NPR Segment Features ASCs

National Public Radio aired a segment featuring ASCs on its financial analysis program Marketplace on Jan. 12, which discussed how the ASC industry is viewed from various perspectives, according to the ASC Association.

The segment features an interview with ASC Association President Kathy Bryant and an ASC Association member from The Surgery Center at Brinton Lake in Glen Mills, Pa., as well as the perspective of the industry from hospital leaders.

To review a transcript of the segment or listen to a recorded broadcast, click here.

Leveraging Technology, Data in Surgery Centers to Deliver Better Patient Outcomes

ASCs are under increasing pressure to capture, track and report key quality indicators (QI) and outcomes data. As evidence of this, one need look no further than CMS and leading ASC accreditation bodies.

CMS had previously called for ASCs to begin submitting quality data in 2009 as part of a congressionally mandated pay-for-performance system. Though that requirement was eventually tabled, the agency has gone on the record that its “clear intention is to implement ASC quality reporting in the future.”

Quality indicators and outcomes data also play a greater role in achieving accreditation from the Joint Commission. In fact, beginning in 2010, the Joint Commission will require ASCs to collect data on infections and post-operative complications for 30 days after all procedures and one year after any procedures involving implantable devices. AAAHC, laboratory and other accreditation bodies are also placing more emphasis on quality data.

Benefits beyond compliance
Looming federal mandates and more stringent accreditation standards are not the only impetus for ASCs to put a priority on quality and outcomes data. Professional societies are also stepping up their interest in tracking a broader array of quality measures to expand national benchmarks and position ASCs for the arrival of pay-for-performance reimbursement models.

Many associations offer benchmarks that allow ASCs to compare their data with national performance statistics on clinical outcomes, staff indicators and billing performance, as well as annual surveys that revolve around compensation, revenue and expenses, which many ASC administrators utilize when auditing practice performance.

Though these initiatives are voluntary, they are excellent starting points for ASCs interested in reaping the clinical and operational rewards that can be derived from measuring quality and outcomes data. Doing so can reveal how an ASC is performing against its competition in such areas as infection rates, hospital admissions, etc., all of which can play a significant role in gaining and maintaining market share and negotiating higher reimbursement rates.

Further, tracking operational measures such as supply costs, days in accounts receivable, etc., against national benchmarks can identify areas for operational improvements when they show significant variances between comparable ASCs.

ASCs can also benchmark against internal data to validate clinical and operational efficacy or identify areas for improvement.

This was the case for Central Bucks Specialists, a hospital-owned outpatient GI lab in Bucks County, PA. After deploying an EHR and documentation system, the practice began tracking indicators to determine the cause of inconsistent room turnover that was creating scheduling problems, patient frustrations and overall operating inefficiencies. In doing so, the ASC identified several inconsistent practice patterns that could benefit from adjustments.

For example, one of the ASC’s six physicians averaged a scope-in to scope-out time that was significantly shorter than his peers. This was determined to be a practice preference, and the physician ultimately opted to slow his scope withdrawal to ensure greater consistency and better adhere to identified GI best practices.

Capturing data is critical challenge
Despite the demonstrated benefits that can be realized from tracking QI and outcomes data, many ASCs have been slow to jump on the bandwagon. The problem is not reluctance; it is the ability to effectively and accurately capture structured, compliant data. This is due in large part to the fact that 82 percent of ASCs do not utilize an EHR and 74 percent utilize dictation and transcription to generate physician procedure notes.

In a paper-based environment, data must be manually gathered from patient charts, a time-consuming and error-prone process. Exacerbating the problem, once the data has been collected, there is no efficient means for querying discreet elements to generate the types of reports necessary to effectively benchmark performance indicators and measure quality and operational outcomes. Because of this lack of automation, many ASCs feel they derive little value from the time spent tracking QI data.

The good news is that many of these hurdles no longer exist. A growing number of health technology vendors now provide software and systems that are capable of capturing, tracking and analyzing a full range of QI and outcomes data and are designed specifically for ASCs.

Technology edge
The emergence of specialty-specific automated procedure documentation solutions for ASC-based services help drive structured and compliant data capture for quality initiatives, benchmarking and other reporting statutes.

