This Week in Surgery Centers: Bruce Johnstone – Expanding Your ASC: Adding an OR

Bruce Johnstone – Expanding Your ASC: Adding an OR

Here’s what to expect on this week’s episode. 🎙️

The second part of our three-part series on “Expanding Your ASC” dropped today! 

Our first episode covered bringing on new surgeons and new specialties. Bruce Johnstone, Principal at Apex, joins us to cover how to add a new OR to your existing facility. Here are seven highlights from our discussion.

1️⃣️ Assess Demand: Utilize data to understand your current OR utilization. Anything above 80-85% indicates potential need. 

2️⃣ Analyze Market: Look at population demographics and competition to gauge demand. 

3️⃣ Stakeholder Input: Gather feedback from surgeons, staff, and even patients. 

4️⃣ Cost Insights: Adding an OR can range from $500K to $1M, covering construction, equipment, and operational costs. 

5️⃣ Compliance & Regulations: Ensure you meet federal (CMS, HIPAA) and state regulations to avoid costly delays. 

6️⃣ Efficient Design: Create functional zones, incorporate advanced technology for better visualization and automation, and design with future expansion in mind. 

7️⃣ Managing Construction: Detailed planning and regular communication are key, consider temporary solutions to maintain safety, and keep patients informed to minimize anxiety. 

Check out the full episode on YouTube or your favorite podcast platform!  

Episode Transcript

[00:00:00] Welcome to this week in Surgery Centers. If you are in the ASC industry, then you are in the right place every week. We’ll start the episode off by sharing an interesting conversation we had with our featured guest, and then we’ll close the episode by recapping the latest news impacting surgery centers.

We’re excited to share with you what we have, so let’s get started and see what the industry’s been up to.

Erica: Hi everyone, here’s what you can expect on today’s episode. Today is part two of our three part podcast series all about expanding your ASC. As we learned last episode, expansion will look different for every surgery center, but whether you’re adding new physicians, introducing a new specialty, opening another or just growing your team, having that growth mindset is essential for your surgery center’s longevity.

Erica: Today we are sitting down with Bruce Johnstone, who is a principal at Apex, and he’s [00:01:00] sharing great advice on how you can successfully add a new OR to your facility. After my conversation with Bruce, we will switch to our Data Insights segment. Last September, HST released a state of the industry report that had 45 chapters of best practices, 125 plus KPIs for ASCs to track, And free benchmarking data for 15 key metrics.

Erica: So we are actually in the process of redoing that 2023 report for 2024. And in the process of doing so, I’ve been re inspired by all the metrics that we’re reviewing. So in honor of it being two months out from our published date, I wanted to share with you. I hope everyone enjoys the episode and here’s what’s going on this week in Surgery Centers. Bruce, welcome to the podcast.

Bruce: Thank you. Glad to be here.

Erica: [00:02:00] Can you please share a little bit more about yourself?

Bruce: Yeah, sure. Happy to. As for myself one of the principals here at Apex we are a healthcare specific design and construction firm. Working across the country.

Bruce: In the healthcare space, private healthcare, which means we get involved in a lot of surgery centers specialty clinics, imaging centers, really anything that survives and thrives in the private healthcare environment. And our team is set up to help clients from start to finish and all the planning phases of projects through to architectural permitting and delivery of construction.

Bruce: So as a firm that’s our position in the market based in Chicago. And like I say, work across the country. That is our story in a nutshell.

Erica: Very cool. And I’m excited to have you on cause we are in the middle of our series about expanding ASCs. So we’ve talked about how to add a physician, how to add certain specialties, but with your expertise, we will be talking about how to add in an operating room to your [00:03:00] existing surgery center.

Erica: So let’s get right into it. How can an ASC kind of assess the demand and need for an additional OR?

Bruce: It’s a good one. This question comes up frequently, as you can imagine. The thing we’re always wanting to do is consider all options and make sure that we’re really analyzing what’s involved when we’re making that consideration of an additional OR.

Bruce: To begin with, what I like to say is collect data and analyze it. We want to make sure that we’re really informed on, The current OR utilization rates. What’s our current position. So we feel like we need more OR space, but how well are we utilizing what we have today? Typically just for reference sake, anything above 80%, 85 percent utilization rate on an OR is pretty good.

Bruce: Pretty high. So if you are already have exceeded that, yeah, you might be in a position where, look we need to look for ways to accomplish additional OR space. Something that factors into that is the [00:04:00] turnover times of the OR. Of course how much time between cases longer, the time that there is might indicate some inefficiencies that need to be addressed as opposed to additional OR space.

