business plan for ambulatory surgery center

Ambulatory Surgery Center Business Plan [Sample Template]

By: Author Solomon O'Chucks

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An ambulatory surgery center is a healthcare facility that specializes in performing outpatient surgical procedures. It is sometimes referred to as a same-day surgery center or outpatient surgery center.

The primary goal of an ambulatory surgery center is to provide a convenient and cost-effective alternative to traditional hospital-based surgical care. Ambulatory surgery centers have gained popularity in recent years due to their ability to deliver high-quality surgical care in a cost-effective and efficient manner.

They play a crucial role in relieving the burden on hospitals and providing patients with a more convenient option for outpatient surgery.

Steps on How to Write an Ambulatory Surgery Center Business Plan

Executive summary.

St. James® Ambulatory Surgery Center, Inc. is a state-of-the-art healthcare facility located in Washington D.C., specializing in providing high-quality outpatient surgical services.

Our center is dedicated to delivering exceptional care, advanced technology, and outstanding patient experiences. At St. James® Ambulatory Surgery Center, patient safety is our top priority. Our facility is equipped with the latest medical technology and staffed by a team of highly skilled and experienced healthcare professionals.

Our surgeons, anesthesiologists, nurses, and support staff are dedicated to ensuring the highest standards of care throughout the surgical journey.

Company Profile

A. our products and services.

Our ambulatory surgery center focuses on performing a wide range of outpatient procedures, catering to the growing demand for convenient and cost-effective surgical care. By offering a comprehensive suite of surgical services, we aim to meet the diverse needs of our patients and healthcare providers.

b. Nature of the Business

St. James® Ambulatory Surgery Center, Inc. will operate as a B2C – Business to consumer business model.

c. The Industry

St. James® Ambulatory Surgery Center, Inc. will operate in the healthcare industry.

d. Mission Statement

Our mission is to be the premier choice for outpatient surgical care in Washington D.C. We aim to foster strong relationships with healthcare providers, insurance companies, and the local community. By collaborating with referring physicians, we ensure seamless coordination of care and promote continuity for our patients.

e. Vision Statement

Our vision at St. James® Ambulatory Surgery Center, Inc. is to become a leading ambulatory surgery center in Washington D.C.

f. Our Tagline (Slogan)

St. James® Ambulatory Surgery Center, Inc. – “Where Excellence Meets Compassionate Care”

g. Legal Structure of the Business (LLC, C Corp, S Corp, LLP)

St. James® Ambulatory Surgery Center, Inc. will be formed as a Limited Liability Company, LLC.

h. Our Organizational Structure

• Medical Director
• Anesthesiologists
• Front Desk Officer

i. Ownership/Shareholder Structure and Board Members

• James Howe (Owner and Chairman/Chief Executive Officer) 51 Percent Shares
• Claire Casius (Board Member) 19 Percent Shares
• Paulson Andrew (Board Member) 10 Percent Shares
• Joel George (Board Member) 10 Percent Shares
• Rhoda Johnson (Board Member and Secretary) 10 Percent Shares.

SWOT Analysis

A. strength.

• James® Ambulatory Surgery Center, Inc. has built a strong reputation for delivering high-quality surgical care, advanced technology, and exceptional patient experiences.
• The center has a team of highly skilled surgeons, anesthesiologists, nurses, and support staff who specialize in providing outpatient surgical care. Their expertise contributes to positive patient outcomes and satisfaction.
• James® Ambulatory Surgery Center, Inc. is equipped with modern and advanced medical technology, ensuring efficient and effective surgical procedures.
• The center’s location in Washington D.C. provides access to a large population and a diverse pool of potential patients. It offers a convenient option for individuals seeking outpatient surgical care in the area.
• As an ambulatory surgery center, St. James® Ambulatory Surgery Center, Inc. has the capacity to provide cost-effective surgical services compared to traditional hospital-based surgeries.

b. Weakness

• The center’s capacity may be limited due to the nature of outpatient surgeries. This can result in longer wait times or the need to prioritize specific procedures, potentially impacting patient satisfaction and the ability to meet demand.
• The center relies on a steady stream of referrals from physicians to maintain a consistent volume of surgeries. Any decline in referrals or strained relationships with referring physicians could impact the center’s patient flow and revenue.
• James® Ambulatory Surgery Center, Inc. depends on timely and accurate reimbursement from insurance companies for financial sustainability. Delays or denials in reimbursement can pose financial challenges.

c. Opportunities

• The increasing preference for outpatient surgeries presents an opportunity for St. James® Ambulatory Surgery Center, Inc. to cater to the growing market demand and expand its patient base.
• Establishing partnerships with healthcare providers and physicians can lead to a steady flow of referrals and strengthen the center’s presence within the healthcare network.
• Investing in marketing efforts to promote the center’s specialized services, exceptional patient care, and a convenient location can attract more patients and referrals.
• St. James® Ambulatory Surgery Center, Inc. can consider expanding its service offerings to include new surgical specialties or procedures, providing a wider range of options to patients and potentially increasing revenue streams.

i. How Big is the Industry?

The ambulatory surgery center industry is considered a big and growing industry.

ii. Is the Industry Growing or Declining?

The ambulatory surgery center industry has experienced significant growth over the past few decades and has become a substantial part of the healthcare landscape.

iii. What are the Future Trends in the Industry?

The ambulatory surgery center industry is continuously evolving to meet patients’ changing needs and preferences while incorporating technological advancements.

The ambulatory surgery center industry is likely to adopt and leverage advanced medical and surgical techniques. This includes the use of minimally invasive procedures, robotic-assisted surgeries, and innovative imaging technologies. These advancements can result in improved patient outcomes, reduced recovery times, and enhanced surgical precision.

iv. Are There Existing Niches in the Industry?

No, there are no niche ideas when it comes to the ambulatory surgery center line of business. This is so because the ambulatory surgery center business is a niche idea in the healthcare industry.

v. Can You Sell a Franchise of Your Business in the Future?

St. James® Ambulatory Surgery Center, Inc. has plans to sell franchises in the nearest future and we will target major cities with growing working class and upwardly mobile people in the United States of America.

• The presence of competing hospitals and other ambulatory surgery centers in the area may pose a threat to St. James® Ambulatory Surgery Center, Inc.
• Changes in healthcare policies and reimbursement structures can impact the financial viability of the center. Reduced reimbursements or changes in insurance coverage may affect revenue streams and profitability.
• Changes in regulations and compliance requirements can impact operations and necessitate costly adaptations or upgrades to meet new standards.

i. Who are the Major Competitors?

• Surgery Center of Oklahoma
• New York Eye and Ear Infirmary of Mount Sinai ASC
• The Surgery Center at Pelham
• Midwest Surgical Hospital
• The Orthopedic Surgery Center of Arizona
• Pacific Heights Surgery Center
• New England Baptist Outpatient Care Center
• Miami Plastic Surgery
• SurgCenter of Palm Beach Gardens
• The Orthopedic Surgery Center of Clearwater
• Austin Eye Surgery Center
• Lakeside Ambulatory Surgery Center
• Pima Street Surgery Center
• The Center for Specialized Surgery
• One Medical Surgery Center
• Colorado Center for Reproductive Medicine Surgery Center
• Advanced Surgery Center of Bethesda
• South Florida ENT Associates Surgery Center
• Montana Eye Surgery Center
• South Texas Surgical Hospital.

ii. Is There a Franchise for Ambulatory Surgery Center Business?

No, there are no franchise opportunities for the ambulatory surgery center business.

iii. Are There Policies, Regulations, or Zoning Laws Affecting Ambulatory Surgery Center Business ?

Yes, there are policies, regulations, and zoning laws that may affect ambulatory surgery center businesses in the United States. But it is important to note that policies, regulations, and zoning laws affecting ambulatory surgery center businesses in the United States can vary depending on the state, county, and local jurisdiction.

Ambulatory surgery center businesses may need to comply with health and safety regulations, including proper sanitation practices, ventilation requirements, and cleanliness standards. These regulations aim to ensure the well-being of customers and prevent any potential health risks.

Local zoning regulations may dictate where ambulatory surgery center businesses can operate. There may be restrictions on the type of commercial zones where these businesses can be established.

Marketing Plan

A. who is your target audience.

i. Age Range

The target audience for St. James® Ambulatory Surgery Center, Inc. may primarily consist of adults, typically ranging from the mid-20s to late adulthood.

ii. Level of Education

The target audience may include individuals with varying levels of education, ranging from high school graduates to those with advanced degrees.

iii. Income Level

St. James® Ambulatory Surgery Center, Inc. may cater to individuals across different income levels. However, given the cost-effective nature of ambulatory surgery centers, the target audience may include individuals from middle-income to higher-income brackets.

iv. Ethnicity

The target audience can be diverse in terms of ethnicity and may cater to individuals from various racial and ethnic backgrounds.

v. Language

St. James® Ambulatory Surgery Center, Inc. may serve individuals who primarily communicate in English, as it is commonly spoken in Washington D.C. However, the center may also provide language assistance services or have multilingual staff to cater to patients who prefer other languages.

vi. Geographical Location: The target audience is primarily based in Washington D.C. and the surrounding areas.

vii. Lifestyle

The target audience’s lifestyle may encompass individuals who lead active lives, maintain a balance between work and personal commitments, and value efficiency and convenience.

b. Advertising and Promotion Strategies

• Host Themed Events That Catch the Attention of Potential Clients.
• Tap Into Text Marketing.
• Use FOMO to Run Photo Promotions.
• Share Your Events in Local Groups and Pages.
• Turn Your Social Media Channels into a Resource
• Develop Your Business Directory Profiles
• Build Relationships with other healthcare service providers and related organizations in our Area

i. Traditional Marketing Strategies

• Marketing through Direct Mail.
• Print Media Marketing – Newspapers & Magazines.
• Broadcast Marketing -Television & Radio Channels.
• OOH Marketing – Public Transit like Buses and Trains, Billboards, Street shows, and Cabs.
• Leverage direct sales, direct mail (postcards, brochures, letters, fliers), tradeshows, print advertising (magazines, newspapers, coupon books, billboards), referral (also known as word-of-mouth marketing), radio, and television.

ii. Digital Marketing Strategies

• Social Media Marketing Platforms.
• Influencer Marketing.
• Email Marketing.
• Content Marketing.
• Search Engine Optimization (SEO) Marketing.
• Affiliate Marketing
• Mobile Marketing.

iii. Social Media Marketing Plan

• Start using chatbots.
• Create a personalized experience for each of our clients.
• Create an efficient content marketing strategy.
• Create a community for our freelance marketers and influencers.
• Gear up our profiles with a diverse content strategy.
• Use brand advocates.
• Create profiles on relevant social media channels.
• Run cross-channel campaigns.

c. Pricing Strategy

St. James® Ambulatory Surgery Center, Inc. will adopt the following pricing strategies:

• Cost-Plus Pricing
• Value-Based Pricing
• Competitive Pricing
• Dynamic Pricing
• Bundle Pricing

Please note that our pricing strategy is based on a careful analysis of the costs and profitability of the business, as well as the needs and preferences of the target customer base.

Sales and Distribution Plan

A. sales channels.

St. James® Ambulatory Surgery Center, Inc. can utilize several sales channels to reach its target audience and promote its services.

We build strong relationships with referring physicians which is essential for generating patient referrals. We will actively engage with local physicians, specialists, and primary care providers to educate them about the center’s capabilities, patient outcomes, and convenience. This can be done through in-person meetings, networking events, and educational seminars.

b. Inventory Strategy

The fact that we will need surgery supplies and medications means that St. James® Ambulatory Surgery Center, Inc. will operate an inventory strategy that is based on a day-to-day methodology for ordering, maintaining, and processing items in our warehouse.

We will develop our strategy with the same thoroughness and attention to detail as we would if we were creating an overall strategy for the business.

St. James® Ambulatory Surgery Center, Inc. will make sure we work with “Just-in-time (JIT) inventory” – (JIT involves holding as little stock as possible, negating the costs and risks involved with keeping a large amount of stock on hand.)

c. Payment Options for Customers

• Bank Transfers
• Credit or Debit Card
• Electronic Payment Systems such as PayPal or Venmo.

d. Return Policy, Incentives, and Guarantees

St. James® Ambulatory Surgery Center, Inc. prioritizes patient satisfaction and strives to provide exceptional care throughout the surgical process. While a traditional return policy does not apply to surgical procedures, the center offers various incentives, guarantees, and assurances to ensure a positive patient experience.

Firstly, St. James® Ambulatory Surgery Center, Inc. focuses on a patient satisfaction guarantee, promising to meet or exceed patient expectations.

To maintain high standards, the center implements a comprehensive quality assurance program. This program includes regular monitoring of surgical outcomes, infection control protocols, and patient safety measures. Continuous improvement efforts ensure patients receive the highest quality of care.

St. James® Ambulatory Surgery Center, Inc. communicates these incentives, guarantees, and assurances clearly through its website, patient brochures, and in-person interactions. By emphasizing patient satisfaction, quality care, transparency, and ongoing support, the center aims to provide a positive and successful surgical experience for every patient.

e. Customer Support Strategy

Our customer support strategy will involve ensuring that clients have easy access to contact the ambulatory surgery center business through multiple communication channels, such as email, phone, and social media. Make sure that all contact information is clearly displayed on the business’s website and promotional materials.

Foster a culture of putting clients first, where staff are trained to listen actively and empathize with clients’ needs. Encourage staff to go the extra mile to ensure clients feel valued and supported. Implement a CRM system to manage client data, track appointments, and follow-up activities.

Operational Plan

Our operational plan will involve developing comprehensive preoperative and postoperative care protocols to optimize patient outcomes and ensure a smooth recovery.

