more than 400%. corrected claim. Claims were resubmitted for underpayments. If timely filing was an issue, appeals Figure 1. COMPARISON GROSS AND NET CHARGES BEFORE /DURING/AFTER RCS BILLING were filed to collect the claim citing new center $14,000,000.00 problems. All claims were followed up on by $13,224,387 collectors and resubmitted when the payer did not Fall 2011 $12,000,000.00 have a record of receipt. Accounts receivable was $10,000,000.00 $9,413,284 brought up to date. Going forward, all claims were $8,000,000.00 Gross Charges submitted and followed up on in a timely basis. Net Charges $6,000,000.00 $4,680,781 $4,597,145 w Compliance in billing – The RCS team’s certified $3,905,406 $4,000,000.00 coders and experienced billing staff reviewed all $2,000,000.00 $2,067,246 questionable claims and payments; the necessary $0.00 corrections were made; and payers and patients Year 1 - No Year 2 - Part Yr Year 3 - Full Yr were notified. RCS Involvement RCS Involvement RCS Involvement 4
  • 6. The Benefits of outsourcing Your ASC’s Billing (continued from page 4) “ ” Gross charges tripled, average gross charges per case doubled, collections increased more than 250%, and profits increased more than 400%. Making the decision to outsource your Revenue To learn more about RCS and how we can Cycle Management is one which can have a profound impact your center’s financial performance, impact upon your ASC’s results. As such, it should call us at 866-889-7722, email us at be trusted only to someone with a proven track revenuecyclesolutions@sourcemed.net, or visit record who truly understands your business. http://sourcemed.net/revenue-cycle/. Achieving results as shown above requires deep domain expertise, highly trained and dedicated professionals, well-defined and proven processes, and a real focus on results. SourceMedical’s RCS team embodies just that - “ASC Billing Done Right”. Improve your Financial Results and Eliminate your Billing Concerns ASC Billing Done Right Deep ASC billing domain expertise means that your surgery center receives maximum reimbursement for all procedures. Whether “in network” or “out of network”, we are focused on quality processes and positive outcomes for every client. Complete Revenue Cycle Management by a Proven Leader Insurance verification, coding, collections, appeals and “Business is all about trusted relationships, and we have forged such denials management, and customized reporting – all a relationship with SourceMedical. They are reliable, professional, from the industry leader in ASC Software and ASC courteous, and have helped us navigate some very complex waters over Billing Services. We provide each client a dedicated the years. Without hesitation, I would recommend their ASC Billing Services to anyone – particularly if you are seeking to improve your top Fall 2011 team of functional experts, ensuring continuity and and bottom line.” eliminating disruptions in your revenue stream. - Mark E. Smith, Chief Administrative Officer Orthopedic Associates of Wisconsin To Learn More: w 866-889-7722 w revenuecyclesolutions@sourcemed.net is now w www.sourcemed.net/revenue-cycle 5
  • 7. fEEdBACK The Sounding Board A Source for Voicing Your ASC Insights The Sounding Board’s mission is to gather feedback, insights and opinions from you, the ASC experts, on the latest news, trends and outlook facing our industry today, and to publish the best of your insights to help benefit our peers. We’d like to hear from you. Selected feedback/insights will be recognized in SourceMedical’s newsletter, magazine or website, as well as submitted for publication. To show our appreciation, authors will be awarded a $500 gift card. Deadline for submissions is April 30, 2012. What are your thoughts on the healthcare reform? What impact do you believe it will have on the ASC Industry? What top 3 operational concerns do you have for the future of ASCs? 1. 2. 3. Your Name: ______________________________________________________________________________ Your Title: _______________________________________________________________________________ Your Phone: ______________________________________________________________________________ Best Date/Time to Reach You? _______________________________________________________________ Fall 2011 Facility Name: ____________________________________________________________________________ Facility Address: __________________________________________________________________________ City: ______________________________________ State: ________________ Zip: _____________________ Please fold your completed feedback form on the dotted line, tape the bottom and mail. No need for postage. You may also fax back to 205-278-1416 or go to our website at http://sourcemed.net/surgery/sounding-board-feedback.php to complete the form on-line. 6
