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Top Reasons Why Surgery Centers Fail

Updated: Jul 29, 2023


A clock built into a medical stethoscope.

In today's ever-changing healthcare environment, surgery centers must have a strong strategic plan to succeed. However, despite having a well-crafted plan, surgery centers may still fail due to various reasons. As a leader in the healthcare accreditation process, Elite Accreditation Consultants has identified the top reasons why surgery centers fail and how to avoid them.


Lack of Strategic Planning


One of the most significant reasons surgery centers fail is the lack of a flexible strategic game plan. With hospitals going into joint ventures with surgery centers and significant changes in healthcare reimbursement, it is crucial to have a flexible game plan. When building a strategic plan, consider both the present and future, so you are ready for changes that could impact the surgery center. For instance, a recent law passed in California states that beginning on Jan. 1, 2013, workers' compensation cases will be reimbursed at 80 percent of Medicare. This law will make a big impact on surgery centers that treat a high volume of workers comp cases. Diversify your payor mix so you can deliver care to patients with PPOs, workers compensation, HMOs, and Medicare.



Inflexibility


Healthcare providers have seen enormous regulatory changes over the past few years, and regardless of what happens in political elections, major changes are to come. Surgery centers that refuse to react to these changes are likely to fail. The most flexible surgery centers are physician-owned entities because they are able to change quickly, and surgeons are incentivized toward success. The most successful surgery centers are the ones that are physician-owned with a flexible game plan.



Patient Care is a Secondary Concern


Quality patient care must be paramount at the surgery center. Without a strong foundation for patient care, there will be infections, complications, inefficiencies, and poor patient satisfaction scores. Patient flow drives business at the surgery center. Patient care has to come first. As long as you are providing top patient care, your doors will continue to stay open.



Inefficient Scheduling


Any inefficiencies at the surgery center are frustrating for surgeons bringing cases in, but when the scheduling is inefficient, they are likely to take their cases right back to the hospital. Losing cases means losing revenue, and surgery centers without a healthy revenue cycle will fail. When there are scheduling nightmares, and a doctor cannot get into the operating room, they will take their cases somewhere else. You might also see surgery centers that are understaffed or have slow recovery times because too much anesthesia was administered.



Inconsistent Staff


Surgery centers with a revolving staff are inefficient and may not work well with the surgeons. New staff members might take a long time getting the histories or physicals done in time for the procedure to start, and that wastes the surgeon's time. Additionally, surgeons prefer to have the same operating room staff whenever possible, so the procedures run more smoothly. A large surgery center may not be able to guarantee that kind of consistency.



Ignorance of Regulatory Issues


Leaders at the surgery center should be aware of regulatory issues and make sure they are compliant. Surgery centers sometimes fail because they weren't aware of non-compliance. Each state has its laws, in addition to federal laws, and each step your surgery center takes must be compliant. Administrators must also be aware of changing regulations and stay abreast of those issues. You need to do your homework before making changes at the surgery center. Some fail because they may not be credentialed to qualify for insurance reimbursement; they may only be able to perform elective procedures.


Top reasons why surgery centers fail & Improper Surgery Center Marketing


This could mean marketing your surgery center on social media, at community gatherings, or with newspaper ads. It also means you have to market it to surgeons and referring physicians. Make sure surgeons in the community are aware of your center and understand the benefits of bringing in their cases. It's also helpful for the surgery center to continuously recruit new surgeons.



Prices are Too High


Prices can't be too high at the surgery center, especially if you are charging for cash-pay services. New technology, operating systems, and office equipment could cost the surgery center a lot of money, but overcharging will drive patients and insurance companies away. Surgeon investors want to see a return on investment. If I'm a partner in the surgery center, the profit is what I yield, so I'll get a premium at the end.



Lack of Proper Accreditation


Accreditation is essential for surgery centers to succeed. Accreditation ensures that the surgery center meets a set of national standards and has implemented best practices to ensure patient safety and quality of care. Accreditation gives surgery centers a competitive edge and improves their marketability to patients, insurance providers, and referring physicians.




Inadequate Financial Management


Inadequate financial management is another reason why surgery centers fail. Financial management is critical to the success of the surgery center. It is essential to have a dedicated and experienced financial management team that can manage the surgery center's revenue cycle, maximize reimbursements, and minimize denials. Surgery centers must have a robust billing and coding process in place to ensure that claims are processed accurately and timely.



Conclusion


Surgery centers can fail due to various reasons, but with proper planning, flexibility, patient-centric care, efficient scheduling, consistent staffing, compliance with regulations, appropriate marketing, reasonable pricing, proper accreditation, and adequate financial management, surgery centers can succeed. Elite Accreditation Consultants can help your surgery center achieve accreditation and provide you with the tools to succeed in today's ever-changing healthcare environment.





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