We will implement effective communication channels to address patient inquiries, concerns, and scheduling needs promptly. We will strive to exceed patient expectations by providing personalized, compassionate, and patient-centered care.

We will implement an efficient scheduling system to minimize patient wait times and optimize resource utilization. Streamline workflow processes to enhance efficiency and productivity within the center. We will continuously monitor and evaluate operational processes to identify areas for improvement and implement necessary changes.

a. What Happens During a Typical Day at an Ambulatory Surgery Center?

• Staff members arrive and prepare the facility for the day, ensuring that consulting and treatment rooms are clean, equipment is functional, and supplies are stocked.
• Clients scheduled for consultations meet with surgeons and other consultants
• The bulk of the day is dedicated to seeing patients for appointments and carrying out surgery and follow-up treatments.
• At the end of the day, the clinic is cleaned and sanitized, and equipment is properly maintained.
• Administrative tasks, such as closing out registers, reconciling payments, and preparing reports, are completed.
• Staff members may review the next day’s schedule and prepare for upcoming appointments and activities.

b. Production Process

There is no production process when it comes to an ambulatory surgery center business.

c. Service Procedure

Pre-operative preparation:.

• Patients arrive at the ASC and complete the necessary paperwork and registration.
• They are taken to a pre-operative area where they change into a surgical gown and undergo vital sign measurements, anesthesia consultations, and any additional necessary tests.

Operating Room (OR) Setup:

• The surgical team prepares the operating room, ensuring that it is sterile and properly equipped for the procedure.
• Surgeons, anesthesiologists, nurses, and other support staff gather in the OR to review the surgical plan and patient information.

Patient Transfer and Anesthesia:

• Patients are transferred from the pre-operative area to the OR on a surgical stretcher or bed.
• Anesthesia is administered to ensure patient comfort and safety during the procedure.

Surgical Procedure:

• The surgical team performs the planned procedure under sterile conditions and follows established surgical protocols.

Postoperative Care and Recovery:

• After the surgery, patients are transferred to a post-anesthesia care unit (PACU) or recovery area.
• Nurses closely monitor patients’ vital signs, pain levels, and overall well-being during the recovery phase.
• Once patients have sufficiently recovered, they receive postoperative instructions and are discharged or transferred to an observation area.

Discharge and Follow-up:

• Patients who are ready for discharge receive comprehensive discharge instructions, including postoperative care guidelines, medication instructions, and follow-up appointments.
• Nurses or designated staff provide information on managing pain, wound care, and potential complications to ensure a smooth recovery process.

Cleaning and Sterilization:

• The OR and other patient care areas are thoroughly cleaned, disinfected, and prepared for subsequent procedures.
• Sterilization processes are followed to ensure that surgical instruments and equipment are ready for future use.

d. The Supply Chain

St. James® Ambulatory Surgery Center, Inc. will establish a business relationship with wholesale supplies of ambulatory surgery supplies and medications.

e. Sources of Income

St. James® Ambulatory Surgery Center, Inc. generates income from various sources related to its services and patient care.

Financial Plan

A. amount needed to start our ambulatory surgery center business.

St. James® Ambulatory Surgery Center, Inc. would need an estimate of $3.5 million to successfully set up our ambulatory surgery center in the United States of America. Please note that this amount includes the salaries of all our staff for the first month of operation.

b. What are the Cost Involved?

• Business Registration Fees – $750.
• Legal expenses for obtaining licenses and permits – $17,300.
• Marketing, Branding, and Promotions – $15,000.
• Business Consultant Fee – $7,500.
• Insurance – $15,400.
• Rent/Lease – $500,000.
• Operational Cost (salaries of employees, payments of bills et al) – $1 million
• start-up inventory – $250,000
• Store Equipment (cash register, security, ventilation, signage) – $4,750
• Equipment and maintenance – $550,000
• Website: $600
• Opening party: $5,000
• Miscellaneous: $5,000

c. Do You Need to Build a Facility? If YES, How Much Will It Cost?

St. James® Ambulatory Surgery Center, Inc. will not build a new facility for our ambulatory surgery center; we intend to start with a long-term lease and after 5 years, we will start the process of acquiring our own facility.

d. What are the Ongoing Expenses for Running an Ambulatory Surgery Center Business?

• Rent or Mortgage
• Utilities such as electricity, water, heating, and cooling.
• Salaries and Wages
• Supplies and Equipment
• Marketing and Advertising
• Maintenance and Repairs
• Licensing and Permits
• General administrative expenses, such as office supplies, accounting services, legal fees, and software subscriptions.

e. What is the Average Salary of your Staff?

• Medical Director – $125,000 Per Year
• Surgeons – $120,000 Per Year
• Anesthesiologists – $118,000 Per Year
• Nurses – $75,000 Per Year
• Accountant – $45,100 Per Year
• Front Desk Officer – $36,100 Per Year

f. How Do You Get Funding to Start an Ambulatory Surgery Center Business?

• Raising money from personal savings and sale of personal stocks and properties
• Applying for a loan from your bank/banks
• Pitching our business idea and applying for business grants and seed funding from the government, donor organizations, and angel investors
• Source for soft loans from our family members and friends.

Financial Projection

A. how much should you charge for your product/service.

The cost of surgery at an ambulatory surgery center can vary depending on several factors, including the specific procedure being performed, geographical location, facility fees, anesthesia services, and any additional services or supplies required. The prices can also vary based on negotiated rates with insurance providers and individual patient circumstances.

b. Sales Forecast?

• First Fiscal Year (FY1): $1.2 million
• Second Fiscal Year (FY2): $2.5 million
• Third Fiscal Year (FY3): $4 million

c. Estimated Profit You Will Make a Year?

• First Fiscal Year (FY1): (20% of revenue generated)
• Second Fiscal Year (FY2): (25% of revenue generated)
• Third Fiscal Year (FY3): (30% of revenue generated)

d. Profit Margin of an Ambulatory Surgery Center 

The ideal profit margin we hope to make at St. James® Ambulatory Surgery Center, Inc. will be between 15 and 35 percent on service charges.

Growth Plan

A. how do you intend to grow and expand by opening more retail outlets/offices or selling a franchise.

St. James® Ambulatory Surgery Center, Inc. will grow our ambulatory surgery center by first opening other facilities in key cities in the United States of America within the first five years of establishing the organization and then will start selling franchises from the sixth year.

b. Where do you intend to expand to and why?

St. James® Ambulatory Surgery Center, Inc. plans to expand to

• Sacramento, California
• Palm Beach Gardens, Florida
• Scottsdale, Arizona
• West Chester, Ohio
• Dallas, Texas
• Washington, D.C.
• New York City, New York
• Las Vegas, Nevada
• Los Angeles, California
• Edmond, Oklahoma
• Nashville, Tennessee.

The reason we intend to expand to these locations is the fact that these cities have a thriving market for the ambulatory surgery business.

The founder of St. James® Ambulatory Surgery Center, Inc. plans to exit the business via family succession. We have positioned structures and processes in place that will help us achieve our plan of successfully transferring the business from one family member to another and from one generation to another without difficulties.

The company has successfully developed a detailed transition plan to smoothly hand over responsibilities to the new successor. This includes transferring ownership, training key personnel, and communicating with employees, customers, and suppliers about the change.

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Top 7 Design Guidelines for Ambulatory Surgery Centers

Back in the seventies, one could wait months for doctor appointments, spend several days in the hospital for a procedure and several weeks out of work recovering. In today’s Ambulatory Surgery Centers (ASCs) , you meet a specialty team of experts who swiftly schedule your procedure and provide quality care with equipment and facilities that are tailored to your specific needs. So how do we continue this positive, efficient momentum and prepare for future growth? Here are the top 7 design guidelines to consider in the design of your ASC.   

• Collaborate with physicians and staff involved. Getting physician and staff input upfront is crucial to the successful design of your facility. Understanding what is important to each member of the team allows the designers to address their needs in the concept development stage. Wearing and walking in a lot of different shoes is key for this collaborative strategy to be successful. When you hear a team member utter things like “wow, thank you, no one has ever asked me what I thought about that before”, you’ll know you’re doing it right.
• Remember that flow and proper balance = efficiency. A smaller footprint is not the only way to increase efficiency when it comes to ASCs. Ideal flow and appropriate layout of pre-op treatment and recovery relative to each specialty increases proficiency . When appropriate for your business model, placing the business office staff near patient check-in might allow a team member to jump in and assist with admitting during peak times. Similarly, positioning the schedulers close to the operating rooms (ORs) proactively facilitates rapid answers to questions and solutions to problems that may arise with the timetable.
• Provide ample space for storage and processing instruments. Designing narrow, long equipment rooms that provide access from either side (instead of a square dead end) helps staff to easily grab-and-go without hassle. Ensuring adequate space for sterilization and cleaning of materials will help thwart infection concerns.
• Address staff needs. Thoughtful planning techniques in surgery center staff and physician break areas outside the restricted zone, such as incorporating natural light and access to nature benefit staff and patients alike. After all, sunlight has been linked with lower stress . Research has repeatedly demonstrated the emotional and physiological benefits of visual and physical access to nature: stressful and negative emotions decrease while pleasant emotions increase. Even small gardens located in healthcare settings such as ASCs offer waiting family members and staff the opportunity for direct interaction with the restorative, calming effects of nature. For staff who may have a 10 or 12-hour shift, appropriate, nonglare light levels brought to the tasks at hand can also improve staff accuracy and effectiveness.
• Plan for expansion. As ASCs have diversified over the past few years, planning for future expansion is vital to the sustainability of these facilities. Design that supports flexible expansion and efficient delivery of services will accommodate many of the recent changes in surgery centers such as movement of total joints as well as spine procedures to these facilities.
• Offer flexibility. Given the trends of newer specialties joining the existing three big specialties in surgery centers — ophthalmology, GI and orthopedics — it’s important to recognize that these different areas have varying needs in operative and recovery timing. For example, ophthalmology surgery may take 15 minutes followed by 30 minutes of recovery while spine surgery may take anywhere from 2½-7 hours, with the patient spending about the same length of time in recovery as they did in the OR. Identifying which specialties are assigned to each OR will allow you to thoughtfully place large medical equipment to accommodate varying procedures, — instead of relocating for each procedure — preventing damage and the need to recalibrate technology in the future. Bottom line: design your ASC to accommodate multiple specialties.
• Design for patient experience Best for last. We understand that warm, engaging and personalized environments help patients recover. In fact, we are experts on the entire Patient Experience topic #humblebrag. (But seriously, on March 20, 2017, one of our Thought Leaders is co-presenting on Positive Correlations Between the Patient Experience, Organizational Performance and Facility Design: Learning from Research and the Field at The Beryl Institute National Patient Experience Conference in Denver, CO. And our research was recently accepted for publication in the peer-reviewed Patient Experience Journal.)

So back to the specific connection between ASC design and patient experience. An empathic knowledge of the patient demographic will support the ideal design concept and plan for a first-impressions-matter space like parking or the lobby. Plan these spaces mindfully, tailored to the patients in the surrounding community and you could add to the following statistic: patient centric design has resulted in a 92% satisfaction rate with both the care and service they receive from ASCs.

Summing it up Safe, high quality service, ease of scheduling, greater personal attention and lower costs are among the main reasons patients cited for the growing popularity of ASCs. Given the increase in patient demand for outpatient surgery, we must continue to grow and develop ASCs to successfully provide convenient, cost effective outpatient care.

Related Insights

Red Rocks Ambulatory Surgery Center’s Business Plan Coursework

The business plan of an outpatient surgical center known as Red Rocks Ambulatory Surgery Center, L.L.C., which is a for-profit business, is presented in this report. The aim of this business is to provide patients with a broad spectrum of diagnostic and therapeutic surgical services. The mission of the surgical center will help in achieving its short-term and long-term goals. From the vision of Red Rocks Surgery Center L.L.C., it is observed that it will provide surgical services with a goal of exceeding patient expectations in a setting designed to create a positive healing experience for its patients and their families. It is a cooperative joint venture with Your Best Health Surgical Services and Healthy Living Hospital. The center will provide surgical services including Surgical Accommodations, Staff Accommodations (Clinical), Staff Accommodations (Administrative), and Patient/Family Accommodations. The plan discusses market conditions and trends. Also, it provides details of licensing, training, and certification requirements. The SWOT Analysis helps in reviewing both internal and external environments. The business plan provides the financial analysis of the proposed business and its financial statements that indicate the financial feasibility of the proposed business. The financial analysis underlines necessary assumptions to support financial projections presented in the document. Also, it provides a brief description of the source of funds. The report ends with Ambulatory Surgery Preliminary Plan and Ambulatory Surgery Schematic Plan that will be implemented by the proposed business.

General Company Description

Red Rocks Ambulatory Surgery Center, L.L.C. (Red Rocks ASC) is a for-profit outpatient surgical center providing patients with a broad spectrum of diagnostic and therapeutic surgical services. Our state-of-the-art facility has been designed and equipped with the most up-to-date medical and surgical technology. The soothing surroundings and dedicated staff are focused on creating a calm and relaxing environment for patients and their families during their surgical procedure and recovery.

Mission Statement

Red Rocks ASC will be the surgical facility of choice for physicians and patients who prefer to undergo elective outpatient surgery in a caring atmosphere with the highest quality of surgical expertise, efficiency and cost effectiveness.

Red Rocks ASC is committed to its values:

• Quality: Our dedication to quality includes continuous performance improvement that ensures positive outcomes and utilizes innovative methods to assure that we exceed our patients’ expectations.
• Professionalism: Our entire organization understands that respect and courtesy are vital components of our everyday culture along with integrity and ethics in all that we do.
• Patient satisfaction: Our teams will strive to exceed our patients’ expectations and needs and our success will be measured by their satisfaction.