Bruce: Maybe there’s some inefficiencies that are slowing down your turnover time. Okay. Between cases of course, case volume comes into play here. So looking at historical case volumes, growth trends, or they’re increasing case volumes, they’re suggesting a rising demand. Is that what’s driving this?

Bruce: So just collect all data you possibly can on how your current. ORs are being, utilized assess it carefully look at scheduling bottlenecks that can often be a big one. And try to just understand whether there’s consistent delays and an inability to accommodate new cases again, these all might be signals for the need for expansion.

Bruce: So that’s one area is the. The data and analyzing it. Another point to be made is the market market around us analyze the [00:05:00] market. So population demographics, is there an aging population that’s driving demand? Or are we seeing that as being caused for this sense that we need additional OR space?

Bruce: Maybe it’s service line related, perhaps there’s additional specialties or services or driving growth. That’s creating that demand for ORs. Of course, always good to analyze your competition, not to get obsessed with it, but look, possible systems, neighboring other private ASCs neighboring what’s their volume.

Bruce: What are they dealing with? So really I think to begin with, it’s always, good to look at the data, look at the market, analyze it once we’ve done that, let’s gather as much input from all stakeholders as we can. So surgeons always have feedback, let’s gather input from the surgeons at the ASC regarding their needs, what they perceive as.

Bruce: Necessary for current capacity and bottlenecks. Staff, of course, working in the center following nursing, administrative staff, et cetera, [00:06:00] include them in discussions about workflow and capacity issues. They’ve also Always got boots on the ground sort of input. Another one that can be very insightful is patient feedback.

Bruce: So consider ways to engage them in a survey process. What’s their experience, any frustration with scheduling delays that might not be as insightful as for surgeon and staff input, but it can’t hurt those are the first frontline things that come to mind there’s other areas operationally to consider what’s the case lengths. Are there peak times of our use cancellations and delays are those creating sort of issues. But, beyond that, once we have a really good framework of what we can get our arms around on the data, then it’s. A good time to run a cost benefit analysis.

Bruce: Let’s let the numbers do the talking and conduct that financial analysis to look at the cost versus of adding an or versus the potential revenue and increased case [00:07:00] volume that will be obtained that way. And just make sure we understand where break even is and where we’re starting to pull ahead.

Bruce: With adding that OR lastly, near and dear to our hearts is the facility and the capability for the facility itself to even accommodate an additional OR that needs to be considered infrastructure wise. There’s a lot of demand for HVAC and electrical power and plumbing to support a new OR.

Bruce: So how well can we accommodate that? So once we go through all the. Analysis of data, like I say, and prove out that it makes sense. Then yes, let’s run it through financial and facility analysis as well. What I can really just summarize is look, make sure that you are as informed about the decision as you possibly can be so that you truly are justifying the need for an OR.

Bruce: As opposed to just feeling a pinch and saying, look, the quick fix is another OR because it may not be the case. Truly be sure that it’s gone through all the paces of validating that a new OR is the solution to [00:08:00] the pinch that you’re feeling. Yeah, those are some thoughts when assessing the demand and need for additional OR space.

Erica: Sure. Yeah, that is all amazing advice. That could have been the whole episode right there. Thank you. So can you also discuss the typical costs involved in expanding with a new OR? I’m sure we could do a whole 30 minutes just on that. Yeah,

Bruce: we sure could. Yeah. Yeah the costs are so dependent on so many different things.

Bruce: We get asked this question all the time, as you can imagine, what should I expect to pay? What’s my investment? I want to make sure I’m getting a solid return on my investment. And yes, it’s necessary, but I guess for the sake of this conversation, let’s try to at least identify what the core costs categories are.

Bruce: Let’s try to break it down by category and try to give you some steer on it. At least of course, the first one being the construction and renovation costs, it’s usually the, between that and the equipment, those are the two biggest areas. So as far as construction and renovation. You have all your planning services.

Bruce: [00:09:00] So design architecture fees that could range in a 10 to 50, 000 range, you have construction. Look, if you’re adding one OR typically for an OR, you’ve got 500 square feet. Let’s say on average, it might be 400 to 600. Let’s call it 500. There’s cost per square foot metrics that go around the industry on this.

Bruce: It’s really difficult to. Pin it down to a cost per square foot. When all you’re doing is adding one OR as opposed to building like a whole new facility where costs spread across that square footage. But we could carry a range from 200 to 500 per square foot, perhaps in the construction.