Menu-driven documentation processes enable fast, easy capture of compliant data at the point of care, without the need for manual manipulation or intervention. The software automatically captures discreet data elements for each procedure, which can then be automatically uploaded to a central repository.

Built-in reporting and analytics tools further simplify quality reporting, clinical research and audit preparation with pre-built reports or customized query-writing capabilities that enable every captured data element, including free text, to be queried, exported and submitted in appropriate formats.

Automation eliminates some of the most significant challenges provider organizations have faced when attempting to participate in quality-based initiatives, such as the Physician Quality Reporting Initiative. Among those were technical and coding problems that resulted in non-payment for thousands of physicians who made a good faith effort to report data.

When ASC-specific EHRs are added to the technology mix, the opportunities to track QI and outcomes data expand exponentially — as do the uses for that data to improve operational and clinical performance. For example, the EHR is an important tool to help ASCs comply with increasingly stringent Joint Commission and AAAHC care standards. It can generate safety alerts, record safety measures taken and significantly streamline the gathering of data and documentation should an audit occur.

By leveraging the EHR’s comprehensive data tracking capabilities, such as scope withdrawal time, adenoma detection rate and rate of cecal intubation, ASCs are able to identify areas for practice improvements.

Conclusion
There is a great deal for ASCs to gain from the capture and tracking of key QI and outcomes data. Internal and external benchmarking can reveal areas for clinical and operational improvements that can directly impact quality of care and the bottom line health of an ASC.

With quality transparency gaining traction as consumers become more familiar with publicly reported data, meaningful benchmarking against local and national competitors and the ability to validate clinical efficacy will play a greater role in gaining and maintaining market share.

Deploying the right technologies, such as automated procedure documentation and coding software and ASC-specific EHRs, eliminates the drain on resources and the potential for human error that can plague QI and outcomes data collection and reporting in a paper-based environment. In doing so, it can help ASCs improve operational and clinical effectiveness and efficiencies and position them for future federal mandates and performance-based payment initiatives.

Ambulatory Surgery Center Outlook for 2010

With 2009 closed, the preparation for a successful 2010 is here. Most centers have considered the trends and utilization by surgeons and begun the budgeting process to establish goals and objectives for 2010. When setting those goals, the greatest factor for existing centers is capturing the appropriate cases from prior utilizers and recruiting new cases from surgeons seeking the efficiency of an ambulatory surgery center (ASC). Management team members need to assess their individual challenges at their center and work to contain cost, improve production and eliminate waste. Similarly, physician partners need to assess their role in the center in assisting the cost control, reviewing data on cost, preference items and consider case adoption when appropriate.

For centers under development or under consideration, team members should be recasting projections, timelines and fully understanding the progression from planning to operations making assurances that the plan reflects today’s environment. As the economy continues to remain slower than anticipated, the economic downturn results in the need for all members of the partnership to personally guarantee loans, there is additional scrutiny of the deal points, terms are aggressive and the process is slower than in past history.

In general, 2010 has many positive aspects to consider. From an operational aspect the decrease in professional fees result in surgeons seeking an ambulatory setting for partnership as well as the need for efficiencies to impact their total practice. The investment in an ASC is often a great stabilizer to a physician base attempting to control their surgical environment and production. An ASC could be formed easily around a smaller core group of physicians to assist in attaining their goals. As with any partnership, the greater affinity for the groups’ cohesiveness the greater focus on core principles and alignment.

As hospitals continue to have pressures and cuts in personnel, the ASC environment can recruit registered nurses and surgical techs more easily by bringing quality offerings with less pressure on elevated salaries. This will allow ASCs the ability to recruit and retain talented employees and bring value to those employees seeking part-time and PRN work schedule. The ASC setting can be of great value to registered nurses, as the flexibility of part-time and PRN work can fill current needs of local resources. Surgeons will continue to seek potential avenues for an ASC and hospitals may consider expanding the potential for joint-venture opportunities. A counter measure by hospitals may be to employ specialists and reducing the potential for surgical intervention outside the hospital catchment entities. This could reduce the availability of specialists needed to expand or develop existing or future ASCs.