Our vision is to provide the greatest surgical expertise in a caring and comfortable atmosphere. Red Rocks ASC will encompass state-of-the-art surgical technology in a cost effective manner. We will provide surgical services with a goal of exceeding patient satisfaction in a setting designed to create a positive healing experience for our patients and their families.

Red Rocks ASC is a limited liability corporation formed in cooperation between Healthy Living Hospital and Your Best Health Surgical Services. By joining together in a unique partnership to create Red Rocks ASC, our physician and administrative leaders are able to draw on years of expertise in providing healthcare services to patients in our community. Our experienced and knowledgeable staff members and physicians are not just employees but are active and engaged members of the community.

Products and Services

Red Rocks ASC is a cooperative joint venture formed in collaboration between Healthy Living Hospital and Your Best Health Surgical Services. Together, this well-established community hospital and the well-respected healthcare professionals have joined forces to create an ambulatory surgical center (ASC) dedicated to providing patients with the latest advances in surgical care in a state-of-the-art facility. Rec Rocks ASC is committed to providing care focused on comfort and convenience of both the patient and their family.

Surgical Services

As an ambulatory facility, Red Rocks ASC provides general surgical services performed on site in a dedicated surgical facility. This is an outpatient based center with no capacity for overnight stays. All patient care services will be completed and the patient discharged within 10 hours of total care and recovery time at the facility. Primary revenue sources will be generated from surgical services and other medical procedures performed on site. The bulk of payments will be received from reimbursement from insurance companies and patient generated revenue from co-pays, deductibles, and self-pay patients.

Red Rocks ASC is capable of performing a broad array of diagnostic and therapeutic interventions including minimally invasive, percutaneous or laparoscopic and open surgical procedures. Orthopedic, podiatric, pain management and ophthalmology procedures are anticipated to be the greatest percentage of procedures performed. Plastic surgery, otolaryngology and general surgery procedures will round out the main types of procedures performed. The facility will not provide gastroenterology endoscopy services, as a dedicated endoscopy facility is located in the general vicinity of the hospital campus.

Overview of Facilities

Surgical Accommodations:

• Three Primary Operating Suites, including a dedicated orthopedic procedures room equipped with state of the art clean room filtration technology
• Minor Procedure/Treatment Rooms
• Eight bed pre-procedure holding bay
• Eight bed post-anesthesia recovery bay
• Two physician consultation rooms for multiple functions

Staff Accommodations (Clinical):

• Male/Female changing area with dedicated locker space in each for 25 staff members including shower and toilet facilities
• Employee break room with full kitchen facilities
• Operating Room Director dedicated office space

Staff Accommodations (Administrative):

• Four patient registration cubicles
• Employee break room with full kitchen facilities, restrooms
• Dedicated office space for scheduling, prior-authorization, coding and billing, health information management, administrative management staff

Patient/Family Accommodations:

• General waiting area with maximum capacity of 25 people
• Surgical waiting area capable of holding up to 15 people

Market Analysis

The main marketing mix for this center includes people who are in need of elective surgery. The primary surgical patient needs will include orthopedic, ophthalmologic cataract procedures, gynecological, urological, plastic surgery, and other general surgery procedures that do not require an overnight patient stay (Ambulatory Surgery Centers in the US…, 2016). This may also include patients recovering from minor accidental injury, such as broken bones, whose condition may require non-emergent elective outpatient surgical procedures as part of their treatment and recovery plan (IBIS World, 2016). The center will be able to handle the surgical needs of many patients with its twenty surgeons and other employees that have been put into place for nursing, sterilization and rehabilitation. In addition, low-acuity patients may be referred to the ambulatory surgical center by the hospital, allowing for the facility patient load to remain focused on high-acuity patients whose care requires overnight or multiple day inpatient stays. This increases the volume of surgical procedures for the ambulatory surgical center and helps to accommodate the needs of the hospital, surgeon, and patient for both inpatient and ambulatory surgical services.

The outpatient surgery center is a perspective-driven example of modern medicine. Plenty of operations that have previously required extensive hospital treatment are now completed in outpatient conditions during one or within several days. The popularity of ambulatory surgery centers is enormous (Boodman, 2014). They have been rising in popularity since the 1970’s (IBIS World, 2016), although there are many concerns about the legitimacy and safety of such centers following the death of Joan Rivers, who was undergoing treatment at a similar type of center in Manhattan (Boodman, 2014). These safety concerns may be assuaged by proper certification for the center, as well as highly qualified staff overseen by the hospital’s large surgery staff of twenty surgeons. The supervising staff can assist in preventing the violations of accreditation that led to Joan Rivers’ death (Boodman, 2014).

The paramount mission of the center for the outpatient surgery is the extension of health care opportunities for patients providing surgical treatment in a quick, efficient, and comfortable environment. The reduction of the time and cost of the treatment occurs due to the use of high-tech equipment and minimally invasive techniques (Al-Amin & Housman, 2012). Therefore, the center for the outpatient surgery is an effective clinical and organizational direction of development for modern medicine and public health. The patient flow should be optimized by minimizing the patient wait time and delays.

It goes without saying that any medical activity is a subject to compulsory licensing. To obtain a license, the potential outpatient surgery center should have an appropriate space, a list of necessary medical equipment, and staff members who have obtained valid certificates and licensures (Mercier & Philip, 2009). The consideration of the licensing application takes place within a two-month period. The license applies only to a specific address. The difficulty lies in the fact that each health care service requires a separate license. A specially created registry can: 1) maintain the necessary documentation, 2) registration, 3) temporary disability materials, 4) regulate the flow of patients, 5) receive calls, 6) manage the implementation of hospitalization, and 7) solve transportation issues.

Employees that are needed per operating room will include one registered nurse (RN), one scrub technician, four pre-operative RNs, four post-operative RNs, two registration clerks, one custodian, two sterilization clerks, and a receptionist with knowledge of medical billing and coding. All employees must have proper training and licenses in their fields (Accreditation Organizations, 2016). The center itself must maintain standards set by the American Association of Accreditation for Ambulatory Surgery Facilities (AAAASF), Healthcare Facilities Accreditation Program (HFAP), and Accreditation Association for Ambulatory Health Care (AAAHC) (Accreditation Organizations, 2016). The AAAASF measures and monitors medical competence. The AAAHC uses peer-based measurements to accredit facilities. HFAP surveys hospitals for quality of care and medical competence (Accreditation Organizations, 2016).

The outpatient center must provide care, and have certified and licensed employees able to provide the quality of care needed for these organizations to approve the center for accreditation so that it can be a trusted as a safe source of healthcare. Aspects of meeting physician needs on both the surgery center’s performance, and that of the main operational room in the hospital, should also be thoroughly considered. In order to avoid any misunderstanding, it is essential to provide investigations and elaborate a uniform standard of health care provision.

Training and Certification

Advances in technology, globalization, and constant organizational transformation are forcing medical centers and their employees to learn and acquire new skills, and developing new business models to work with new technologies. In order not to lose their competitive edge, medical centers have to constantly increase the pace of acquisition of necessary knowledge and skills. Such a need presents the center’s management with a dilemma: On the one hand, employees need more training hours, but in the framework of constant change, the number of hours devoted to training is strictly limited. In this connection, the surgical learning is the best solution to the problem. Using this approach, the maximum efficiency will be achieved through the training of specialists empowering the development and implementation of short and narrowed-focused lessons that are required for surgeons and employees.

The basic idea of surgical training in this business plan is based on the fact that employees do not need comprehensive training, concerning the new technology or program (Maruthappu, Duclos, Lipsitz, Orgill, and Carty, 2015). They will however, need to learn more specific aspects related to the current operation.

The reduced content should be transformed into short courses that are fast to develop and easy to use. Short training programs are more easily integrated into the working schedule of the staff. The attendance of training courses will be increased by the fact that the programs are short and more engaging As a result, the progressive ambulatory surgical center will benefit from optimally trained and certified staff.

Construction

In the planning of a new ambulatory surgical center, construction factors are another important consideration. Constructing a new space will include the cost of construction. In addition, it will also include the need for zoning and bringing the building up-to-code, according to city requirements. The design of the building must include handicap accessibility, since many patients may require the need for wheelchairs before or after surgery. Parking should be ample and easy to access for patients (Boodman, 2014). The design of the outpatient surgery center should follow the overall design of the hospital to provide continuity. All the rooms should be equipped with special chairs and other utilities necessary for the pre- and post-operation periods. The number of operating rooms should be approximately seven, to provide timely surgeries. At the same time, the center should include physician space; such as changing rooms and workspace for paperwork. Staff space, such as changing rooms, should also be included. It is also important to point out that the creation of a break room for relaxation and rest will reduce the stress level of employees. Its design should be performed in a shade of green, as such color contributes to pacification and comfort.

The billing system should be organized appropriately to guarantee the calculating costs of medical service queries to the insurance companies and their processing. Revenue cycle management activities including prior authorizations, calculation of copayment, cost-share and deductibles and third party payer claim processing will be performed on a dedicated practice management system.

The equipment of the center for outpatient surgery will allow for providing virtually the entire spectrum of surgical operations from the day surgery category. In particular, the following equipment is necessary to provide the appropriate treatment:

• Endoscopic equipment for endo-surgery;
• Holmium laser that was previously inaccessible under the conditions of ambulatory operations to treat diseases of the bladder wall using it as a laser scalpel;
• Ultrasound devices in both the operating and observation rooms;
• Medical facilities including apparatus for RFA and EVLT, heart monitor and / or a pulse oximeter, blood pressure monitors, ventilation apparatus, defibrillator, operating table, medical couch;
• Consumables: disposable kits for the operating field, intravenous catheters, gloves, etc.;
• Sterilization equipment;
• Medicines according to the profile of the medical center;
• Anesthesia equipment, equipment tracking, monitors, and others will ensure the high-quality of operations using all the possible kinds of general and local anesthesia. For example, equipment installed for the anesthesiologist and expert classes will include anesthesia-breathing apparatus of Draeger.

Daycare chambers will be equipped with functional beds, Ventilator Puritan Bennett 560, and oxygen concentrators. The installed equipment will allow monitoring the condition of the patient transmitted from the operating room, and to react promptly to any deviation from the norm.

The main costs for the implementation of the business plan will relate to equipment and facilities as well as the medicine purchase. When planning costs, the fact that the center will be inactive during the licensing period should also be taken into account. Staff costs related to wages includes the monthly labor costs of personnel and tax rates. Capital expenditures include the following expenses:

• Building of premises for the outpatient surgery center, design, and repair facilities;
• Equipment, furniture, air-conditioning, and ventilation system.

Fixed costs related to the work of the center will comprise:

• Production costs include cost of materials for the surgery complex, repair costs, clothing for staff;
• Administrative and office expenses such utilities, current expenses for office supplies and materials for office equipment, security alarm);
• The total labor costs;
• Constant marketing costs.

In addition, electricity, thermal energy, and other resources should be considered while planning costs.

Operational Plan

Red Rocks ASC was founded by Healthy Living Hospital, in conjunction with Your Best Health Surgical Services. It is operated and managed by Red Rocks L.L.C. Board of Directors, with the help of many others, as seen in the organization chart.

Surgeons hold leases with Red Rocks Ambulatory Surgery Center, L.L.C., which require a renewal process every three years. Red Rocks ASC operates with the guidance of facility policies, which are to be followed strictly by all employees. Facility policies are reviewed by the policy committee every five years or sooner if needed.

All potential employees of Red Rocks ASC must undergo a face-to-face interview process, pass a pre-employment drug screen, be current on all necessary immunizations as outlined in the employee packet, including influenza, and hold an active license (if necessary) in the state of Arizona. Once hired, employees are required to complete a mentorship program through Red Rocks ASC. The mentorship program begins with a minimum of three days of training, with additional days required per specialty field. Training will include an overview of the company, expectations, policy overview, disciplinary action steps, a tour of the facility, and two to six weeks of specialty training with a mentor, depending on the area of interest. Employees must be able to pass a skills interview by the end of the mentorship period, or continue with additional training until competency is met. Employees must be able to pass a random drug screen and stay current on necessary immunizations.

In the event of unforeseen circumstances, such as a reduction in patients or employees, Red Rocks ASC will consult with the Board of Directors to make the best decision in order to continue providing patient care. In the event of a decrease in patient load, Red Rocks ASC will make every effort to continue to employ every employee, with the possibility of an employee transfer to Healthy Living Hospital, with every intention to return to Red Rocks ASC when the patient load increases. Red Rocks ASC will make every effort to prevent employee loss due to a decrease in patient load, by actively advertising services and striving to maintain and improve patient satisfaction. In the event that Red Rocks ASC experiences a decrease in employees, advertising efforts will increase in order to maintain employee and patient satisfaction and quality of care. Employee transfers from Healthy Living Hospital will be honored as temporary or permanent employees of Red Rocks ASC.

Red Rocks ASC will strive to maintain high patient satisfaction, with the goal of always improving. Patient satisfaction surveys will be offered during discharge and mailed home to those who wish to complete the surveys at a later date. Results of the survey will be kept in a database to track patient satisfaction and to help develop plans of improvement.

SWOT Analysis

Swot analysis template, situation being analysed: red rock’s ambulatory surgery center.