Bruce: There’s always HVAC utility related work scope that needs to be done. When we move over to the equipment costs side of things, Again, a big range because what type of center is this? Is there going to be a lot of imaging as a just basic surgical equipment? Or is there additional costs for imaging and that sort of thing, integration of technology.

Bruce: I guess [00:10:00] really just to look at the lump sum at the end of the day, because we could go through all of the costs of, Operational and technology, and even a lot of times there’s regulatory and compliance costs that need to be factored in and so on. But for a single OR expansion the total range could be in the 500 to million dollar range for an additional OR with the lion’s share of that being the construction and equipment Operationally, I think some of the things are often overlooked in forecasting the cost of a new R is the operational costs and technology related items, because look, if you’re going to add another or what about staffing?

Bruce: What about training? What about the supplies that start up costs for an additional or in that sense? Might always not be, calculated accurately. And then some soft costs on it software that can be in the tens of thousands of dollars as well. I think as a general range, if we use that 500, 2 million to [00:11:00] capture sort of everything, not just.

Bruce: Our scope, not just the architectural design and construction scope, but really everything across the the gamut of expansion is a pretty good range to carry. And then I guess the advice there is just ensure that you’re engaging. Experts to help in the planning pre planning is your friend.

Bruce: It’s critical. Make sure that you’ve got really good advice and accurate input on how well this can be done and what the costs are going to be and what’s included for the scope. So a roundabout answer to your question but that’s some thoughts anyway.

Erica: Yeah, no, it’s a loaded question and it’s.

Erica: I mean your range is perfect because it’s impossible to say what, the cost might be for one facility versus another. There’s so many variables. But you did mention regulatory and compliance and I’d like to go back to that for a second. Are there any issues there that ASCs should be aware of?

Bruce: Yeah, this is a tripping point oftentimes because the thought can be that look, if I’m licensed with the [00:12:00] state I should be good to go. But. We can’t forget that there’s really federal as well as state regulations to be in compliance. So maybe if we just go through what typically the federal versus state versus accreditations, what those things can look like to start with.

Bruce: We need that Medicare certification. We have to be certified by CMS. To be a N. A. S. C. That’s seeing cases and getting reimbursed. Otherwise, coverage for Medicare just won’t be there. And there’s some other things from a federal standpoint as well. Of course, HIPAA and OSHA. For patient care, patient protection, OSHA standards for safety.

Bruce: But really it’s just, I want to emphasize the need to be aware of CMS. It’s not only state, it’s also CMS. We’ve had, we’ve seen centers before where the expansion’s done or the facility is built. And they have left the the CMS part of it until the end. And now you’re just, there’s the time clock is ticking and you’re, Missed revenue can be in the millions of dollars per month, even but not having the center [00:13:00] open.

Bruce: So be aware of the federal, the application process for CMS. When it comes to state most states require ASC, ASC to be licensed. So the state health departments have their regulations, which we need to make sure that we’re covered there and get licensed. But the license licensure can vary state to state.

Bruce: Some have the certificate of need process that needs to be adhered to. And that can be a lengthy, complicated process depending on whether this is a specialty specific center or multi specialty. It can be challenging to get licensure and see when states, if competition is high in that given area.

Bruce: So that can be another tripping point. Of course there’s legal advice and consultants to be engaged to navigate that process, but just to be aware that it exists. And then, the accreditation piece as well, there’s accrediting organizations. Triple H C or a quad a depending on what the center is.

Bruce: It’s not always mandatory, but sometimes it is those I’ll call them third party accrediting bodies to [00:14:00] be in compliance, understand what they’re. What those organizations require and to be in compliance there, they have inspections and things of that nature that need to be conducted. And it can be rigorous, so be aware of what’s needed for your payer mix.

Bruce: A couple of other things maybe to mention that outside of just licensure and accreditation is also compliance on billing and coding compliance. Outside of our area of expertise, but certainly can become a tripping point. Things like Stark law and to kick back statue, ASC really need to ensure that they’re adhering to those things to prevent conflicts of interest can become very costly from a standpoint of, perhaps.

Bruce: legal issues that might come up as a result of that. Lastly, there’s always HR, credentialing needs for clinical staff, making sure that they’re properly credentialed so that reimbursements are not an issue later on. I guess the similar to the previous topic that we’re chatting about, staying [00:15:00] informed is always the key on these things and be proactive about understanding what regulatory compliance things apply to your center because it’s not a, it’s not a standard thing across all centers.