  • 8. IMPORTANT: DO NOT ENLARGE, REDUCE OR MOVE the FIM and POSTNET barcodes. They are only valid as printed! valid as prin IMPORTANT: DO NOT ENLARGE, REDUCE OR MOVE the FIM and POSTNET barcodes. They are only Special care mustSpecial care ensure FIM and POSTNET barcode are actual size AND placed properly on the mail piece on the mail pie be taken to must be taken to ensure FIM and POSTNET barcode are actual size AND placed properly to meet both USPS regulationsUSPS regulations and automation compatibility standards. to meet both and automation compatibility standards. FOLD AT DOTTED LINE NO POSTAGE NO POSTAGE NECESSARY NECESSARY IF MAILED IF MAILED IN THE IN THE UNITED STATES UNITED STATES BUSINESS REPLY MAIL BUSINESS REPLY MAIL FIRST-CLASS MAIL FIRST-CLASS MAIL PERMIT NO. 148 WALLINGFORD CT PERMIT NO. 64 WALLINGFORD CT POSTAGE WILL BE PAID BY ADDRESSEE POSTAGE WILL BE PAID BY ADDRESSEE SOURCE MEDICAL MEDICAL SOURCE 866 N MAIN 866 N MAIN STREET EXT STE 1 STREET EXT STE 1 WALLINGFORD CT 06492-9609 06492-9609 WALLINGFORD CT FOLD AT DOTTED LINE Artwork for User Defined (4" x 5.5")Defined (4" x 5.5") Produced by DAZzle Designer 2002, Version 4.3.08 Version 4.3.08 Artwork for User Produced by DAZzle Designer 2002, Layout: C:Program FilesEnvMgr32Dazzle32B4X55.LYT Envelope Manager Software, www.EnvelopeManager.com, (800) 576-3279 (c) Layout: C:Program FilesEnvMgr32Dazzle32B4X55.LYT Envelope Manager Software, www.EnvelopeManager.com, (c) January 28, 2009 January 28, 2009 06:04:58 06:04:58 U.S. Postal Service, Serial #NO U.S. Postal Service, Serial #NO
  • 9. BUSINESS Meaningful Use and its Impact on Ambulatory Surgery Centers Gary Clark, Regional Vice President of Sales, Surgery Division E very day I speak with ambulatory surgery center (ASC) clients and prospects regarding the American Recovery and Reinvestment Act of 2009. These conversations typically focus on the almost $26 billion available for health information technology (HIT) and how it impacts their facilities and physicians. I find that most of the surgeons, medical directors, and administrators I speak with understand that the Medicare and Medicaid EHR incentive programs provide incentive payments to eligible professionals (EPs), hospitals, and critical access hospitals (CAHs) that demonstrate meaningful use (MU) of certified EHR technology. They are also painfully aware that ambulatory surgery centers themselves are not eligible for these incentive payments. The one thing I disclose, which most people are not aware of, is that patient encounters in an ambulatory surgery center As you review this complete list, you will see that can be included when calculating an EP’s meaningful a certified EHR can easily accommodate these 25 use attestation. measures in your ambulatory surgery center. Some examples include: According to the CMS website, “EPs who practice w A computerized provider order entry (CPOE) in multiple locations must have 50 percent or more module allowing EPs to meet meaningful use when of their patient encounters during the reporting ordering medications; maintaining a list of active period at a practice/location equipped with certified medications and medication allergies; EHR technology. Every patient encounter in all w An embedded drug-drug/drug-allergy interactions Places of Service (POS), except a hospital inpatient module; department (POS 21) or a hospital emergency w And the ability for EPs to maintain an up-to-date department (POS 23), should be included in the problem list. denominator of the calculation, which would include patient encounters in an ambulatory surgical center In conclusion, though it is true that ambulatory (POS 24).” surgery centers are not directly eligible to receive incentive payments through the Medicare and So what does this mean for your ambulatory surgery Medicaid EHR incentive programs, they can still center? If you have a certified EHR, you can help positively contribute to their EPs’ attainment of MU your EPs achieve their meaningful use attestation by having a certified EHR deployed at their facility. Fall 2011 which, in turn, will allow them to be eligible for incentive payments. There are a total of 25 MU For more information about HITECH-EHR, objectives for EPs. A certified EHR must meet all 25 please visit our website at http://sourcemed. measures, and EPs must attest to a minimum of 20 of net/hitech-surgery/. If you would like to learn these measures to qualify for an incentive payment. more about SourceMedical’s certified EHR For a complete list of all MU core measures, please solution, please visit http://sourcemed.net/ visit www.cms.gov/EHRIncentivePrograms. vision/. 8
  • 10. TECHNOLOGY Improving ASC Performance Through Data Analysis Tyler Strain, Senior Account Executive, Surgery Division O ver the course of eight years I have worked with over 600 ASCs, both independently- owned and corporate-managed, in establishing, SourcePlus Business Intelligence and SourcePlus EdgeSurvey available through SourceMedical. executing, and maintaining data analytic strategies So the question becomes what specific data points with the single goal of improving performance. are relevant to my ASC’s operations? The term ‘data analysis’ can be defined as the Based on our experience in working with the leading process of gathering, inspecting, cleansing, independent facilities, consultants, and over 200 transforming, and modeling data with the goal of management companies, here are some suggested highlighting useful information to support effective key data points to analyze to help with improving decision making. Paramount to this process is performance: ensuring both proper data collection standards are in place and an ability to extract the data in a way w Scheduling: Identify any gaps in the schedule and which allows a center to measure the critical areas ensure block times are being used appropriately. within its ASC. The center may