A significant strength would be the close association and location near to the hospital. Many patients will express misgivings about going to ambulatory surgery centers because they are not ‘real hospitals’, such as the fears expressed by Wendy Salo (Boodman, 2014). Being attached to a hospital with such a reputable staff of surgeons can help ease the concern of some patients. It can also provide more outpatient services with a hospital affiliation (IBIS World, 2016). One of the most important advantages is the unloading of hospital beds by transferring part of routine surgical interventions in terms of health centers, which operates in the hospital structure. At the same time, the organization of early discharge of patients from the hospital with subsequent follow-up care in the clinic would benefit both the center and patients (Merrill & Laur, 2010). All patients will be placed in the superior chambers equipped with modern facilities and are under round-the-clock supervision of qualified medical staff so that they will feel comfortable and calm. Moreover, the postoperative complications in the surgical day hospitals are on average less than 1% (Carey, Burgess, & Young, 2011). The quality of operations in the outpatient surgery center is defined by experienced surgeons and nurses. Comparing volumes within the main operating rooms with those of outpatient environment, one might note the increased capacity of the latter. What is more, one might note such advantages as follows:

• Reduced wait times for patients. Outpatient surgery centers have shorter wait times and fewer budgetary constraints (IBIS World, 2016);
• The release of specialized surgical hospital beds for the treatment of clinically complex patients;
• The same surgeon holds the complete continuity of the examination and treatment of patients; preoperative preparation, surgery, postoperative treatment until the patient’s hospital discharge;
• Patients stay at home in habitual environment (Grisel & Arjmand, 2009);
• Active lifestyle contributes to the rapid recovery;
• Reducing the probability of in-hospital infections and thromboembolic complications in patients;
• Significant financial savings (Ambulatory Surgery Center Association, n.d.).

A significant weakness is the ambulatory surgery center’s affiliation with a hospital. While this can be viewed as strength, it doubles as a weakness. Both the ambulatory surgical center and the surgical services department of the hospital have goals based on volume and revenue. In addition, competition from other local ambulatory surgical centers could potentially reduce the volume of procedures, thereby reducing revenue (Courtemanche & Plotzke, 2010). Another weakness is the need for the center to be constructed. Construction costs, zoning, and time are all involved in the construction process, which can be a weakness for the center. Lastly, this new ASC will take time to develop a presence and reputation within the community in order to gain both respect and acknowledgment as its own entity rather than being known as the hospital’s surgical center.

Opportunities

The content of operations of the ambulatory surgery center is determined by the variety of forms of its activity:

• The outpatient center is part of the overall hospital, but it will be its own separate entity (Pickles, 2015). This means that the center will have its own financial statements. It also requires a deep understanding of the regional health care delivery system in order to provide legally and ethically sound care (Pickles, 2015).
• Selection of patients with surgical diseases among the population including the workers and employees of industrial enterprises, institutions, and other organizations;
• Implementation of permanent relationships with the clinics and dispensaries;
• Clinical diagnostic study of supervised patients using modern methods and equipment;
• Consultative reception of patients of surgical clinics and dispensaries for the selection of patients requiring surgical treatment; definition of the indications for surgery, preoperative examination, the scope of the operation, and capabilities;
• Diagnostic use of invasive techniques, performance of operations according to the approved list, the observation of patients operated on in the next few hours after surgery in the recovery room of the hospital, day surgery follow-up treatment at home;
• Comprehensive treatment of patients with surgical diseases including drug and infusion treatment, the use of extended wear bandages, physiotherapy, plasmapheresis, medication blockade, and the necessary range of rehabilitation measures (Starr, 2012);
• Organization of follow-up care for operated patients for a timely implementation of the necessary therapeutic and preventive measures to prevent disability and reduce its period. Research and comprehensive assessment of the short- and long-term results of the surgical treatment and the development of evidence-based recommendations.
• Further training of surgeons and nursing, training of graduates of medical institutions.

The main threats include competition with other hospitals and other centers. This can especially be an issue with the large amount of distrust people feel for outpatient surgery centers (Boodman, 2014). Competing with other organizations can entail providing the best care possible. It can also involve providing a more comfortable and compassionate environment that will be memorable to patients in their difficult and often scary times of receiving surgery.

Initial capital requirements are one of the biggest threats facing ASCs (IBIS World, 2016). Being part of a hospital can help this center establish the capital needed to get started. Still, it will be a major financial endeavor. One of the other project risks is associated with possible changes in the financial situation in the country, due to the influence of internal or external factors. One more threat category may include a possible increase in costs and timing on the establishment of the center’s services or a possible reduction or increase in prices for services.

The probable management risks are related primarily to the inability of managers or a team to implement the project objectives and to achieve goals set in the business plan. The reduction of this type of risk is largely determined by the effective selection of personnel. To reduce this type of risk, it is possible to use the potential of employment agency as well as the use of the resource business consultants, who have extensive experience in implementing projects.

Other risks include all kinds of risks of natural disasters, other force majeure related to property damage and clients’ lawsuits in connection with human error. The above risks are easily minimized through insurance mechanisms. Based on the foregoing, all of the project risks can be regarded as moderate that is quite acceptable for the successful implementation of this business plan. Finally, taking into account all the above issues, it seems possible to implement the business plan within half a year.

Financial Analysis

Underlying assumptions.

The Collaborative Learning Community (CLC) Red Team has based this financial analysis on the following:

• Red Rocks Ambulatory Surgery Center, L.L.C. is expected to yield an annual revenue growth rate between 7%-8% per year. With the recent changes to Medicare reimbursement, this rate may be slightly lower than expected, although, the center does expect yearly revenue growth (Koenig, Doherty, Dreyfus, & Xanthopoulos, 2009, p. 22).
• Due to the collaboration of Healthy Living Hospital and Your Best Health Surgical Services, this entity will have the financial backing to proceed with the addition of the outpatient surgical center that will be constructed in a new space attached to the hospital.

Sensitivity Analysis

The CLC Red Team understands that due to Medicare reimbursement rates that there may exist a slowing of the expected yearly revenue growth, but it is not deterred by this because it recognizes that the need for surgical procedures will not decline due to changes in the economy. In addition, there are those individuals who are covered by private insurance who will need Red Rocks ASC’s services: therefore, the CLC cannot find a reason as to why this organization will not enjoy financial growth.

Source of Funds

General assumptions.

Profit and Loss Statements

Balance sheet.

Cash Flow Analysis

Breakeven Analysis

Ambulatory Surgery Preliminary Plan

Peripheral Core

Pre-op holding.

The preliminary plan clarifies the ambulatory surgery unit space requirements by showing the location of all the fixed walls and open areas and identifies entrances, exits, and exact traffic patterns.

Ambulatory Surgery Schematic Plan

The schematic plan shows all of the specific movable modular casework, modularfurniture systems, and materials handling components appropriate for a typical ambulatory surgery unit.

Accreditation Organizations. (2016). Ambulatory Surgery Center Association . Web.

Al-Amin, M., & Housman, M. (2012). Ambulatory surgery center and general hospital competition. Health Care Management Review , 37 ( 3 ), 223-234.

Ambulatory Surgery Center Association. (n.d.). ASCs: A positive trend in health care. Web.

Boodman, S.A (2014). Popularity of ambulatory surgery centers leads to questions about safety. Kaiser Health News . Web.

Carey, K., Burgess, J. F., & Young, G. J. (2011). Hospital competition and financial performance: The effects of ambulatory surgery centers. Health Economics , 20 ( 5 ), 571-581.

Courtemanche, C., & Plotzke, M. (2010). Does competition from ambulatory surgical centers affect hospital surgical output? Journal of Health Economics , 29 (5), 765-773.

Grisel, J., & Arjmand, E. (2009). Comparing quality at an ambulatory surgery center and a hospital-based facility: Preliminary findings. Otolaryngology – Head and Neck Surgery , 141 (6), 701-709.

IBIS World. (2016). Ambulatory surgery centers in the US: Market research report. Web.

Koenig, L., Doherty, J., Dreyfus, J., & Xanthopoulos, J. (2009). An analysis of recent growth of ambulatory surgical centers. ASC Coalition . Web.

Maruthappu, M., Duclos, A., Lipsitz, S. R., Orgill, D., & Carty, M. J. (2015). Surgical learning curves and operative efficiency: A cross-specialty observational study. BMJ Open, 5 (1), 1-7.

Mercier, D., & Philip, M. (2009). Is Your Ambulatory Surgery Center Licensed, Accredited or Certified? ASA Monitor, 72 (8), 10-14.

Merrill, D. G., & Laur, J. J. (2010). Management by outcomes: Efficiency and operational success in the ambulatory surgery center. Anesthesiology Clinics, 28 (2), 329-351.

Pickles, V. (2015). Strategic planning for your surgery center. Ophthalmology Management . Web.

Starr, C. (2012). Ambulatory surgical centers: Good for you and your patients. Medscape . Web.

SWOT analysis. Businessballs.com . Web.

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IvyPanda. (2022, June 4). Red Rocks Ambulatory Surgery Center's Business Plan. https://ivypanda.com/essays/red-rocks-ambulatory-surgery-centers-business-plan/

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1. IvyPanda . "Red Rocks Ambulatory Surgery Center's Business Plan." June 4, 2022. https://ivypanda.com/essays/red-rocks-ambulatory-surgery-centers-business-plan/.

Bibliography

IvyPanda . "Red Rocks Ambulatory Surgery Center's Business Plan." June 4, 2022. https://ivypanda.com/essays/red-rocks-ambulatory-surgery-centers-business-plan/.

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Building an Ambulatory Surgery Center is complex. We're here to help make it simple.

The task of building and opening a new Ambulatory Surgery Center (ASC) can be overwhelming. There are critical decisions to make, timelines to manage, and an endless to-do list to tackle before you’re able to open the doors and perform your first case.

We can help make it simple. We have helped numerous ASCs through the process of planning, building, and operating a new facility from the ground up. Our dedicated team of clinical and operational ASC experts can provide guidance at every step, and our broad portfolio of products and solutions ensures you have everything you need on day 1.

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No two ASCs are exactly the same – and no two ASC development projects are exactly the same either. We will work together to develop a tailored solution based on the unique needs of your new ASC and where you are in the development process.

Here are some of the ways we can support you and your new ASC.

• Create a custom project plan to help you prioritize tasks and manage timelines
• Share clinical and operational insights to help you make informed decisions and maximize the potential of your new ASC
• Provide tailored equipment and supply recommendations based on your unique needs
• Support the setup and stocking of your facility with our broad portfolio of products and services
• Connect you with specialized industry experts to help tackle all the tasks on your list

4 things to ask your distributor about new ASCs

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Ambulatory Surgery Center Design: Development and Planning

Introduction

During the pre-development process of an ambulatory surgery center design, common mistakes are often made that may negatively affect the purpose and viability of the center. Once the center is in operation, it can be nearly impossible to reverse the effects of these errors – and as a result, the entire lifespan of the design will be negatively impacted.

These faults could be avoided if thorough research is performed and if competent professionals are available to assist the designers and architects in meeting their goals. The following, if executed and performed prior to the development phase, will augment the true viability of any ambulatory surgery center design and project.

Comprehensive Business Plan Development

Ensuring the thorough progression of a business plan is the first step in the successful development of all types of establishments, including an ambulatory surgery center. The business plan, therefore, is the foundation for such a project.

The business plan should include the following:

• Micro and macro factors that will give a good indication of the viability and the best possible manner in which to structure the planned venture
• Detailed financial data
• Operational and legal structure of the planned venture

Joint Ownership

Successfully concluding the joint ownership arrangements with strategic partners prior to the development of an ambulatory surgery center is the one factor that most contributes to the long-term success. Physicians and hospitals solely own most of the surgery centers, but the ever-changing dynamics of the healthcare industry are busy lending itself to provider alignments.

Overbuilding Phenomena

The real key is to build a quality care facility that will meet the anticipated volumes without adding unnecessary expenses, such as overbuilding. This will ensure that the fixed costs will be minimized, which will give the healthcare facility a much greater chance of meeting its budgetary and financial goals.

Legal and Regulatory Hurdles

The healthcare industry is highly regulated, and it requires expertise in securities, tax, administrative law issues, and partnership/corporate arrangements. Many legal and regulatory roadblocks need to be navigated to ensure the successful consummation of an ambulatory surgery center design and project.

Reference: Zasa, Joseph JD. CRITICAL STEPS BEFORE DEVELOPING AN AMBULATORY SURGERY CENTER Managing Partner, ASD Management Retrieved December, 2011, from http://www.asdmanagement.com/critical steps.html http://bldd.com/portfolio/pah asa.html

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Best Practices for Efficient Surgery Center Development

Surgery centers are becoming increasingly popular as a more convenient, cost-effective, and patient-centered alternative to traditional hospitals. Surgery center development involves a comprehensive planning process that covers every aspect of the facility, from market research and funding to construction and ongoing operations. It also involves building relationships with physicians and other healthcare providers and developing a marketing plan to attract new patients. In this article, we’ll delve into the various aspects of surgery center development, including how to open a surgery center, construction, and surgical center designs.

Understanding the Basics of Surgery Center Development

How to open a surgery center, cost of opening a surgical center, surgery center construction.

Before opening a surgery center, it is essential to understand the basics of what goes into developing such a facility. Surgery center development involves many factors, including market research, funding, licensing and accreditation, equipment, staffing, etc.

Check out these articles after you’re done

• Strategies for reducing doctor burnout in the workplace
• Conducting Market Research : Before opening a surgery center, it is critical to research the local market to determine the need and demand for such a facility. This includes assessing the area’s demographics, identifying potential competition, and choosing the types of surgical procedures most in order.
• Creating a Business Plan : A comprehensive business plan is crucial to the success of any surgery center. It outlines the facility’s goals, strategies, and projections and serves as a roadmap for its development and growth.
• Obtaining Licensing and Accreditation : Surgery centers are regulated by various state and federal agencies, and getting the necessary licenses and accreditations before opening for business is essential. Most States require a certificate of need (CON), so check your State and County guidelines for additional information. This process can be complex, so working with a professional team to ensure compliance with all regulations is often helpful.
•   Securing Funding : The cost of developing a surgery center can be substantial, and ensuring adequate funding is essential. This may involve obtaining loans, grants, or investments from private sources.
• Hiring a Professional Team : A thriving surgery center requires a team of skilled professionals, including medical staff, administrators, and support staff. Selecting and hiring the right team ensures the facility’s success.