Currently, building and labor costs are lower due to the economic pressures and the need for contractors to keep crews active, resulting in lower costs and rental rates. This is a critical point for existing center remodeling and expansion allowing for tired assets to be updated and keep pace in the local standard of care. Additionally, the start-up facility has the opportunity to increase margin by lower cost space and lower lease rates as the entire construction cost is decreased. This drives great value, as the fixed cost is often over a longer time frame and the savings great over the life of the lease. Additionally, the availability of new, used and refurbished equipment remains of value with the current pressures on companies to move existing equipment and reduce inventory in all categories. Equipment and surgical instrumentation companies are increasing the ability to provide valuable terms and payment methods to meet centers needs.

Reimbursement is always a challenge in any healthcare entity. In the ASC industry the negotiation of contracts and details that must be included in each negotiation is critical to the success of a center. Each year, a careful evaluation of the centers managed care contracts, covered codes, multiple procedures, carve-outs and implant reimbursement must be reviewed and negotiated. Beyond the contracting, the appropriate billing and collections- to-contract standards must be complied to receive each dollar on every case. As the consolidation of payors continues and contract language becomes more complex, it is essential that your team has the appropriate resources to grow net revenues. The collection of co-pay and deductibles must also be conducted in a proactive manner. Each patient must be notified of the expectations at time- of-service and associated costs of the surgical encounter. The evaluation of in and out-of-network must be weighed, justified and aligned with each state’s regulatory guidelines. As the co-pay and deductible becomes more burdensome on the population, the potential for the delay in elective cases being scheduled timely may occur.

As the healthcare debate continues, ASCs continue to be the lower-cost environment to assist in keeping healthcare costs from climbing into the future. Assuring the right case for the right environment is often an indicator that is overlooked in an ASC. Having partners understand the appropriate case type, acuity, co-morbidities and implant reimbursement is key to assisting in the profitability of cases. ASC management teams must communicate trends and encourage participation in the process allowing all employees become knowledgeable in the aggregate center costs. All team members must have the necessary attention to detail, high customer service and clinical excellence required of today’s successful ASC. The center’s management team must proactively manage the center to optimal levels to assure the clinical and financial performance of the center.

At Practice Partners in Healthcare we specialize in de novo and turn-around opportunities, providing a unique development process and management arrangements. Practice Partners is a minority equity holder, leaving the majority to physicians and hospital partners. We bring success-proven management expertise to the clinical, financial and regulatory performance of new and existing surgery centers. Experienced in both CON and non-CON states our team provides seasoned talent for developing and managing physician-owned and hospital-physician joint ventured surgery centers.

Larry Taylor is president and CEO of Practice Partners in Healthcare, Inc.

 

Legal Issues for 2010

The ambulatory surgery center industry (ASC) confronted both challenges and change in 2009. However, with numerous ASC developments underway and an economic recovery on the horizon, the ASC industry is poised to perform well in 2010. This article addresses the key business and critical healthcare regulatory developments of this past year and their potential impact on the ASC industry for 2010.

Sale to ASC Management Companies and Health Systems

A significant business issue confronted in 2009 by the ASC industry was the decline in transactions involving a sale of a significant equity interest in an ASC to an ASC management company or health system. This decline was likely precipitated at least in part by a few historical ASC management companies that slowed down their acquisition strategies due to the tightened credit market.

In addition, the terms and pricing associated with a sale of a significant equity stake in an ASC clearly changed. For the past few years, many ASC management companies and health systems were willing to acquire a controlling equity interest in an ASC for a 7-plus purchase price multiple. Most purchase price multiples have dropped into the 5-6 range.

The purchase price formula is typically calculated as follows: (i) the ASC’s earnings before interest, taxes, depreciation and amortization (EBITDA) for the prior twelve months; multiplied by (ii) the purchase price multiple (e.g., 5-6 range); less (iii) the ASC’s long-term liabilities; multiplied by (iv) the ownership percentage being purchased. For example,. assume an ASC with $800,000 in EBITDA and no long-term debt desires to sell a 51 percent interest to an ASC management company, then the purchase price could range from $2 million to $2.5 million (e.g., [($800,000 x 5 to 6) – $0] x 51 percent).