Bruce: It does depend on what state you’re in, what specialty you’re in, those sorts of things. Stay informed, be mindful of regular audits, get in front of them, be prepared for them get the legal advice, consulting advice. That is always a way to stay out of trouble.

Erica: I agree. Perfect. Let’s do some of the fun stuff.

Erica: What are the best practices for designing an efficient OR?

Bruce: Yeah, absolutely. I guess to start with, first and foremost the efficiencies. We want to talk about workflow efficiencies. The OR size. As always a, point of topic, a topic of sometimes contention between what staff versus surgeons versus administrators might all have opinions on, but adequate size in the O.

Bruce: R. ensuring that it’s large enough to accommodate [00:16:00] necessary equipment. And personnel comfortably is critical for maximizing efficiencies. One thing that we find that as far as best practice, that can be very beneficial is to create zones. So dividing the OR into functional zones for different activities.

Bruce: Whether they’re sterile zone, anesthesia zone, equipment zone, et cetera, but really just help streamline that workflow reduce the risk of contamination as well, but streamlining workflow within the OR and then beyond that within the OR suite. So traffic flow, we talked about this.

Bruce: Extensively our team does with clients understanding what the pathways are for staff and for patients how equipment moves to the space to minimize cross traffic, again, preventing contamination, but just, it’s crucial to identify what that looks like within the OR suite. And then within the OR itself the technology integration.

Bruce: Is another critical one [00:17:00] because, and this is again applies to within the OR as well as within other work zones in the suite, but incorporating advanced technology, advanced imaging and display technology, monitors, imaging equipment, things of that nature that you’re getting that this best of visual visualization as you can during procedures is going to benefit the workflow without doubt.

Bruce: Automation can be your friend. So having things automated for lighting, temperature control, equipment management, just streamlining those operations. So you don’t have to think about it. So it comes just naturally it comes, it’s automated and comes naturally without thinking about it. It’s already set in stone.

Bruce: Equipment management is a big one. Having adequate storage ample storage for both equipment and supplies within the OR. Avoid that clutter, make sure everything is easily accessible communication systems. We see ORs that work very well with paging systems. Help facilitate [00:18:00] communication among OR staff and other departments within the facility.

Bruce: Knowing where patients are up to, pre and post op those sorts of things. Lastly, We’re always trying to future proof as much as we possibly can design with future in mind, future expansion in mind. So what sort of infrastructures we needed for whatever new equipment or technologies might be brought in at a later date, that’s just simple, best practice, trying to think ahead, not just design for today, design for tomorrow.

Bruce: So I think really what we’re trying to accomplish at the end of the day is efficient, functional start on the workflow side of things. And then of course, ensure that it’s. Safe and conducive to high quality patient care regularly involving surgical team in that design process can really help that part of it to make sure that we’re not overlooking something that’s just patient care related going to be a detriment.

Bruce: So yeah, it gotta be practical, gotta be functional. And got to provide the best tools we can for patient care.

Erica: Perfect. So for existing ASCs who want to add a note, add the OR, they’ve done [00:19:00] all their due diligence. They know they’re going to do it. How can they manage the construction process to minimize disruptions to their existing operations?

Erica: Do they typically close? While construction’s going on, is there a way to remain open?

Bruce: Yeah. Great question. I guess a lot of this just hinges on how well pre planning again and communication amongst all stakeholders is conducted.

Bruce: But whether it needs to be shut down or can be done while being operational is so facility dependent. We’ve done a lot of studies or feasibility studies on centers before where. The phasing plan is obviously reasonable and feasible to keep the facility running and others where it’s just not, you just can’t keep the center running safely.

Bruce: Construction and surgery just don’t go too well together. So unless we can create clearly defined zones It may not work effectively. So how we arrive at that, is the question here. We want to make sure that things are done in a coordinated way. Otherwise it can [00:20:00] become extremely stressful for everyone involved.

Bruce: So to start with detailed planning, we want to include both a pre construction sort of application to it as well as designs. It’s not only, Hey, it fits, here’s a layout, here’s a design. We can draw it up, but also. Pre construction, meaning what’s going to happen at each phase of the construction process when we’re removing walls, constructing walls, we’re bringing in, mechanicals when we’re working overhead within the space is it separate?

Bruce: Can it be done in a fashion that’s separate from current operations or not? And sometimes we find is that there’s a staged shutdown where we might need to shut down at certain stages of the construction process where for a few days a week, whatever it might be at a critical stage of construction, we need to shut down.