Opening a surgical center depends on location, size, type of procedures offered, equipment and supplies needed, staff salaries, and marketing expenses. Generally, the cost can range from several hundred thousand to several million dollars. Additionally, there are ongoing costs, such as utilities, insurance, and maintenance, that must be taken into account. It is recommended to thoroughly research and plan the budget before opening a surgical center and consult with financial and healthcare experts to ensure the project’s economic viability.

• Choosing a Location : The location of a surgery center is critical to its success, as it must be easily accessible to both patients and staff. Factors to consider when choosing a site include population density, parking, public transportation, and proximity to other healthcare facilities.
• Designing the Building : The design of a surgery center must be functional, efficient, and safe, with careful consideration given to factors such as patient flow, staffing, and equipment. Working with experienced architects and engineers ensures the building meets all regulations and standards.
• Planning for Equipment and Supplies : A surgery center requires a significant amount of specialized equipment and supplies, including surgical instruments, anesthesia machines, and much more. Planning for these costs and ensuring adequate funding is available is essential.
• Hiring a Contractor : Once the plans for the surgery center are in place, it is time to hire a contractor to construct the building. Choosing a contractor with experience in healthcare construction and a strong track record of delivering quality projects on time and within budget is essential.

Surgical Center Designs

• Overview of Different Designs : Surgery centers can be designed in various ways, including outpatient centers, inpatient centers, and hybrid facilities. Each design has its unique benefits and limitations, and choosing the right design for your facility is essential based on your goals and the needs of your patients.
• Factors to Consider When Choosing a Design : When choosing a design for your surgery center, it is essential to consider factors such as patient volume, surgical procedures, and staffing requirements. Additionally, it would be best to consider each design’s financial impact, including construction costs, operating expenses, and revenue potential.
• Outpatient vs inpatient  Centers : Inpatient surgery centers are designed for patients requiring overnight stays. In contrast, outpatient centers are intended for patients who can be treated and discharged on the same day. Each type of center has its unique benefits and limitations, and it is essential to carefully weigh these factors when deciding which design is suitable for your surgery center.
• Hybrid Facilities : Hybrid facilities combine inpatient and outpatient centers, offering the best of both worlds. These facilities can be a good choice for centers that expect to provide overnight and same-day surgical procedures.

Advanced Strategies for Surgery Center Development

Developing a business strategy for a surgery center involves understanding the market dynamics, patient needs, and competitive landscape. This includes creating a robust business development plan that focuses on market penetration, service expansion, and forming strategic partnerships.

Building an Ambulatory Surgery Center (ASC)

The process of building an ASC requires meticulous planning and execution. It involves site selection, design, construction, and ensuring compliance with healthcare regulations. The goal is to create a facility that is patient-friendly, efficient, and capable of delivering high-quality surgical care.

ASC Facility Development

Developing an ASC facility goes beyond construction. It encompasses creating a patient-centric environment, integrating advanced medical technologies, and ensuring operational efficiency. This development phase is crucial for setting up a facility that meets the evolving needs of healthcare delivery.

Surgical Center Remodel

Remodeling an existing surgical center involves upgrading facilities, incorporating new technologies, and redesigning spaces to improve functionality and patient experience. This process is essential for centers looking to modernize and stay competitive in the healthcare market.

Surgery center development is a complex process that requires careful planning, research, and execution. By understanding the basics of surgery center development, creating a comprehensive business plan, securing funding, and choosing the right design, you can ensure the success of your surgery center. Whether starting from scratch or looking to expand an existing facility, the key to success is working with experienced professionals who can help you navigate the complex world of surgery center development.

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Critical Steps Before Developing an Ambulatory Surgery Center

By Joseph Zasa, JD Managing Partner, ASD Management

The freestanding ambulatory surgery industry has seen tremendous growth since the first dedicated freestanding outpatient center was founded in Phoenix in 1970. Today it is estimated that over 2,400 surgery centers are in operation throughout the United States. The health care industry is also experiencing growth and rapid changes effecting the delivery of care. Change in reimbursement in health care is effecting all providers which, in turn, requires ambulatory surgery centers to operate more efficiently than ever before.

This article submits that with careful and competent planning prior to actual development and construction, the risks inherent in developing a de-novo facility can be substantially minimized, greater efficiencies can be achieved and the goals of the principals developing the facility can be met and exceeded.

In the course of our practice, we see common mistakes made in the surgery center pre-development process which negatively effect the viability and purpose of an ambulatory surgery center throughout its life span. These mistakes are exceptionally difficult to undo once the center is in operation. However, regardless of whether it is a hospital or a physician, the mistakes can be easily avoided through thorough research and the engagement of competent professionals to assist the principals in meeting their goals.

Thus, the following are four critical steps which, performed and executed correctly prior to development, will augment the viability of an ambulatory surgery center project.

1. Development of a Comprehensive Business Plan We often use the analogy of building a house when meeting with new clients. Before you build, you need to take soil samples and construct a proper foundation. The development of a business plan is the first step toward the successful development of any business, including an ambulatory surgery center. Thus, the business plan serves as the foundation for the project.

The business plan should include both micro and macro factors which will give indication as to the viability and most successful manner to structure the venture. Some macro-economic and macro-operational issues include whether there is an overabundance of competing facilities (hospitals and surgery centers) in the market, the ability for the venture to gain and retain key third party payor contracts due to pre-existing relationships in the market, the history of the development of independent for profit ventures in the market, and historic reimbursement in the market. A synopsis of some micro factors include meeting with physicians and gathering data regarding the number of cases and types of cases that will be performed at the facility, political factors singular to the market, the mix or type of cases expected to be performed at the facility, the desires of the physicians regarding the operation and day to day management of the facility, the practice patterns and supply cost patterns for the physicians, and the financial resources of the owners of the facility.

The business plan should include detailed financial data including a minimum of three (3) pro forma financial forecasts based on volume of cases performed. Included should be a projected income statement, sources and uses of funds, balance sheet, supply cost per case assumption, revenue per case assumption, staffing pattern assumption, expected payor mix as a percentage of volume, assumption regarding equipment requirements, and a debt to equity assumption. The data gathered (described above) should be used to make these assumptions. Furthermore, in concert with the architect and/or designer (see below) the developer should determine the size of the facility. A key concern is overbuilding based on over optimistic projection of cases. Similarly, in almost every instance, it is important to be able to expand the size and scope of the project based on changing needs.

The business plan should also set forth a legal and operational structure for the venture. After conferring with the client and their legal counsel (see below), a legal entity to operate the venture (limited liability company, limited partnership, limited liability partnership) should be selected which will meet the needs of the principals participating in the venture. Importantly, if the project will be joint ventured with physicians and/or a hospital, certain assumptions regarding ownership, governance, rights and duties of the owners, and overall operation of the surgery center should be set forth in the business plan. See Joint Ownership below. Lastly, if the project will be owned by more than one party, a capitalization structure must be set forth which prices the units of membership interest in correlation with the projected equity raised and debt incurred.

In summary, the development of the business plan has a threefold purpose. First, it is necessary to lay a firm foundation for the project so that the investors in the ambulatory center have a more complete understanding of the dynamics inherent to the venture’s success. Second, the business plan should also be used to secure financing and other capital required for the project since nearly all surgery center development projects utilize debt financing. Third, regardless of whether the project is begun by a hospital or by a group of physicians, if the founding party desires to enter into a joint ownership arrangement, the business plan is used as a starting point to discuss joint ownership since it includes all material factors relating to the surgery center’s development, operation and ongoing viability.

2. Joint Ownership If there is one factor which contributes the most to the long term success of an ambulatory surgery center, it is the successful consummation of joint ownership arrangements with strategic partners prior to the development of an ambulatory surgery center. While there are many, and will continue to be many successful surgery centers owned solely by hospitals and physicians, the changing dynamics of the health care industry lends itself to provider alignment. Historic pitfalls include:

• One physician owning too much of the surgery center which creates professional jealousy.
• A hospital owning too much of the surgery center which creates resentment by physicians because they feel that they lose control and direction over patient care which is a common reason for the establishment of a surgery center by physicians.
• Control vested in the hands of too few, or one entity. The need for a mutually beneficial arrangement is of critical importance.

There are numerous tax, legal and administrative issues which must be addressed during the course of negotiations. Key factors include the balance of powers, rights, duties, and obligations as well as the division of equity in the project. These issues can be successfully addressed with competent advisors with experience in surgery center joint ventures and principals willing to make the effort to correctly structure a venture to augment its long term viability. Furthermore, it is important for the participants to acknowledge the contribution of each potential partner so that the developer and the advisors to the project can structure a mutually beneficial joint ownership arrangement which meets the strategic goals of each partner.

Too often political and personal issues impede the actualization of a joint venture; however, if a surgery center project, through either the efforts of the developer, the principals, or their advisors, can avoid the common joint ownership pitfalls listed above and enlist the support of key strategic partners in the venture, it will greatly enhance the long term success of the project.

3. The Overbuilding Phenomena – Selecting an Experienced Designer
 The development of an ambulatory surgery center involves a series of complex and interrelated tasks. A surgery center is a high “fixed cost” business with the three highest expenditures during development being construction costs, land acquisition costs, and equipment costs. None of these costs vary with volume or revenue generated by the surgery center; therefore, they are deemed to be fixed. In fact, there are only two material variable costs associated with operating a surgery center: supply cost and staffing. Thus, the economic viability of a surgery center is very volume sensitive since enough cases must be performed to meet the relatively high fixed costs. However, once the volume reaches the fixed cost level, or break even point, the surgery center can experience significant economies of scale once the census exceeds the break even point. The most successful surgery centers take advantage of these economies of scale.

The key to realizing economies of scale, of course, is to build a quality facility to meet the anticipated volume, without overbuilding and adding unnecessary expense to the project. This will minimize the fixed cost and give the facility a greater chance to meet its financial and budgetary goals.

It cannot be emphasized enough that the selection of an architectural firm and/or design-build firm that has experience designing numerous ambulatory surgery centers in different states is of paramount importance since state and local regulations can vary and effect the size and scope of the project. It is strongly suggested that the participants in the surgery center venture interview firms with expertise designing and building numerous ambulatory surgery centers so that the architect and the developer work in conjunction with one another to minimize space requirements and still maintain a facility with the highest standards of care.

4. The Legal and Regulatory Hurdles – Selecting the Right Attorney The health care industry is a highly regulated industry which requires expertise in tax, corporate/partnership, securities, and administrative law issues. Since many ambulatory surgery centers are owned by physicians and other partners (hospitals, management firms), the attorney selected must be familiar with the Stark laws, the Safe Harbor provisions, private inurement issues for not for profit hospitals, revenue rulings from the IRS, advisory opinions from the Office of Inspector General, and numerous state and federal laws governing for profit joint ventures.

There are many legal and regulatory roadblocks which must be navigated in order to consummate a successful surgery center project. It is imperative that the law firm selected has experience in all facets of health law, as well as specific experience assisting clients in the surgery center industry. Apart from the regulatory aspects, key tasks include assisting the developer in selecting an operating entity for the project, formation of the surgery center legal entity, drafting the operating agreement or limited partnership agreement, drafting the prospectus and related offering documents (if joint ventured), and working with state regulatory agencies during licensing.

The selection of a law firm that is familiar with the nuances of the laws and regulations specific to the surgery center industry and who is motivated to make the venture work for the client is invaluable to the developer and the client during and after the pre-development process.

In conclusion, the four critical factors set forth above are interrelated and can be performed simultaneously. The numerous pitfalls inherent in the pre-development process can be overcome prior to the commencement of any ambulatory project if careful planning is utilized to establish a foundation for the long term success of the venture.

The Complete Guide To Ambulatory Surgery Center Business Financing And Raising Capital

By alex ryzhkov, resources on ambulatory surgery center.

• Financial Model
• Business Plan
• Value Proposition
• One-Page Business Plan
• SWOT Analysis
• Business Model
• Marketing Plan

Introduction

Overview of ambulatory surgery center (asc) business.

An Ambulatory Surgery Center (ASC) is a medical facility that provides same-day surgical care to patients who do not require hospitalization overnight. ASCs offer a convenient and cost-effective alternative to traditional hospital surgeries, as patients can undergo various procedures and return home on the same day.

When starting or expanding an ASC, one of the key considerations is financing. Ambulatory surgery center financing involves securing the necessary funds to cover the costs associated with setting up and operating the facility. Raising capital for a surgery center can be challenging, but there are several viable options available.

Business financing for surgery centers can be obtained through various sources, including traditional banks, private lenders, venture capitalists, and even public funding programs. Each option has its own requirements and advantages, and it is important for entrepreneurs to carefully assess their financial needs and evaluate the most suitable funding sources.

To secure funds for surgery center start-up , entrepreneurs can explore options such as bank loans, lines of credit, equipment leasing, or even personal investments. Collaborating with investors or seeking venture capital can also provide additional financial support in exchange for equity in the business.

Ambulatory surgery center financing options can be further expanded by considering alternative funding sources. These may include grants, crowdfunding, or strategic partnerships with healthcare organizations, insurance providers, or medical equipment suppliers.

Raising capital for surgery center businesses requires careful planning and strategy. Entrepreneurs should develop a comprehensive business plan, highlighting the potential for profitability, market demand, and competitive advantages of their ASC. This plan will be essential when presenting the investment opportunity to potential lenders or investors.

