Sedalia Surgery Center is a Reminder of the Importance of ASCs

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Phyllis-Fischer-thumbPhyllis Fischer, Administrator

Located in Sedalia, Mo., Sedalia Surgery Center is a fully accredited, fully equipped ambulatory surgery center that is highly valued by its local community. Once the community becomes aware of its services, that is.

According to Phyllis Fischer, administrator, among the biggest challenges confronting ASCs is the unfamiliarity that not just patients have with her type of facility, but also legislators. The Ambulatory Surgery Center Association has worked hard to rectify this, she said, but there is a great deal of education left to be done.

A winner in quality and in patient satisfaction

Fischer first joined Sedalia 10 years ago, starting as an office manager and ascending to the role of administrator five years ago. During her time as administrator, she has led the organization in achieving exceptional patient-satisfaction scores. As a result, Sedalia has seen an increase in its return rate and has been the recipient of the APEX Quality Award for Patient Satisfaction & Overall Care for five consecutive years.

Sedalia’s success with patient satisfaction has to do with its commitment to quality, down to the very last detail, Fischer said.

As an ASC, CMS surveyors pay Sedalia a visit every three years. On its last visit, CMS zeroed in on a few environmental issues in the center, namely rust on the equipment wheels and oxygen tanks in the operating room.

While this may not seem like a huge problem on the surface, Fischer said, the cost of replacing this equipment or calling in the vendor to remedy the rust issues was prohibitive.

“As a preventative measure, we began to investigate ways we could take care of the rust without having to spend a lot of money purchasing new equipment,” she said. “We thought about sandblasting, so we contacted a local person here who did that type of work.”

She and her team then repainted and retouched the equipment and oxygen tanks to give them a fresh look. When the surveyors returned, they were impressed by the efficiency and economy of Sedalia’s solution and by the team’s willingness to tackle this issue on their own.

Fischer listed two benefits resulting from the effort: repairing the breach in quality and potential for infection that could have proliferated from the rust and the significant improvement in appearance for the organization.

Looking ahead to the future, Fischer said Sedalia is planning to expand upon the number of procedures it is already offering as a multispecialty facility. For example, the organization is looking to add vein procedures and widen its orthoscopic service line.

Figuring out storage and insurance issues

At this juncture, Sedalia is confronting two primary challenges: limited storage and the insurance exchange.

Since there is no incentive or initiative for ASCs to go electronic, Sedalia does not have an EHR.

“Being a small facility, it’s just an expense the board did not want to undertake at this time, and since they were all struggling with it in their own practices, they didn’t want to go down that road until we have to,” Fischer said.

Nevertheless, buildings weren’t constructed with storage in mind, she added. “We are trying to reduce storage issues, so we do scan. We started with our most current files and have now transitioned to where they’re able to shred, so that’s helping with our storage problems.”

Currently, the board is also debating whether to go in-network with a major insurance carrier. Previously, a facility could benefit from being out-of-network. But now, patients are choosing high-deductible plans to keep the premiums at a lower cost, and it makes it harder for patients to go out-of-network and for facilities to negotiate with the patient so that they are not penalized for choosing your facility, Fischer explained.

“So, we lose those cases. An issue with going in-network with a carrier is that you actually get reimbursed substantially less than you do when you are out-of-network.”

Therefore, the question for Sedalia and its board, comprised largely of physicians who own the center, has become, Which is more beneficial? Being in-network or staying out-of-network?

A little-known benefit within the community

ASCs provide their communities with convenience and quality. Fischer said most legislators will acknowledge the cost savings created by ASCs, but will then immediately transition to discussing reducing rates of reimbursements to hospitals rather than increasing rates of reimbursements to ASCs.

She wishes a happy medium could be found.

“We are 56 percent Medicare, and so the procedures that we do play a large part in how we do financially since certain procedures just don’t reimburse as well. The association has done a really great job of speaking with the legislators and informing them. And I think it’s just a matter of continuing to provide that education. We as ASCs have to make our voice heard as well.”

In the meantime, she hopes that Sedalia can play a role in informing the public at large about the benefits of an ASC.

“I just don’t think people in general realize what an ASC is all about until you actually visit one. We have an awesome staff that is very personal. Patients are not treated like another number. They’re treated like individuals. Until they’re here, however, it’s just not common knowledge.”

by Pete Fernbaugh

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