Surgical Solutions IPA was borne from identifying a chasm in health care where despite substantially every metric pointing to ambulatory surgery centers (ASCs) as the optimal site for outpatient surgeries, they continue to be undervalued and underutilized. SSIPA brings together independent ASCs into a single association for the purposes of improving financial performance, growing volume, and reducing operating expenses for each center. SSIPA enables ASCs to discover this new-found leverage and compete with their powerful adversaries. Such improved performance ultimately cascades down to improving and expanding patient care.
SSIPA was founded by healthcare executive and veteran Gregg Gordon who has 30+ years of experience in all facets of how providers and payors partner to do business. After he moved from the corporate payor side to advocating for providers, he realized that independent ASCs were struggling to demonstrate their value to their payor partners and gain access to new markets. An organized network of independent ASCs enables payors to effectively utilize site-of-service care management tools, reduce medical expenses for both FFS and at-risk value-based deals, improve member satisfaction, and more.
To help Gregg with this endeavor, he has assembled a team of some of the most well-respected professionals in their fields to a) develop new sources of patient direction to SSIPA’s members; b) maintain and support full regulatory compliance for data and quality protocols; c) promote SSIPA’s network via media/branding/marketing efforts, d) provide clinical expertise via a Chief Medical Officer; and e) keep SSIPA properly focused via a Board of Advisors, the members of which who are each experts in their areas of health care.
Why a Single “Association”?
Independent ASCs have struggled to negotiate competitive rates, seek resolutions to claims and/or operational issues, and gain access to new sources of patient volume as each of them are individual organizations. At SSIPA we remove that barrier and unite them into one network that enables them to have more leverage, improve their contractual terms, solve issues with greater expediency, and meet the needs of patients who might otherwise not know that they have an alternative to going to a hospital for their outpatient procedures. Some other benefits include:
- Reduced cost: Hospital outpatient departments are nearly 2x the cost of the same case at an independent ASC and hospital expenses are 60-65% of total medical expenses. For an insurance company or at-risk provider, having an option to disintermediate a hospital through an organized delivery system of freestanding ASCs allows for a reduction of medical cost and an improved overall performance.
- Paradigm Shift in Leverage: Hospitals/health systems continue to out-leverage payors leading to higher medical costs, poor quality performance metrics, and member dissatisfaction. SSIPA offers to a payor the opportunity to move more OP cases out of the hospital ecosystem to reduce total medical expenses, improve the quality scorecard, and increase patient satisfaction.
- Patient Satisfaction: Patients who experience an adverse event at a hospital, e.g. a hospital-acquired infection, have a lower chance of the same at an ASC. Patients also value simple things like better parking arrangements, nicer aesthetics in the waiting room, thoughtful patient throughput from pre-op to OR to post-op recovery, and more. ASCs cater to patients in ways that hospitals cannot and do not.
- Physician Satisfaction: Surgeons who are seeking to schedule their cases at a hospital compete with the full spectrum of specialists who seek the same and often are battling to secure preferred time slots. ASCs are considerably more accommodating and value physicians accordingly versus hospitals who often commoditize physicians.
- Data Collection: As payors consider how to manage premium and revenue collection, having more information about their members enables them to price products and benefits with greater accuracy. SSIPA’s relationships with ASCs will allow them to collect risk-scoring data, assist with patient satisfaction data collection, support CMS-level STAR rating improvement activities, and more.
An Organized Network Enables ASCs to:
- Improve one or many payor agreements that will drive increases in revenue.
- No longer endure the opportunity costs of not having business development staff and develop relationships with key partners like at-risk providers.
- Use economies of scale to get better discounts on supplies, address labor and benefits challenges, and solicit other solutions to operational/administrative headaches.
Implementing these three concepts will enable independent ASCs to accomplish their primary goals: with an increase in revenue, an increase in volume, and a reduction in administrative costs, ASCs will have an opportunity to expand in terms of specialties offered, Operating Rooms added, locations, staff, etc. It seems like all of the stakeholders know that ASCs need to be valued more, but no one has yet figured out how to accomplish that. SSIPA knows how and will do it.
Types of Associations
The flexibility of a network of ASCs is that they can be curated for specific partner needs, e.g. narrowing the network of ASCs to only include orthopedics-focused centers for a workers comp company; enabling a women’s health company to steer members to ASCs who specialize in women’s reproductive health; empowering a company that self-insures and wants to pay less than what a hospital will charge; helping to create a larger savings pool for at-risk provider organizations and their payor partners, etc.
Dispelling the Myth about Hospitals
Hospitals have long been considered the default “premier” place to go for care. Many are associated with large health systems who are believed to attract the best clinical talent, have the latest technology and equipment, etc., but the data shows that for certain types of outpatient procedures, patients actually tend to have worse outcomes when visiting a hospital vs an ASC.
Costs are higher at hospitals, the rate of acquired infections is greater, and the patient experience can be lackluster. Patient satisfaction reports often reflect a colder and impersonal experience at a hospital… and physicians are often challenged as well as they compete for limited OR time and contend with low morale. Patients are happier going to an independent ASC than to a hospital and it’s often for the simple things such as convenient/free parking, an engaged and friendly clinical and administrative team, modern office environments and comfort elements, but most importantly, they are treated with dignity and respect.