Some new well-funded corporate buyers have also emerged in 2009. Additionally, hospitals continue to have an appetite for ASC acquisitions. As a result, a slight uptick in these transactions can be anticipated for 2010. While purchase price multiples will likely hover in the 5-6 range, ASC companies have also introduced more creative strategies to make deals more attractive to selling physicians, including the use of earn-outs and staged transactions. These strategies warrant careful attention as they can introduce new healthcare regulatory and other legal issues into the mix.

Hospital/Physician Alignment Options and Changes to the Stark Law

Hospitals and health systems will likely continue to leverage their higher reimbursement rates and community branding as a means to attract ASCs to them over other corporate investors. Historically, some hospitals pursued an “under arrangement” transaction strategy with physicians in an ASC setting.

While the terms of an “under-arrangement” transaction can vary considerably, it typically involves a physician-owned company leasing the space, equipment and/or staff to the hospital — perhaps on a turn-key basis. The hospital bills Medicare and other payors for the services and pays the physician-owned entity a fixed fee, variable fee or hybrid fixed/variable fee.

However, Stark law changes that became effective as of Oct. 1, 2009 forced hospitals and physicians to restructure or unwind such arrangements. In particular, the scope of the Stark law was expanded to apply not only to the entity billing for a “designated health service” (i.e., the hospital) but also the entity that is performing the designated health service (i.e., the physician-owned entity). In addition, the Stark law no longer permits a physician owned entity to lease space or equipment on a per-click, percentage of revenue or other similar fee structure.

In what appears to be an emerging trend across the country, a number of health systems are also considering (or for many — reconsidering) a broad spectrum of hospital/physician alignment and integration options including physician practice acquisitions, use of the foundation model, and entering into professional service and employment arrangements with surgeons and other proceduralists. These strategies may be driven at least in part by the changes to the Stark law as well as the mutual desire of hospitals and physicians to collaborate in the provision of healthcare services in a more meaningful and long-term manner.

Migration of Procedures From Hospitals Into the ASC

At the individual ASC level, in spite of a slight decrease in demand, many ASCs have grown their profits. The revenue growth may be due in part to the movement into the ASC of procedures historically required to be performed in the hospital setting, such as vascular access and certain orthopedic procedures.

The emergence of these procedures new to the ASC setting has been primarily driven by advances in medical technology as well as the expanded list of Medicare ASC covered procedures under the revised ASC payment system. Adopted by the Centers for Medicare and Medicaid Services in 2007, the revised ASC payment system allows an ASC facility fee to be paid for any surgical procedure performed at an ASC, except those surgical procedures that CMS determines are either not safe when furnished in an ASC or in which the expected duration of services would exceed 24 hours following admission.

The addition of these procedures to an ASC can have an immediate positive impact on an ASC’s bottom-line. As a result, many ASCs are examining the viability of adding these procedures to their ASC by attracting the appropriate physician specialists and sub-specialists and properly equipping the facility for such procedures.

Physician Re-Syndications

Physician re-syndications (i.e., sale of equity interests to physicians) remain very active for a number of reasons. First, ASC companies and physician owners of ASCs often desire to solidify physician utilizers’ relationships to their ASC by having them purchase equity interests. Second, a number of ASCs are reselling equity that was repurchased from prior physician investors who are no longer utilizing the facility.

Many ASCs, however, are struggling with how to make the buy-in price to physicians more attractive. The purchase price must be consistent with fair market value to minimize anti-kickback law issues. The purchase price formula for a physician’s purchase of a minority interest is the same as the formula used by an ASC management company, except that a 2-4 purchase price multiple is typically used in lieu of the 5-7 multiple. The buy-in, however, can still be quite significant. For example, assume the same ASC, as previously mentioned, desires to sell to a 5 percent equity interest to a physician, then the purchase price could range from $80,000 to $160,000 (i.e., [($800,000 x 2 to 4) - $0] x 5 percent) Allowing the ASC or its owners to loan monies to the physician to buy-in, including through an advance of future ASC distributions, could raise regulatory concerns. Accordingly, an ASC may consider alternative strategies to make the purchase price more affordable. These strategies may include the use of a dividend recapitalization or preferred distribution (which are treated as a liability in the formula described above thereby reducing the purchase price).