Bruce: So just exhaustively going through a detailed plan of. Both design and pre construction to identify all areas of risk, all areas of disruption, and can we mitigate [00:21:00] them? Is the, is a general, intent there, but what I want to emphasize is stakeholder communication, having regular meetings assuming that a plan can be developed for expanding an OR, an existing facility.

Bruce: Holding regular meetings throughout the duration of it with staff, Contractor team, administration, you name it, discuss process, progress, discuss concerns, discuss upcoming milestones and what it might involve for the center and everyone that’s there on site is really important and defining what those communication needs are.

Bruce: Channels are going to be so that everyone is clearly informed along the way. Sometimes what’s needed is temporary solutions. Maybe a temporary facility where you’re relocating certain functions not surgically, of course, but maybe administratively, if it can be or at least defining Alternative routes for, pathways within the space for patients and staff.

Bruce: So coming up with temporary solutions is usually part of that phasing plan. Safety and compliance is a non negotiable, so [00:22:00] we have to make sure that we’ve been able to maintain a safe environment. The other thing that sometimes is overlooked as patient communication to overcome disruption, everyone just needs to be informed, including the patient.

Bruce: Patient’s scheduled for surgery during construction phase. Even if you might have a plan that you feel like it’s pretty bulletproof, make sure the patient knows that there could be disruption just to help minimize anxiety so that they don’t show up and discover that there’s construction going on and just add to that anxiety that’s already there.

Bruce: Always good to have contingency plans. Just think of all of the we create risk registers. So what are all of the items are at risk at any given point during this process? And let’s make sure that we have contingency plans for them. At the end of the day, the better the plan, the better the.

Bruce: process, the better the finished product. That’s just be sure to think it through from all fronts so there’s minimal disruption, minimal stress that’s some thoughts. Yeah there’s lots of tips and tricks, but that’s some [00:23:00] initial thoughts anyway.

Erica: That is excellent advice.

Erica: All right. Last question, Bruce, we do this every week with our guests. What is one thing our listeners can do this week to improve their surgery centers?

Bruce: Yeah, I guess we’ve been talking about workflows and that sort of thing best in practice design, et cetera. I guess the thing I would encourage physicians and surgery center administrators to do is carefully examine all existing workflows.

Bruce: Staff, patients identify potential bottlenecks that exist in daily movement throughout the facility. Thank you. Might be placement of equipment storage equipment might be location of supply storage might be lack of adequate signage. So wayfinding might be a challenge but conduct a thorough assessment and document Any bottlenecks, anything that pops up as a potential bottleneck.

Bruce: And what that’ll do is it’ll create an opportunity for immediate [00:24:00] improvement. You’ll come away with ideally you’ll come away with a short list of things that, that look, they could be accumulating to workflow inefficiencies. So if we just address these items, it’s a very simple Sort of task that can be assigned to administrators to go through and yeah, just create a more efficient and organized environment, reduce stress for staff, minimize delays really at the end of the day, we’re looking to improve that over overall patient experience.

Bruce: So it should contribute to that. So that is 1 thing that you all can take away and hopefully improve without too much, burden on your team.

Erica: Love it. Thank you so much for all the tips and thanks for coming on today.

Bruce: Absolutely. Thank you so much.

Erica: Welcome to Data Insights, where we turn data into dialogue and numbers into narrative. HST Pathways released a state of the industry report late last year highlighting best practices, key process steps, and KPIs for [00:25:00] every step of the patient journey and for nearly every recurring administrative duty.

Erica: Most importantly, using our own unique dataset from our clients, we were able to extract data points so that anyone in the industry could compare themselves to their peers. A few quick disclaimers. We only pulled data from clients who gave us permission, and that was around 450 ASCs, and then we omitted any extreme outliers.

Erica: And in honor of the 2024 report coming out in just two short months, today I want to share with you a few data points from the 2023 report that I thought were most interesting. So for all of the metrics, I’ll follow the same format. I’ll share the data. The impact it has on your bottom line, and three tips to improve. The first metric I want to look at is unused OR block time. Our data analysts determined that on average, 42 percent of blocked OR time actually ends up going unused. This is a critical data point to [00:26:00] monitor because unused OR time represents a direct loss of potential revenue as fewer procedures are performed and fixed costs such as staffing and utilities remain the same, ultimately leading to lower profitability. If you would like to improve your blocked OR time utilization rates, I would recommend three things. One, create policies that allow for the reallocation of unused OR time to other surgeons and have all your surgeons sign this policy. A few weeks ago, we published an episode with Amy Ishmael on how to maximize OR utilization through blocked time best practices.