Ambulatory surgery center investment opportunities exist for those interested in financing such businesses. Investors can participate in the growth and success of ASCs by providing capital in exchange for a return on investment. These opportunities can be lucrative, especially in regions with a high demand for outpatient surgical services.

As with any business venture, diligence and research are key. Entrepreneurs entering the ambulatory surgery center business should consider various capital raising strategies and funding sources, taking into account the specific needs and goals of their venture.

Tips and Tricks for Ambulatory Surgery Center Financing:

• Develop a detailed and comprehensive business plan showcasing the potential profitability and competitive advantages of the ASC.
• Explore multiple funding options, including traditional banks, private lenders, venture capitalists, and strategic partnerships.
• Consider alternative financing sources such as grants, crowdfunding, or equipment leasing.
• Seek the guidance of healthcare consultants or financial experts experienced in ASC financing.
• Network with industry professionals and attend relevant conferences or events to learn about new funding opportunities.

Importance of financing and raising capital in ASC business

Financing and raising capital are essential components for the success and growth of an Ambulatory Surgery Center (ASC) business. Whether you are starting a new center or looking to expand an existing one, having access to adequate funds is crucial.

Ambulatory surgery center financing plays a vital role in covering various expenses associated with the establishment and operation of a surgical facility. These expenses may include facility construction, medical equipment purchases, staff recruitment and training, marketing and advertising, and other operational costs.

Moreover, raising capital for a surgery center is necessary to ensure that the ASC has the financial resources to maintain high-quality patient care, invest in cutting-edge technology, and adhere to regulatory standards. Without proper funding, it becomes challenging for an ASC to deliver optimal healthcare services and remain competitive in the industry.

There are various business financing options for surgery centers that entrepreneurs can explore to secure the necessary funds. These options may include traditional bank loans, lines of credit, lease financing, equipment financing, venture capital, private equity investments, and partnerships.

When considering capital raising strategies for surgery center businesses , it is crucial to evaluate each option's benefits, risks, and requirements. This evaluation ensures that the chosen financing method aligns with the ASC's long-term goals, risk appetite, and financial structure.

• Seek advice from experienced healthcare financial consultants and professionals.
• Develop a comprehensive business plan that demonstrates the potential profitability and sustainability of your ASC.
• Explore potential partnerships or collaborations to leverage additional financial resources.
• Consider joining industry associations or networks to gain access to funding sources specifically tailored for ASC businesses.
• Showcase your track record of successful surgeries, patient outcomes, and satisfied physicians to attract potential investors.
• Stay informed about the latest trends, regulations, and reimbursement policies in the healthcare industry to make informed financing decisions.

Funding sources for ambulatory surgery centers can come from various channels, including banks, private investors, healthcare-focused lenders, government grants, and even crowdfunding platforms. Each funding source may have unique requirements, interest rates, terms, and conditions, necessitating thorough research and due diligence.

In conclusion, financing and raising capital in an ASC business are crucial to ensure sustainable growth, operational excellence, and the ability to provide superior healthcare services. Entrepreneurs must explore and evaluate various funding options, develop sound capital raising strategies, and seek professional advice to secure necessary funds for their surgery center ventures.

Traditional bank loans as a source of capital for ASC business

When it comes to ambulatory surgery center financing, traditional bank loans have long been a reliable and popular option for raising capital. As surgery centers require significant investments to establish and operate, finding the right funding sources is crucial for entrepreneurs in this field.

Securing funds for a surgery center start-up can be a challenging task, but traditional bank loans offer a viable solution. These loans provide access to the necessary capital required for equipment purchases, leasehold improvements, and working capital needs.

Business financing for surgery centers can be complex, but banks are generally familiar with the unique needs and financial requirements of this industry. They understand that ambulatory surgery centers require substantial investments in equipment, facility construction, and highly specialized staff.

Therefore, banks typically offer competitive interest rates and repayment terms that are tailored to the unique demands of the ASC business. A well-prepared and comprehensive business plan can greatly enhance the chances of securing a traditional bank loan.

• Prepare a detailed business plan that highlights the profitability and long-term sustainability of your ASC business.
• Provide accurate financial projections and demonstrate your understanding of the industry's potential challenges and opportunities.
• Have a strong credit history and a solid personal and business financial track record.
• Be prepared to invest a portion of your own capital into the project as a sign of commitment and confidence.
• Build relationships with local banks and lenders with a focus on healthcare financing.

The availability of traditional bank loans as a funding source for ambulatory surgery centers provides entrepreneurs with a reliable option to raise capital. By carefully preparing and presenting a comprehensive business plan, establishing strong financial credibility, and building relationships with lenders, surgery center entrepreneurs can increase their chances of securing the necessary funds for their start-up or expansion projects.

Venture capital as a potential source of funding for ASC business

When it comes to ambulatory surgery center (ASC) business financing, one potential source of funding that entrepreneurs should consider is venture capital . Venture capital can provide the necessary funds for start-up costs, expansion, or other financial needs of an ASC.

Raising capital for a surgery center can be a complex process, and exploring various funding options is essential. Venture capital firms specialize in providing funding to promising businesses in exchange for equity or a share of future profits. These firms are often willing to take on higher risks associated with early-stage businesses, making them a viable option for ASC entrepreneurs.

There are several advantages to securing venture capital for an ASC start-up or expansion. Firstly, venture capital can provide a significant amount of funding, which may not be easily obtainable through other financing options. This infusion of capital can enable an ASC to make necessary investments in equipment, infrastructure, and staff, ensuring high-quality patient care.

Another advantage of venture capital funding is the expertise and network that venture capitalists bring to the table. In addition to providing financial backing, venture capitalists often have experienced professionals who can offer valuable guidance, strategic advice, and industry connections. Access to these resources can greatly benefit ASC entrepreneurs and enhance the chances of success in a competitive healthcare landscape.

However, it is important to note that venture capital funding may not be suitable for all ASC businesses. Venture capitalists typically look for businesses with high growth potential and the potential for substantial returns on their investment. As such, ASC entrepreneurs should carefully evaluate their business model, growth projections, and market potential before seeking venture capital.

Here are some tips and tricks to consider when exploring venture capital as a funding option for your ASC:

• Thoroughly research venture capital firms to find the ones that align with your healthcare niche and have a track record of successful investments.
• Prepare a comprehensive business plan that outlines your ASC's growth strategy, financial projections, and potential market opportunities.
• Highlight your competitive advantage and the unique aspects of your ASC that make it an attractive investment opportunity.
• Be prepared for due diligence , as venture capitalists will thoroughly analyze your business, market conditions, and potential risks before making a funding decision.
• Consider working with a healthcare-focused investment banker or advisor who can help navigate the intricacies of the venture capital landscape and increase your chances of securing funding.

Venture capital can be an attractive funding option for ASC entrepreneurs looking to secure funds for their start-up or expansion plans. By thoroughly researching venture capital firms, preparing a strong business plan, and highlighting unique aspects of your ASC, you can increase your chances of securing venture capital funding and fueling the growth of your business.

Angel investors and their role in financing ASC business

When it comes to ambulatory surgery center financing and raising capital for surgery centers , angel investors can play a crucial role. These individuals are typically high net-worth individuals who provide funding to early-stage businesses in exchange for equity or ownership shares.

In the context of ASCs, angel investors can offer business financing for surgery centers by providing the necessary capital to start or expand the facility. They can also serve as important mentors and advisors, leveraging their experience and industry knowledge to guide the entrepreneurs in their journey.

Angel investors bring their expertise and network to the table, which can significantly benefit ASC entrepreneurs in securing funds for their start-up. They are often more willing to take risks compared to traditional lenders, providing greater flexibility and more favorable terms for financing options.

One of the key aspects of engaging with angel investors is the need to present a compelling business plan that highlights the potential profitability and growth of the ASC. Investors look for a well-thought-out strategy, a clear understanding of the market, and a solid financial projection. Therefore, entrepreneurs must demonstrate their commitment, expertise, and passion for the industry.

Here are a few capital raising strategies for surgery center businesses that can help entrepreneurs attract angel investors:

• Develop a strong network: Building relationships with potential angel investors and industry experts can increase visibility and credibility.
• Seek mentorship: Engaging with experienced mentors who have successfully raised funds for ASCs can provide valuable guidance and insights.
• Showcase unique value proposition: Differentiating the ASC from competitors and highlighting its unique value proposition can attract the attention of angel investors.
• Focus on profitability: Demonstrating a clear path to profitability and a realistic return on investment is crucial in gaining investor confidence.
• Prepare a comprehensive business plan: A well-documented business plan that covers all aspects of the ASC's operations, marketing, and financials is essential for attracting angel investors.

Angel investors are just one of the many funding sources for ambulatory surgery centers . However, their involvement can bring more than just monetary support. Their experience, knowledge, and connections can greatly contribute to the success of an ASC start-up or expansion venture.

Therefore, ambulatory surgery center investment opportunities should consider engaging with angel investors as a viable option for business financing.

Crowdfunding as an alternative method to raise capital for ASC business

When it comes to ambulatory surgery center financing , finding the right sources of capital can be challenging. Traditional funding options may come with stringent requirements and lengthy approval processes, making it difficult for entrepreneurs in this industry to secure funds for their surgery center start-up .

Fortunately, there is a growing trend in business financing for surgery centers - crowdfunding . This alternative method of raising capital has gained popularity in recent years, offering ambulatory surgery center funding options that are more accessible and streamlined.

With crowdfunding, entrepreneurs have the opportunity to secure funds for their surgery center business through a collective effort of individuals or organizations. By leveraging online platforms dedicated to crowdfunding campaigns, surgery center entrepreneurs can reach a wider audience and attract potential investors who are interested in ambulatory surgery center investment opportunities .

Capital raising strategies for surgery center businesses using crowdfunding can vary, but here are a few tips and tricks to consider:

• Develop a compelling and well-designed crowdfunding campaign page that clearly explains the purpose and goals of your ambulatory surgery center .
• Offer attractive incentives for potential investors, such as discounted services or exclusive perks.
• Utilize social media and other marketing channels to promote your crowdfunding campaign and reach a larger audience.
• Engage with potential investors through regular updates and communication to build trust and maintain their interest.
• Highlight the unique selling points and potential impact of your surgery center to attract investors who align with your vision.

By considering funding sources for ambulatory surgery centers like crowdfunding, entrepreneurs in the industry can explore financing options that may not have been available to them before. Crowdfunding offers a more inclusive and democratic approach to business financing , allowing individuals from various backgrounds to contribute to the success of an ambulatory surgery center .

Ultimately, leveraging crowdfunding as a business financing guide for surgery center entrepreneurs can provide a viable solution for securing capital and bringing surgery center ideas to life.

Government grants and subsidies for financing ASC business

When it comes to ambulatory surgery center financing , exploring different funding options is essential. One such option is government grants and subsidies, which can provide valuable financial assistance for surgery center entrepreneurs . These grants and subsidies can be a significant source of raising capital for surgery center start-ups, ensuring a smooth launch and sustainable growth.

Government grants and subsidies offer business financing for surgery centers by providing financial support directly from government entities. They are typically awarded based on specific criteria and can cover a wide range of areas, such as facility construction, equipment acquisition, workforce training, and research and development.

Securing funds for a surgery center start-up through government grants and subsidies requires thorough research and planning. It is essential to identify relevant grant opportunities and understand their eligibility requirements. Ambulatory surgery center funding options can vary depending on factors such as location, business model, and target patient population.

Entrepreneurs looking to take advantage of financing options for ambulatory surgery centers should consider the following steps:

• Research government grants and subsidies programs at the local, state, and federal levels
• Understand the specific requirements and eligibility criteria for each grant or subsidy
• Prepare a comprehensive business plan that aligns with the objectives and priorities of the funding program
• Seek assistance from experts or consultants who specialize in government grants and subsidies
• Submit a professional and well-prepared application, including all necessary documents and supporting evidence

By following these steps, surgery center entrepreneurs can increase their chances of securing funding through government grants and subsidies. This can significantly contribute to the overall capital raising strategies for surgery center businesses and help in realizing ambulatory surgery center investment opportunities .

The potential of private equity firms in providing capital for ASC business

When it comes to ambulatory surgery center financing, one potential avenue that entrepreneurs can explore is the involvement of private equity firms. These firms have the resources and expertise to provide the necessary capital for surgery center businesses to start and grow.

Raising capital for a surgery center can be a challenging endeavor, given the significant costs associated with establishing and operating such a facility. Traditional funding sources may not always be readily available or sufficient to meet the financial needs of entrepreneurs in this industry. This is where private equity firms can play a crucial role.

Private equity firms specialize in investing in private companies with high growth potential. They have a deep understanding of various industries, including healthcare, and can bring valuable expertise and financial resources to the table. Their involvement in the ASC business can potentially open doors to new opportunities and accelerate growth.

Securing funds for a surgery center start-up can be a complex process, requiring a thorough understanding of the financing options available. Private equity firms offer a range of funding sources for ambulatory surgery centers, including both equity and debt financing. They can tailor financing options to meet the specific needs and goals of the surgery center business.

For surgery center entrepreneurs seeking capital, it is essential to explore different capital raising strategies. Private equity firms can provide not only the necessary funds but also guidance and support throughout the financing process. Their industry knowledge and network can help entrepreneurs navigate the complexities of securing funding and capitalize on investment opportunities.

Entrepreneurs in the surgery center industry can benefit from a business financing guide that highlights the potential investment opportunities in ambulatory surgery centers. Private equity firms can be an excellent source of insight and information in this regard. They can provide entrepreneurs with a comprehensive understanding of the financial landscape and help them make informed decisions.

