By Stephen W. Earnhart, MS
CEO
Earnhart & Associates
Austin, TX
Some ambulatory surgery managers have a hard time seeing that money saved is money earned. Many hospitals, surgery centers, and surgeons’ offices focus so much effort on increasing revenue and not enough on controlling their expenses. Can and should you do both? Of course, but sometimes we all get in a position that one of those options just isn’t there for you at that time.
For example, you have cajoled every surgeon you have for more cases; however, with the new year, most patients have not met their deductible, and surgery is down. You cannot get cases that are not there, but what a great way to reduce staffing and save some money by encouraging staff to take winter vacations or use paid time off.
What about payer contracts? Most manages are so unaware about what they are supposed to receive in reimbursement that much of it slips away. You are losing money that you have earned and are not collecting. Now, during these historically slow surgery months, is a great time to review each of your contracts.
It’s surprising that few facilities are even aware of one huge expense: the cost of anesthesia drugs and supplies. The last time we analyzed this data, about two years ago, the average cost was around $60 per case for general and around $30 for other.
Check yours, and see where they lay. Again, I guarantee that you will be surprised at how this controllable expense creeps up. Controlling this cost often is as easy as making your providers aware of the price of the various items.
Updating surgeon preference cards is another way to make money by saving money. Many of the outdated cards still contain items that are no longer used but still packaged and/or opened on the back table and Mayo Tray that you are paying for. Custom packs, while convenient for staff, typically are significantly overpriced by the vendors. Again, there are items in packs that the surgeon no longer uses due to different surgical techniques, or there are surgical approaches, such as draping, that no longer apply. It is well worth your time to have someone review the items against the updated preference cards. A savings of even $30 per case adds up quickly!
Check your inventory. Almost every facility has outdated or soon-to-be outdated supplies in your sterile supply room. Making sure stock is rotated appropriately can save money on waste each year.
The historically “slow” surgical months are a great time to change to barcoding your storerooms and items. So many patient chargeable expenses never get billed. In a recent audit we performed, an average of $200 used per case was never billed due to outdated charge sheets or just plain oversight. Audit yourself to see where you fall. All of these ideas add up to steady income over time. [Earnhart & Associates is a consulting firm specializing in all aspects of outpatient surgery development and management. Earnhart & Associates can be reached at 5114 Balcones Woods Drive, Suite 307-203, Austin, TX 78759. Phone: (512) 297-7575. Fax: (512) 233-2979. E-mail: [email protected]. Web: www.earnhart.com.]