Alternatively, an ASC could undergo a tax-free restructuring so that the ASC is owned through a physician group practice. Group practice ownership of an ASC may allow an ASC to depart from a fair market value buy-in price.

Physician Buy-Backs

Many ASCs continue to be confronted with physician partnership and “deadweight” issues. A recently filed lawsuit, DeBartolo v. HealthSouth Corp. brings to the forefront the issue of non-productive physician owners in ASCs. The lawsuit was filed by a surgeon investor in an ASC whose shares were repurchased because of his failure to perform at least one-third of his procedures at the ASC.

The case is significant because it addresses the critical issue of whether the repurchase of a physician’s equity interest for failing to utilize the ASC would violate the anti-kickback law. On the one hand, the federal anti-kickback law ASC safe harbor mandates that a physician must perform at least one-third of his procedures at the multi-specialty facility in which he has an ownership interest. However, regulatory concerns could also arise if an ASC’s redemption of a non-productive physician is intended to penalize the physician for not selecting this particular facility for the procedure.

Nevertheless, many ASCs have incorporated compliance with the one-third test requirement into their governing documents. If a physician owner fails to perform at least one-third of his or her ASC procedures at the ASC in which he or she is an owner, then the ASC’s governing document may provide that such physician’s ownership interest in the ASC can be repurchased by the ASC or its other owners.

In an early ruling in DeBartolo, the federal court dismissed the lawsuit indicating it should be addressed under state law. While too early to determine, this initial ruling suggests that physician buy-back issues may simply raise state contract law claims. It is therefore critical that an ASC’s governing document incorporates the latest terms and mechanisms for dealing with physician equity buy-backs in a manner that takes into account the latest regulatory and other legal guidance.

Conclusion

There is no denying that this past year was a bit sluggish for the ASC industry, particularly in the transactional front, as it faced its own set of challenges including dealing with aggressive payor “out-of-network” billing strategies and the potential impact of health system reform. However, most ASCs escaped generally unscathed from the economic woes of this past year.

As 2010 gets underway, there are a number of favorable indicators for the ASC industry. Newly emerging buyers with capital are in search of ASC acquisition opportunities. Hospitals remain interested in pursuing collaborative strategies with physicians, particularly in the ASC and other outpatient sectors. And, ASCs are adopting a number of revenue enhancement strategies including through performing procedures not historically performed in the ASC setting, physician re-syndications and by adding ancillary revenue streams (e.g., anesthesia). As a result, the ASC industry is poised to have a strong year in 2010.

Healthcare Trust of America Acquires Colorado Medical Office Building, Surgery Center

Healthcare Trust of America, based in Scottsdale, Ariz., has acquired Hampden Place Medical Center in Englewood, Colo., for $18.6 million, according to an HTA news release.

Hampden Place houses an ambulatory surgery center, medical imaging and physiotherapy facilities, and medical offices for orthopedic, hematology-oncology and related-physician practices, according to the release. The facility was developed in conjunction with local physicians and HCA HealthOne Hospital System.

Read the release about HTA’s acquisition of Hampden Place Medical Center.

Dr. Peter Colquhoun Discusses Four Opportunities for Ophthalmology at Surgery Centers in 2010

Peter Colquhoun, MD, a board-certified ophthalmologist at Southwest Michigan Eye Center in Battle Creek, Mich., and physician-owner of Brookside Surgery Center, also in Battle Creek, discusses four opportunities for ophthalmology in ASCs.