Key points to consider:

• Private equity firms have the potential to provide capital for ambulatory surgery centers.
• They offer expertise and financial resources to support the growth of surgery center businesses.
• Private equity firms provide various funding options, including equity and debt financing.
• Their involvement can open doors to new opportunities and accelerate growth.
• Entrepreneurs can benefit from their industry knowledge and network.

Tips for successfully raising capital and financing for ASC business

When it comes to starting or expanding an ambulatory surgery center (ASC), securing the necessary funds is crucial. The right financing options and capital raising strategies can make all the difference in turning your business dreams into a reality. Here are some valuable tips to help you successfully raise capital and acquire the necessary financing for your ASC:

• Research your options: Familiarize yourself with the various ambulatory surgery center funding options available to you. This includes exploring traditional bank loans, government grants, investor partnerships, and other financing alternatives.
• Develop a comprehensive business plan: A well-structured and detailed business plan is essential for attracting potential investors or lenders. It should outline your goals, financial projections, marketing strategies, and competitive analysis.
• Build a strong network: Network with industry professionals, potential investors, and other ASC entrepreneurs. Attend conferences, join relevant associations, and actively engage in discussions to expand your connections and gain insights into potential avenues for raising capital for your surgery center .
• Identify funding sources: Funding sources for ambulatory surgery centers can vary widely, including loan programs specifically designed for healthcare businesses or specialized venture capital firms. Research and identify the funding sources that align with your ASC's unique needs and goals.
• Showcase profitability: Highlight the potential profitability and return on investment (ROI) of your ASC to attract potential investors. Provide financial projections and demonstrate how your business will generate consistent revenue and maintain a competitive edge in the market.
• Seek expert advice: Consulting with industry experts, such as accountants, financial advisors, and healthcare consultants, can provide valuable guidance on financing options and capital raising strategies for your ASC.

By following these business financing guidelines for surgery center entrepreneurs , you can boost your chances of securing the necessary funds to launch or expand your ambulatory surgery center. Remember, thorough research, a comprehensive business plan, and a strong network are the key ingredients for success in obtaining the financing you need.

Securing financing and raising capital is a critical aspect of running a successful Ambulatory Surgery Center business. With the industry poised for growth, it is essential for ASC owners and operators to understand the various avenues available for obtaining capital. This guide has provided an overview of traditional bank loans, venture capital, angel investors, crowdfunding, government grants, subsidies, and private equity firms as potential sources of funding. By employing the tips and strategies discussed, ASCs can increase their chances of securing the necessary capital for success in this dynamic industry. With the right financing in place, ASCs can continue to provide efficient and cost-effective outpatient surgical care, meeting the increasing healthcare needs of patients.

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Drafting a budget: Start with a business plan

Creating a budget for an ambulatory surgery center can be an intimidating task for even the most senior of management. With so many factors to consider—staffing, projected case volume and upcoming equipment purchases, just to name a few—many are tempted to dive in, crunch some numbers, and cross it off their to-do list as quickly as possible. But drafting a budget becomes a far less daunting process if some pre-budgeting work is finished first. Before the barrage of numbers and spreadsheets, it is critical to examine the ASC on a qualitative basis. By completing a comprehensive analysis of the center, its community, and the larger ASC landscape within the healthcare industry, ASC leaders can create a far more realistic and practical budget for the year(s) ahead. Sometimes called a SWOT analysis (Strengths, Weaknesses, Opportunities, and Threats), this review of an ASC’s current capabilities and future goals is critical to provide a basic framework for a reliable budget. Below are three steps to take before even opening the budgeting software to ensure a highly accurate and well-organized financial plan:

Define internal strengths and weaknesses

As Harvard Business Review writes, whether you are leading a startup or an established company, “information about an organization’s internal capabilities is crucial to informing your goals and strategy and making the right business decisions.” This is true for international corporations and local medical facilities alike. It is critical to determine an ASC’s strengths before heading into a new year and a new budget: Is the ASC’s strength its people, and therefore funds should be shifted away from recruitment and more toward retention? Equally as important, what are the center’s weaknesses? Is some of its technology outdated, and will it need to be replaced? Are reimbursements for its service lines decreasing, and are there other, more profitable specialties senior leaders could introduce? Knowing this information is critical to not only improving the organization’s operational efficiency, patient care capabilities and growth opportunities, but also to thoughtfully compiling an informed, specific and highly accurate budget.

Identify external opportunities and threats

According to a report by the University of California at Berkeley, the next step in creating a comprehensive business plan and associated budget is finding “the opportunities for growth, greater profit, and larger market share. Assessing opportunity in relation to competition is imperative.” This is especially pertinent in the rapidly evolving healthcare industry. Not only did the number of ASCs in the U.S. double between 2000 and 2010, but healthcare analytics firm Sg2’s 2015 growth forecast report predicts surgeries performed in an outpatient setting will grow by 19 percent between 2015 and 2025, while the number of inpatient procedures will be reduced by 4 percent. With this expected amount of growth in such a dynamic landscape, it is critical to measure both opportunities to expand in local communities and achieve new growth, and accurately assess potential threats in the community, region or overall industry itself. What trends are occurring that may impact your ASC’s growth rate, productivity or success? What chances do ASC leaders have to expand their service offerings, and their overall capacity to serve their patient pool? ASC leaders must proactively measure and track this data to generate an accurate budget that allocates funds toward reaching for growth opportunities, while compensating for possible losses of business due to external threats.

Examine the year’s projected “bumps”

After determining the ASC’s strengths, weaknesses, opportunities and threats, there is one final step to take to complete the action plan and, from there, build out a budget. This final step is an in-depth analysis of any expected “bumps” in the upcoming year. This includes equipment replacements, equipment purchases for new or expanding service lines, and any retirements among key staff members, especially senior physicians. For example, if Physician A has been a senior physician at the ASC for 10-plus years and has decided to retire, how will the organization compensate for this loss? Will you fill the gap with a new physician, moving funds toward recruitment and training efforts? Will you perhaps wind down whatever service/specialty he offered, and allocate the funds toward launching a new specialty at the facility? This is where examining the reimbursement landscape becomes essential. How can you cater the ASC to offer the most profitable and necessary procedures for your particular community? Because the payor mix will not change dramatically from year to year, it is critical to examine the industry overall and position the ASC for success in the market. This may include increasing physician productivity; for example, if Physician B did 500 cases last year, what do we think he can do next year, and how can we encourage him to complete this goal? Looking for the key drivers of the facility and ways to increase operational efficiency, including picking up lost cases and filling gaps in patient care, is essential to allocate funds appropriately in a well-planned budget. To learn more about creating a successful business plan and operating budget, please contact [email protected] .

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Operating Room Business Planning is important because it helps identify aspects of a surgery program that can realistically increase market share and are at risk for loss to competitors. It helps develop a plan to both protect and increase the current market share. Efficient operating room management is a key driver of a hospital’s economic success.

In general, a business plan is an essential tool for entrepreneurs and business owners of any type. It helps to set clear goals and guidelines for managing the business, and can be used to set employee goals, obtain funding, or even sell the business one day. A business plan is like a roadmap to success, providing greater clarity on all aspects of the business, from marketing and finance to operations and product/service details. Unlike most businesses that offer products and services to the public, hospitals and ambulatory surgical centers have many layers to their operation that expose them to government regulation and lawsuits. It is especially important, therefor, to have the guidence of a company like SMI Group to steer your efforts in developing your operating room business plan.

Roadmap to Operational & Marketing Success

There are several reasons why having a operating room business plan for your hospital or ambulatory surgical center is important. For one, it helps to steer the operation and marketing as it starts and grows, guiding ownership through each stage of starting and managing the business. A good business plan can also help to secure funding by showing potential investors that the business is worth investing in. Additionally, a well-written business plan can help to set and communicate goals, both for the owner and for employees, making it easier to track progress and achieve success.

An operating room business plan can also help to prove the viability of the business in the market. There are several ways a surgery center can increase its market share. Some of these include emphasizing convenience, identifying and meeting distinct local market needs, being proactive in patient outreach, adopting a customer opportunity perspective and disrupting the notion of “patient loyalty”¹. By conducting market research and analyzing competitors, a hospital or ambulatory surgery center can develop an effective marketing strategy and set appropriate price points for services. In some cases, market research may reveal that it does not make sense to start a particular business based on existing competition. In other cases, market research can guide the development of marketing strategies that others lack.

Market Share is Critical

In the healthcare industry, market share is critical. Measurement of it, and tactics to grow it, are getting more complicated as patients connect with providers in more sophisticated ways. One way to take market share from competitors is by developing the physician relationship and by the expansion of your ambulatory surgical center (or network of centers).

Building an ambulatory surgical center with many locations requires a marketing and consumer experience strategy. If patients are not happy with their surgical experience, they will go elsewhere, making a multifaceted approach to protecting and increasing market share essential in the healthcare industry.

Overall, having a well-written business plan can help hospitals or ambulatory surgery centers avoid failure by providing a clear path forward and helping them make informed decisions about their operation.

The purpose of Operating Room Business Planning is to identify aspects of your surgery program that:

• Can realistically increase market share.
• Are at risk for loss to competitors.
• Develop a plan to both protect and increase your current market share.
• Develop an understanding of your physicians’ needs and the criteria they use to evaluate which hospitals to base their practices.
• Develop strategic plans to achieve optimal satisfaction levels and long-term relationships between your hospital and medical staff with the goal of increasing referrals.
• Position your hospital and medical staff as one strategic unit, improving your ability to market to and negotiate with managed care organizations.

Why Choose Surgery Management Improvement (SMI) Group?

The SMI Group’s Principals have worked as senior level executives and vice presidents of hospital management consulting firms including Chi Systems, DJ Sullivan & Associates, and Johnson & Johnson Healthcare Systems Inc.

• SMI Group brings you experienced, dedicated clinical and business professionals who care about your hospital management. We will craft a winning strategy to successfully implement change for your organization.
• The Principals and Founders of the Surgery Management Improvement Group share a combined total of seventy years of experience as hospital management CONSULTANTS.
• All our consultants are seasoned professionals with perioperative clinical, surgery business, sterile processing, and high-level management experience.

Operating Room Scheduling Management

Operating room planning is a complex task where numerous resources must be synchronized in order to achieve efficiency. Surgeon availability, operating team scheduling, patient related information (i.e. estimated operating time, priority and diagnosis), equipment, and support resources must all be carefully orchestrated.

Anesthesiology Program Consulting

A well-defined, coordinated anesthesiology program is essential to a cost and operationally effective, marketable operating room. Areas of evaluation and development expertise include: Program Evaluation and Design, Anesthesiologist/CRNA/ Resident Care Team Process Evaluation, Surgeon Nursing Interrelationship

Operating Room Succession Planning

Use our tools and assistance to plan your operating room management succession. Our process identifies key roles, the management capabilities of existing staff, and cultivates qualified internal candidates to become superior leaders for tomorrow’s perioperative environment.

Ambulatory Surgery Center Program Development

SMI Group provides hospital and surgery center consulting services that provide ambulatory surgery program development & management solutions. We help you retain & grow Ambulatory Market Share while improving expected surgery outcomes.

Consulting Services

Case studies.

How to Write a Business Plan for an Outpatient Medical Practice

Noah Parsons

16 min. read

Updated February 7, 2024

Free Download:  Sample Medical Practice Business Plan Template

So you’re thinking about starting your own outpatient medical practice.

You probably have many good reasons to open a private practice. Private practices can be lucrative, although it requires you to spend time building relationships with patients while also attending to all business processes that are part of running your practice .

Maybe you want more autonomy over your practice and your workflow. Or maybe you hope to expand your services to underserved areas or specific populations based on your expertise.

If you’re thinking about starting an outpatient medical practice, one of the first things you should do is write a business plan. Even if you’re able to self-fund your practice and don’t need outside investment, your business plan is a great tool for thinking through all the different aspects of building a profitable and sustainable practice.

You should go into this thinking about your business plan as a living document, not something you do once and then file away forever. Use it as a tool, especially around your financials. Revisit and update it regularly by comparing your forecasts to your actuals and adjusting as necessary.

To help you get started, you can download our free business plan template . If you’ve never written a business plan before, Bplans also offers a library of sample medical business plans that you can review or even download to use as a model.

• Executive summary

The first section that will appear in your business plan is the executive summary . But before you dive right in, it’s the section of your plan that you should actually write last. It’s a summary and an overview of your outpatient medical practice and your plans, so it will be easy to put together after you’ve written the rest of your plan.  

Executive summaries are short—keep it to one to two pages. Keep in mind that if you’re using your plan to get funding, investors and banks tend to read your executive summary to get a sense of whether to read on and consider your request. Do not neglect it; just write it last.

Your executive summary will include the following sections:

• Who you are: Your business name, location, and contact information.  
• What you offer and the problem your business solves: What does your practice offer and why is it needed? This is your value proposition .
• Target market: Who is your ideal patient? Do they self-pay or use insurance? Be specific.
• Competition: Who else is offering similar services?
• Team: Who is on your management team?
• Financial summary: Explain your business model, startup costs, revenues, and liabilities to the company. Mention your funding needs.
• Milestones and traction: How have you validated that there’s a need for your practice in your location?

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Position your practice’s business opportunity

Now that you’re familiar with what’s included in your executive summary, tuck that information away, and get to work on the rest of your plan.

Think of the next few sections of your plan as the overarching description of your practice’s business opportunity. You’ll cover the problem you’ve identified and the solution that your practice offers. Then you’ll think through your ideal customer , your competition , and your opportunities for growth . This section area should describe the services you provide and how they benefit your patients.