Erica: And she gave amazing insights as to what that policy could look like and things like that. If you haven’t created a policy or even if you have, I would highly recommend that episode. Anyway, that was the only tip one, create the policies to offer incentives to physicians to maximize their allocated OR time.

Erica: And then three share publicly in the break room or in board meetings, which physicians [00:27:00] are performing the best in terms of blocked OR time utilization. The second metric is revenue per case. So here are the top three specialties bringing in the most revenue per case. The first is Ortho, which averages $5,449 per case. The second is cardio, which averages $4,355 per case, and the third is plastics, which averages $3,732 per case. Now, we actually, in the full report, did the top 12, so if you want to see more than just the top three check out the full State of the Industry report.

Erica: I’ll include a link in the episode notes. But anyway, this data point is extremely important to track, understand, and benchmark against. It can be leveraged during negotiations with payers, incorporated into performance reviews used to project future revenue, and also used to drive your surgery center’s [00:28:00] growth strategy.

Erica: Thank you. And after analyzing your own data and identifying your top three revenue generating specialties, or maybe even if you are single specialty, you can do it by, your top three revenue generating procedures and go at it from that way too. But I would recommend obviously prioritizing the recruitment and retention of physicians.

Erica: who provide procedures in those high revenue specialties. Then you can adjust the case mix to include a higher proportion of those specific specialties, of course, without compromising on quality or putting a bad taste in any of the other physician’s mouths who might not do that specialty, but adjusting the case mix could help.

Erica: And then lastly, invest in targeted marketing to attract more patients for those high revenue procedures. The third metric I want to talk about is patient deposit collection rates. So a typical ASC only collects 53 percent of expected patient deposits [00:29:00] at the time of service. Now, effective deposit collection is a critical component of the revenue cycle.

Erica: The more you can collect upfront, the more you can reduce your outstanding balances, minimize bad debt, reduce the amount of time you have to spend on the back end following up with patients, and also minimize the number of patients you have to send to collections. If you are looking to collect more up front, and let’s be real, I think everybody is here are three ideas to improve.

Erica: The first is to implement pre service financial counseling to ensure patients understand their financial responsibility. So this could be something that you do in house, it could be something that you outsource, but either way you have to be completely transparent with patients. That’s just going to build that trust and if they trust you then they’re more likely to pay you.

Erica: The second is to use automated systems to generate accurate patient financial estimates that include a simple pay now button where patients can [00:30:00] immediately pay online in the comfort of their own home, in the convenience of having their wallet and their credit card right there, you really want to make it as simple for them as possible.

Erica: And the third is to establish and communicate clear payment policies, including how important deposits are before the date of service.

Erica: And as a rule of thumb, a patient should never hear what they owe for the first time when they walk in on the day of surgery. I trust none of you are doing that, but it just, the day of surgery is already stressful enough, and then to throw the financial element into it, which is already so confusing for patients just will not help you with that patient deposit rate.

Erica: And if this in general is something that you’re looking to do, improve that upfront collection process HSC has some really cool tools that a bunch of ASCs use to help them do exactly that. All right, for our fourth and final metric, let’s talk about billing post date of service. On [00:31:00] average, ASCs are taking 3.

Erica: 6 days to bill after the patient’s procedure is complete. So days to bill is a key indicator of the efficiency of the entire revenue cycle, as this number directly affects the speed at which the surgery center receives payments from payers. By keeping days to bill low, surgery centers can optimize cash flow and reduce the risk of delayed payments or any cash flow interruptions.

Erica: It’s also super important for compliance with regulatory requirements and maintaining a transparent and efficient billing process. Three tips to lower your days to bill. Would be use an EHR and practice management system. Ideally one that is integrated with the clearinghouse to just help streamline the process altogether.

Erica: The second is to provide regular training for billing staff to ensure they are up to date with best practices. And the third is to conduct regular audits of the billing process to identify bottlenecks [00:32:00] and any areas for improvement. So there you have it, four data points to benchmark your ASC against and 12 tips to improve.

Erica: If you’re interested in more data points and use cases, subscribe to our podcast so that you don’t miss any upcoming segments. Or head to the website to check out the full state of the industry report to get your hands on even more data. And make sure you keep an eye out for the 2024 version which should come out mid to late September this year.

Erica: And that officially wraps up this week’s podcast. Thank you as always for spending a few minutes of your week with us. Make sure to subscribe or leave a review on whichever platform you’re listening from. I hope you have a great day and we will see you again next week.