1. Multi-focal implants. Although the price of lens implants are bundled into payments for cataract surgery, if a physician and patient select a higher-end multi-focal implant, such as Alcon’s ReStor IOL or AMO ReZoom IOL, surgery centers, at least in Michigan, can balance bill a patient for the additional cost of the lens, says Dr. Colquhoun. Balance billing allows for cataract patients, who are often covered by Medicare, to receive the highest-level technology — a technology that Medicare would otherwise deny, he says.
2. Intravitreal injections. Dr. Colquhoun says his ASC is exploring offering intravitreal injections, such as Avastin and Lucentis, to treat various retinal disorders including age-related macular degeneration, diabetes and vascular occlusions. The ASC is currently analyzing potential reimbursement rates and demand for the procedure to determine if it is advantageous for the ASC.
3. Mini glaucoma shunts. Dr. Colquhoun’s practice is also considering bringing in a glaucoma specialist in the coming year. If the practice is successful in attracting an additional physician, Dr. Colquhoun says the new specialist could bring additional business to the ASC by performing implantations of mini shunts to treat glaucoma, which can be performed in an ambulatory setting.
4. Oculoplastics. Finally, although the volume of plastic surgery has dropped dramatically with the economy, Dr. Colquhoun expects some of that business to rebound in 2010. “With the economy improving in the next year, we are hoping lid corrections and other elective ophthalmic procedures, such as LASIK, will increase,” he says.

Tennessee Hospital Opens Outpatient Surgery Center

Baptist Hospital West in Knoxville, Tenn., has opened a $15 million outpatient surgery center, according to a report by the News Sentinel.

The 21,500-square-foot Mercy Surgery Center West features four operating rooms and two procedure rooms.

Surgeries in a number of specialties including pain management, gastroenterology, plastic surgery, gynecology, ENT, orthopedics and general surgery will be performed at the center.

Read the News Sentinel’s report on Mercy Surgery Center West.

3 Tips for Reducing Delayed Claims in Surgery Centers

CPT copyright 2008 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

Mike McFadin, operations manager of national bill review at Sedgwick Claims Management Services, a third-party claims administrator and productivity management firm, and David Kessler, DC, MHA, medical director of Sedgwick CMS’s Ohio managed care operations programs, provide three tips for reducing delayed and denied insurance claims in ASCs.

1. Use revenue code 278 for surgical implants. One of the most common reasons ASCs are asked to resubmit claims is for the use of inappropriate revenue codes for surgical implants. ASCs bill for surgical implants under a variety of supply codes, including 270 (medical/surgical supplies), 272 (sterile supplies) and 279 (other supplies and devices); however, facilities should use revenue code 278 for implants to ensure expedient claims processing, says Mr. McFadin.

“The most appropriate and direct way to bill for surgical implants is to use revenue code 278, regardless of whether the implant is carved out or paid as bulk,” he says.

2. Ensure that surgical procedure codes that can be billed under multiple revenue codes are billed using the most appropriate code. Certain surgical procedures may be billed using multiple revenue codes. When this occurs, it is important that coders take care to bill using the most appropriate revenue code. For example, a spinal injection (CPT 62310) may be billed under pharmaceutical revenue code 250 or surgical revenue codes 360 (operating room services)Delayed Claims and 490 (ambulatory surgical care). Code 490 is the most appropriate for that procedure and will help improve the timeliness of claims processing, says Mr. McFadin.

3. Include documentation of medical need for multiple first assistants. Dr. Kessler says that it is becoming more common for physicians, especially in Ohio, to bill for the use of first assistants and even multiple assistants, such as an assisting physician or physician assistant, in the OR. When additional physicians and/or PAs are used for an operation, claims should include upfront documentation explaining the medical need for the assistants, says Dr. Kessler.

“If there is a proactive comment on the claim of why the use of an assistant or assistants was required, such as because of the severity of medical problem, then the claim can more easily move through the system,” says Dr. Kessler. “If it is unclear whether or not all individuals were reasonably necessary for the procedure, the claim will undergo peer review. By using documentation of its necessity of a lead in, providers can receive approval more quickly.”

Learn more about Sedgwick Claims Management Services.

The information provided should be utilized for educational purposes only. Facilities are ultimately responsible for verifying the reporting policies of individual commercial and MAC/FI carriers prior to claim submissions.

