The Top 10 Things You Should Focus on at Your ASC John R. Seitz, CEO Ambulatory Surgical Group

#10 Anesthesia Directly impacts efficiency of the ASC and the “happy factor” of patients, physicians, and staff. May (or may not) be motivated by an ownership interest in the ASC. Coverage for all rooms, all the time? Governance and control issues? What to measure – Room turnover – Cases/day – Total cost/case – Patient satisfaction – Staff and physician surveys

#9 Supplies Disposables, Implants, Gas, Office Implants can have a major impact on cash flow Price + Terms How you track inventory and purchasing What to measure – Costs as % of Income – Costs/case

#8 Distributions The ultimate performance measure. Regular v “We have money left over” How you communicate and make a distribution Follow up on checks not cashed What you need to measure – Collections – Cash flow – Acounts payable

#7 Cash Balance Updated Daily Communicated regularly Current against plan/budget Eye on Accounts Payable What to measure – Daily account balance

#6 Staff HCMHC Turnover is expensive Per Diem is inefficient and expensive OT is expensive and wearing What to measure – FTE costs/case – FTE costs as % of Income – # FTE/ Cases (procedures)

#5 Cases Cases today = cash tomorrow Establish targets Case volume is a thermometer of how the center is performing and how it is being viewed by your physicians Tracking and communication What to measure – Cases/day – Cases by physician, by specialty – Cases/OR

#4 Reports Report on the good and the bad Reports should be accurate and transparent Reports should be relevant and timely Reports to Physicians – Cases – Collections – Financial – Quality – Satisfaction Reports to Staff – Departmental – Quality – Satisfaction

#3 Collections Cash in the door What to expect: Daily, weekly targets – recognize problems as they happen Action plan pre-established for problems – immediate and ready What to measure – Daily cash collections – Cumulative cash for the month

#2 Patients HCMHC Choices Direct communication to physician

#1 Physicians The good, the bad and the ugly Why are they at your ASC – Scheduling, Convenience – Efficient – Income Communication Expectations The “D” word What to measure – Cases/Procedures – Cost/Case