Same-Day Surgery Manager: Questions about bonuses, moving GI procedures
Questions about bonuses, moving GI procedures
CRNA administrators, lap bands are OK?
By Stephen W. Earnhart, MS
CEO
Earnhart & Associates
Austin, TX
Question: Our surgery center was bought by a chain surgery center at the end of last year. We received a bonus every quarter for the past 12 years by the surgeons who owned it before they sold it. Ever since XXX Company bought us, we have not received any type of bonus. They tell us we probably will not receive a bonus — that it is not in their budget! We complained to our surgeons, but they just tell us that they have no say in the management of the center any further. How many centers do pay a bonus to the surgery center staff? Is this company just plain cheap?"
Answer: I am sure that XXX paid a handsome price for your surgery center to the owners. They are going to try to recoup as much of that as possible and as quickly as possible! Most centers I am familiar with do pay their staff a bonus or some form of incentive. So yes, I think that company is just plain cheap.
Question: Can a certified registered nurse anesthetist be the chief of anesthesia at a hospital?
Answer: Of course! Many are, and they do a great job.
Question: Our gastrointestinal (GI) surgeon told us that he is going to have to take his cases to the surgery center down the street because Blue Cross/Blue Shield is going to reduce his professional fee if he continues to do it in the hospital. Is he just giving us that excuse, or is this true?
Answer: Actually, he is right. Blue Cross/Blue Shield is reducing the professional fee to surgeons if they do their gastrointestinal cases in the hospital — and will actually pay them more if they are done in a lower-cost facility such as a surgery center. You can expect to see them begin doing that with other procedures as well, and other payers to follow! It's not good news for hospital outpatient departments.
Question: Lap band (bariatric) surgery only is allowed as an inpatient procedure, right? We heard that a surgery center across town is doing this in their center and discharging patients that day. Isn't that illegal?
Answer: It isn't illegal in the sense that someone goes to jail and no, it is not on the Medicare-approved list for outpatient surgery and cannot be performed on Medicare patients in a surgery center and be reimbursed. However, for the rest of the world, it is being performed at many surgery centers. The "fee" (usually cash up front) can be very high — up to $25,000 in some cases — so as you can imagine, it is a very popular procedure. Typically, the reason that many centers don't do the procedure is they don't have the surgeon to perform it.
(Editor's note: Earnhart & Associates is an ambulatory surgery consulting firm specializing in all aspects of surgery center development and management. Contact Earnhart at 3112 Windsor Road, Suite A-242, Austin, TX 78703. E-mail: [email protected]. Web: www.earnhart.com.)
Question: Our surgery center was bought by a chain surgery center at the end of last year. We received a bonus every quarter for the past 12 years by the surgeons who owned it before they sold it. Ever since XXX Company bought us, we have not received any type of bonus. They tell us we probably will not receive a bonus that it is not in their budget!Subscribe Now for Access
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