Free Webinar: Hospital-Doctor ASC Joint Ventures: A Highly Efficient Physician Engagement Tool

Title: Hospital-Doctor ASC Joint Ventures: A Highly Efficient Physician Engagement Tool

Date: Feb. 11, 2010

Time: 1:15-2:15 CST

Sponsored by: Medical Surgical Partners

Overview: The era of loose cooperation and occasional competition between hospitals and their private practice medical staff members is drawing to a close. As a result, hospitals and health systems must align with physicians to meet the demands for price, quality, efficiency and community service imposed by private payors, government and empowered consumers. Hospitals and health systems are faced with a wide range of physician engagement tools and strategies to meet this challenge.

Nearly 1,700 hospital-physician surgery center joint ventures exist in the United States. These arrangements facilitate service line development, offer market development opportunities, ameliorate the compensation needs of employed surgeons, provide a vehicle for real estate investment by non-surgeon staff, reduce the cost of care in the community, enhance access to care and care quality and are an incubator for development of physician leaders. Most importantly, such joint ventures are efficient to organize and offer a win-win situation for hospitals and physicians seeking to align the hospital’s mission and economic interests with those of its physicians.

Notwithstanding the power of ASC joint ventures, many hospital executives find them counter-intuitive because of short term loss of hospital surgical revenue.

Topics covered will include:

• Examination of the market drivers behind ASC joint ventures;
• Economic factors underlying their performance and impact on hospital operations; and
• Joint-venture structure issues central to successful hospital-physician surgery centers.

Correctly approached, hospital-physician ASC joint ventures are a powerful physician engagement tool that produces reliable results quickly and efficiently and without substantial capital and operational investment by the health system.

Speaker information:
David Thoene, Managing Partner, Medical Surgical Partners — Mr. Thoene has 27 years’ experience consulting for and developing ASC throughout the United States and was instrumental in perfecting the hospital-physician ASC joint venture model used by many major health systems and hospitals throughout the country. He has published articles in national trade journals on topics such as evaluating real estate options for surgery center development and has been a speaker at national conferences on topics related to ASC development. Mr. Thoene was the vice president of development for FSC Health and Titan Health Corp., founded the development arm of Randlett Associates Incorporated and is the founder of Medical Surgical Partners. Mr. Thoene has developed surgery center investments for physicians, academic medical centers and health systems.

Registration:
To register, click here.

Virtual Conference Offers Infection Prevention Guidance

If you are tasked with infection control responsibilities at your ambulatory surgery center or surgical hospital, you won’t want to miss the fourth annual virtual ICT Conference on Professional Development, designed to deliver the latest infection prevention information through the context of professional development for infection control practitioners in all kinds of healthcare settings.

Participating in the conference is an excellent way to help boost infection prevention knowledge among staff in order to meet the new infection control conditions for coverage from the Centers for Medicare & Medicaid Services (CMS) for ambulatory care.

The virtual ICT Conference on Professional Development will be held Feb. 9-10, 2010. This dynamic event is a fantastic way to learn and network — all for free and from the comfort of your home or office. Because the conference is completely virtual and online, there’s no expense related to travel or inconvenience due to time spent away from the job.

Thanks to cutting-edge technology, the conference’s educational sessions, networking opportunities and exhibits are all virtual, meaning that you experience the event live through your computer and high-speed Internet connection. Once inside the virtual show doors, you’ll be able to browse the expo floor, chat with exhibitor booth staff and other attendees, download e-literature and attend live presentations via Webcast.

The conference agenda addresses key issues and trends in infection prevention, with presentations delivered by veteran industry experts in infection prevention, patient safety, risk management, quality improvement and professional development. Topics include the evolving role of the infection preventionist, making the business case for infection prevention, inter-departmental collaboration for improved infection control, asset management, best practices for the OR and sterile processing, regulatory and standards compliance and much more. Some sessions feature Q&A sessions, and free contact hours of continuing education will be offered on select Webcasts.

For more information about the ICT Conference on Professional Development, including the agenda and details about how to register, visit www.ictconference.com.

The ICT Conference on Professional Development is produced by Virgo Publishing LLC, publisher of SurgiStrategies magazine and sister publication Infection Control Today magazine, among other titles in its Medical Group.

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