Improving Profitability at a Single-Specialty GI ASC: Q&A With Jackie Harrison of Practice Partners and Alabama Digestive Health Endoscopy Center

Jackie Harrison is vice president of operations for Practice Partners in Healthcare, which is part of the joint venture, along with local physicians and Tenet Healthcare Corp., that operates Alabama Digestive Health Endoscopy Center in Birmingham, Ala.

Q: GI has been hard hit by declining reimbursements, especially in the ASC setting, in the last few years. What has ADHEC done to address these concerns?

Jackie Harrison: ADHEC responded proactively in anticipation of lower reimbursements by auditing all our managed care contracts and, where rates had become stale, initiating discussions with payors to tweak rates upward wherever possible. We also conducted detailed claims analysis by payor on our [most-commonly] used codes to ensure that we were not leaving money on the table with regards to denied or pended claims, incorrect payments, appeals, etc.

Q: Could you describe one or two successful ways that your ASC was able to reduce costs?

JH: We constantly review all disposables and other items for price reductions that do not affect quality. Recent items [we've reviewed that led to] a significant decrease in annual costs are bite blocks, brushes, grounding pads, gowns and enzymatic cleaner. I have one LPN assigned to order supplies and review costs with me to assure we are getting the best pricing possible. Annually, we also look at our scope repair expenses and reassign those repairs also to get the best pricing while quality is maintained.

Q: Recent reports have also indicated that there could be a shortage in GI physicians over the next few years. How has ADHEC addressed recruiting and brought in new physicians/cases to the center?

JH: We don't like surprises, so we ask questions. We're in constant communication with our physician partners to know what they're thinking. We talk about their future expansion plans and ADHEC's capacity to increase patient volume. Both sides are monitoring today's recruiting environment, but also looking two to three years down the road.

Q: What advice do you have for single-specialty ASCs that may be intimidated by reimbursement/regulatory issues?

JH: The key is to be persistent and proactive. Steady management of both areas is a critical component to the success of a center, so you'll want staff with managed care knowledge and expertise staying current on the reimbursement and regulatory environments in your state. Also, stay plugged into your state's ASC association; a unified voice among many facilities will lessen the intimidation of taking on payors and agencies all alone.

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