be able to consolidate cases or release staff early. Emphasis should also be placed The key to proper data analysis is ensuring the data on cases that are profitable (based on procedure is relevant and actionable. Well-run centers need and payer). to clearly establish performance goals in all areas of operations and implement data collection strategies w Supply Management: Management software Fall 2011 which measure a facility’s outcomes. Fundamental in your ASC should be able to track supply costs to this process is empowering your staff with the and confirm pricing against your supply contracts. proper tools to both collect and extract these Additionally, point-of-care documentation should performance metrics. There are powerful business include the status of each supply item scheduled analytic, reporting, and benchmarking products that to be used on the pick list. The ability to track work in conjunction with your ASC management supplies that have been used, returned, or wasted software to enhance the data collection and is paramount to controlling your inventory extracting process. Examples of these products are overhead. 9
  • 11. w Cost per Case: Point-of-care supply tracking of the variances are identified, best practices can will enable your facility to track the total costs of be identified and implemented. a case. With declining reimbursements, well-run centers are looking at costing analytics as a way to w Case Volume: Analyze case volume by physician combat shrinking revenues. to identify any trends in caseloads. This allows the center to identify key physicians that are driving w A/R Days: Ensure a baseline goal for days in A/R the business and those that are not performing up has been established and monitor for any outliers to expectations. or identification of any negative trends. These are just a few examples of the relevant data w Clinical Times: Time is money; accurately record points that need to be analyzed on a regular basis. clinical times and analyze the efficiency of the There is a wealth of information residing in your clinical staff/physicians by OR. ASC management software that your staff collects on a daily basis. Take action now and leverage this w Net Revenue: Analyze and trend variances in information through the available data analytic tools revenue by specialty and physician. Variances to drive better performance in your center. may be occurring with the same specialty when performing the same procedures. Once the causes To learn more about SourceMedical’s business analytics and reporting tools, please visit our website at http://sourcemed.net/vision/sourceplus/sourceplus-business-intelligence-bi/ and http://sourcemed.net/sourceplus/sourceplus-edgesurvey/. The right product, for the right procedure at the right time At Cardinal Health, we focus on making healthcare more cost-effective so We’re a full-service provider of: our customers can focus on delivering exceptional care to their patients. • Medical-surgical products Renowned for our exceptional quality, value and service, we’re proud to • Pharmaceuticals have a presence in one of every four surgery centers across the country. We • Presource procedure packs owe our track record to a simple philosophy delivering on our customers’ — • Technology solutions immediate needs and being supportive of their long-term success. • Customized services Fall 2011 Lit. No. 2AMB5041 (06/2010) cardinalhealth.com 10
  • 12. Don’t compromise when making your EHR decision. Partner with the company ASCs choose more often than all others combined. Top Ten Reasons Why Now May Be the Right Time to Implement Vision EHR™ w Vision EHR is certified as a Full Inpatient EHR system and validates our commitment to meeting the highest industry standards for an EHR application Is fully integrated into the workflow, security, and reporting of your management system w Has specialty-driven chart templates and is customizable w Promotes best practices for workflow and achieves high user acceptance w w Ensures consistent and thorough clinical documentation Eliminates costly document storage w Helps facilities achieve and maintain compliance with regulatory requirements w Has flexible payment options and can fully pay for itself in as little as 15 months w Supports inventory management and cost analysis w Is backed by our Meaningful Use Compliance Guarantee for ASCs w “Vision EHR’s on-demand access to patient charts has simultaneously proven very beneficial to [our] staff and eliminates chart hunting. Anesthesiologists, PACU nurses, and billing staff have instant access to patient charts as needed which improves information workflows and creates more efficient processes. Additionally, enabling insight into multiple areas allows for faster identification and resolution of problems.” - Ed O’Byrne, Administrator, Stratham Surgery Center For an assessment on how Vision EHR can help your facility lower costs and improve care, please call Patrick Doyle at 866-675-3546, or visit us at sourcemed.net/sourceplus/vision-ehr/. SourceMedical is the premier provider of clinical and management software solutions. TM Our innovative solutions currently assist over 2,200 ASCs and specialty hospitals improve operational efficiency and cash flow while facilitating improved service and care. www.sourcemed.net Wallingford, CT 06492 866 North Main St. Extension TM SC6400