• Problem and solution

First, describe the problem that you’ve identified and how your practice solves that problem. Here’s a brief example:

The problem : There is a lack of affordable pediatric and gynecological care available in coastal areas of Lane County, Oregon. Many patients have to travel miles to the closest practice.  

The solution : Dr. Gardner plans to open Ocean Lane Outpatient Care to serve smaller Oregon coastal communities scattered outside of major towns with major hospitals. Due to her focus on pediatric and gynecological care, Dr. Gardner’s particular services are especially valuable in this location due to the lack of available service providers in the area. Dr. Gardner’s practice will accept private insurance and Medicaid, as well as a sliding scale for patients in a certain income bracket.   

The services section identifies what kind of medical practice you are opening. Restate who your practice serves and what kind of services you specialize in. Talk about how your practice approaches treatment and what goals you have in addition to providing quality care. Here’s an example from a sample business plan for a medical practice.

Include a breakdown of all services furnished by the clinic, being as granular as possible. For example:

Gynecology:

• Annual women’s wellness exam

Pediatrics:

• Immunizations
• Youth eating disorder treatment
• Target market

Next, talk about your ideal patients. If you’re in the earliest stages, you’ll want to do some research that verifies your hypotheses.

For example, Dr. Gardner would have needed to verify her assumption that people in coastal towns in Oregon are in need of pediatric and gynecological services—a need that isn’t currently satisfied by available resources.

A formal market analysis can help verify that there’s a need for your particular practice in your intended location.  

Your target market section should include:

• TAM, SAM, and SOM: Total Available Market (TAM), Segment of the Available Market (SAM), Share of the Market (SOM). Here, you are looking at the difference between targeting everyone: TAM (all people who need medical care—so all humans in your area), versus your ideal clients: SAM (maybe this is those with certain insurance or ability to self-pay), versus the number of new patients you think you can realistically reach: SOM, especially within your first few years. The idea is that not everyone will be an ideal patient. It matters because you can waste a lot of money with marketing outreach to everyone, instead of targeting a specific population that is more likely to be looking for your services.
• Buyer persona : Imagine there’s one specific patient who represents your ideal patient. Be specific. Maybe she’s 34 years old, has private insurance, is relatively healthy, but needs more regular medical care and advice.  
• Competition and competition matrix : List competitors and analyze what makes them competitive. For instance, your competitors might be large hospitals because of the wide range of services they offer. You might also be competing with local chiropractors or other alternative medicine practices that already have a foothold in local communities.
• Future products and services : Name the products/services you will offer as your practice grows and earns more money and as your patients develop new needs. Maybe you will want to open a second location when you gain enough patients. Or maybe you will want to extend your practice’s hours of operation.

Ideal patient profile

Your ideal patient profile identifies the type of patient whom you hope to attract and retain. To clarify, this does not mean you only serve your ideal patient type. Rather, focusing your outreach efforts on attracting your ideal patient will allow you to grow your practice more effectively than targeting a large number of patients who may or may not be in the market for your practice’s specialty.

When developing your ideal patient profile, consider:

• Who you enjoy working with
• Who needs the services you provide
• Who can and will pay your pricing (or have an insurance plan that you want to accept)

For instance, because Dr. Gardner specializes in preventive and curative care, a patient seeking palliative treatment for terminal cancer is not the ideal patient. This patient would not receive the best care for their needs from Dr. Gardner’s services.

Acquiring a new patient is six to seven times more expensive than retaining a current patient. In order to support and retain current patients, develop a strategy to proactively meet their needs and set benchmarks to measure the success of your strategy.

• Execution: How your practice will respond to the opportunity

First, your business plan laid out the opportunity at hand. Now, the rest of your plan will focus on how to take advantage of that opportunity. Now is the time to lay out what you’ll do to attract patients and set up a viable business model with healthy financials.

Components of this section include:

• Your marketing and sales plan
• Strategic partnerships or alliances
• Your operations plan
• Your team and company information
• Financial plan
• Milestones and metrics that you’ll need to hit to be viable
• Your key assumptions and risks
• Your funding ask and exit strategy, if applicable
• Marketing and sales plan

The marketing and sales component of your plan should include how you plan to reach the patients in your target market, how you’ll bill for your services, and what you need to do to bring in the right number and type of patients.

• Positioning : Describe how you will present your company to your customers with your positioning statement . Think about answering these questions: What are you offering your patients that they can’t get elsewhere? Why should they pick you instead of another practice? Where do you see yourself in the competitive landscape? Use this model to help:

“For [target market description] who [target market need], [how our business offering meets the need]. Unlike [key competition], it [most distinguishing feature].”

For [coastal community members] who [require gynecological care], Ocean Lane Outpatient Care [provides both pediatric and women’s health services]. Unlike [other area medical practices], Ocean Lane Outpatient Care is [conveniently located near the communities it serves and can fill the gap between pure pediatric care and full-blown adult care for young women].

• Pricing and billing : Medical pricing is complex, especially if you plan to work with insurance companies. Practice Builders says that “a 10 percent increase in pricing can result in a much better return than a 10 percent reduction in costs—or even a 10 percent increase in patient volume.”

Make sure you price your services at what they are worth and explain your pricing to your patients. Consider the demographics your practice serves when you choose your pricing. Research other practices in the area and learn more   about how you can choose the best prices for your patients and your practice.Also, consider how you will get patients to keep coming back to your practice. Sometimes you can increase sales by upselling and cross-selling , or offering complementary services.

If you accept insurance, the contracts you set up with insurance companies for reimbursement will probably dictate your pricing, so this is a good place to talk about your negotiation strategy as well.

• Update your website and social media frequently and ensure your website is mobile-friendly and share-friendly with credible links added.
• Make sure all communications with and about patients are HIPAA-compliant . Download a HIPAA Compliance Guide to ensure you are following regulations.
• Maintain a positive online reputation for your practice as a key management technique. You can do this by claiming your profile on any third-party sites that list it. Encourage your patients to review you online, too.
• Strategic alliances : List any people or organizations with whom you are working. You will most likely need to partner with a regional lab for medical testing. Opening an on-site lab can be costly for a smaller practice. You will most likely need to partner with a nearby hospital as part of a referral system or to share select services and equipment.

The operations section of your business plan covers how your business works, from the logistics to the technology.

• Technology: Describe how your technology works, but do not go into too much detail. Investors can ask for more information if they want to. Will you rent or buy equipment ? The technology you need ranges from simple items like thermometers to more complex items like centrifuges.
• Billing and information storage: Provide a brief overview of how you will manage information technology and patient records to promote safety, efficiency, and compliance with HIPPA  regulations and industry standards. Explain your usage of Electronic Medical Record (EMR) software in this section.
• Payment types you accept: Consider payment types such as private pay, private insurance, Medicaid/Medicare, etc. What kind of referrals can you offer to the uninsured or those who cannot afford your services?
• Milestones and metrics

In this part of your plan, you set measurable, achievable milestones, such as the number of new patients added per month in the first year of operations. Milestones can be about any aspect of your medical practice as long as they emphasize growth. For metrics , decide which numbers to check regularly to track your company’s health. This area should also include information about traction (past successes) and risks:

• Traction: Look back at major milestones you have achieved. Hopefully, they demonstrate that your business model works and that you are filling a need for your market. If you’re looking to attract private funders, this section is important since it shows your initial success .
• Key assumptions and risks : Acknowledge the assumptions you are basing your business on. Set out to prove them right if you can. Also, discuss risks so that investors know you have considered what could go wrong and that you have a plan for dealing with challenges. Malpractice suits and changing healthcare regulations are risks specific to the healthcare field. Malpractice insurance is a must for addressing the former. Changing healthcare regulations can affect the volume of patients who are able to afford your services.

Your team can be more important than your product or service. Describe your team here, even if it is just you and a receptionist who answers the phone in your office building.

• Management team and qualifications: Address who works for you, what do they do, and how much you pay them. Compile the details of their relevant experience and education.
• Hiring plans : Outline who, if anyone, you need to hire to fill skills gaps in your management team and how much you plan to pay them.
• Company overview

The company overview tells about who you and your staff are and appeals to potential investors. Keep it short—it should be the shortest chapter of your business plan but is still very important.

It needs to include these elements:

• Mission statement : Your mission statement articulates your goals for what your company does for its customers, employees, and owners. It will read something like this: “Our mission is to provide X (services) for Y (customers) by Z (methods).” For instance, Ocean Lane Outpatient Care is dedicated to providing quality care for all the inhabitants of coastal Lane County by providing affordable and versatile services.”
• Intellectual property : List any patents you have or have pending, and mention any core technology you are licensing from another company.
• Legal structure and ownership : Explain your business structure and who owns how much of it. More on considerations for physicians and legal structure here.
• Business location : Describe the company’s location and any facilities it owns.
• Company history if it’s an existing company

Having a solid financial plan is critical, whether you’re seeking funding or not.  A typical financial plan includes projections by month for the first year and annual projection for the next three to five.

Include these key elements:

• Profit and loss statement : this explains how your business made a profit or incurred a loss in a given amount of time (typically three months) by listing all revenue and expenses, then documenting the total amount of net profit or loss.
• Cash flow statement: documentation of how much cash the business brought in, how much it paid out, and the amount of its ending cash balance (on a monthly basis).
• Balance sheet : snapshots how your company is performing at a given moment by including how much money you have in the bank, how much your customers owe you, and how much you owe your vendors.
• Sales forecast : projections of what you think you will sell in a given timeframe (one to three years).
• Business ratios : Comparisons of your company’s financials with numbers from the industry profile.
• Keep it brief. For example, Dr. Gardner will employ administrative aides and nurses.
• Use of funds : Needed if you’re seeking investment or a loan. This section explains how you will use investors’ money.
• Exit strategy : You only need this if you’re seeking outside investment. An exit strategy is a method by which entrepreneurs and investors, especially those that have invested large sums of money, transfer ownership of their business to a third party to recoup money invested in the business. Common exit strategies include being acquired by another company, the sale of equity, or a management or employee buyout.

When writing your financial plan, make sure to consider startup costs . For a medical practice, average startup costs can include initial fees, malpractice insurance, cost of renting or leasing office space, and the cost of any legal or tax advisors.

Consider submitting your plan to at least five to 10 banks if you need help financing your startup costs. Many banks have divisions designated to providing loans to new dental and medical practices , so submit your plan to that division if you can. Startup costs can be high in the medical field, so make sure not to underestimate them.

Finally, your appendix is the holder for any supporting information such as charts, images, graphs, and more. If you need to include large sets of data or pages of information, put it here. That way, it is available but does not distract from the plan’s most important pieces.

For instance, you can expand on your personnel plan with charts of each employee’s annual insurance costs. You can also include versions of your profit and loss statements and other financials that extend further into the future.

Don’t forget to go back to your executive summary! Remember to keep it brief and write it based on what you have written already.

When you’re ready to write your business plan, there are an array of resources available to you. Download our free business startup checklist to think about the next steps. Also, check out our free business plan template . Reviewing sample business plans in the medical field can help you get a better sense of the process and information you’ll provide. Downloading this plan for a family medicine clinic will probably be most helpful if you’re setting up a primary care practice.

Remember that this plan is a living document. Schedule a regular business plan review meeting. You should review your trajectory and compare your financial projections to your actuals frequently to keep your practice on track.

Noah is the COO at Palo Alto Software, makers of the online business plan app LivePlan. He started his career at Yahoo! and then helped start the user review site Epinions.com. From there he started a software distribution business in the UK before coming to Palo Alto Software to run the marketing and product teams.

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4 considerations for creating successful ASC strategies

Ambulatory surgery center (ASC) volumes continue to increase as the healthcare industry shifts its focus for growth and care delivery innovation to non-hospital sites. But traditionally, health systems have preferred to keep cases in the hospital to ensure greater reimbursement. As a result, most health systems currently have a limited ASC presence.

Given the continued growth of procedures in the ASC setting, health systems need to consider their ASC footprint more proactively, especially for surgical specialties core to the health system’s business. For health systems new to owning or operating ASCs, we offer four items to consider as they evaluate ASC opportunities.

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• You should identify the top opportunities for ASC margin improvement.

Nicholas Hula

Ellie Wiles

Posted on May 15, 2024

Updated on May 17, 2024

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Top 7 KPI Metrics for Ambulatory Surgical Center Success

Related blogs.

• Revolutionizing Healthcare: The Lucrative Business of Ambulatory Surgical Centers
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• Unlocking the Secrets to Building a Successful ASC Business - Your Ultimate Guide!

Percentage of successful surgeries

Patient satisfaction rate, average length of stay in recovery, number of surgical procedures performed per month, average surgical wait time, percentage of patient referrals, number of insurance providers accepted.

Welcome, fellow entrepreneurs! Are you looking to gain some valuable insights into the Key Performance Indicators (KPIs) that matter most in the ambulatory surgical center industry? Well, you're in the right place! As a seasoned business owner with years of experience in this field, I'll share what I've learned about the top seven KPI metrics you need to track and calculate for success. So, let's dive in!

• Percentage of successful surgeries: Measuring the number of procedures that result in positive outcomes is essential for any ambulatory surgical center. By keeping track of this KPI, you can identify areas for improvement and ensure your patients receive the best possible care.
• Patient satisfaction rate: Keeping your patients happy is crucial to building a successful and trustworthy surgical center. Measuring their satisfaction rate will provide insights into areas where you should improve and show you what you're doing right.

Now, let's take a look at some other core KPIs you need to track:

Stay tuned for more in-depth information on each KPI and how to track and calculate it to achieve success in your ambulatory surgical center.

One of the most critical KPIs for an ambulatory surgical center is the percentage of successful surgeries. This metric measures the number of procedures that were completed without complications or adverse events. By tracking this metric, surgery centers can ensure they are providing high-quality services to their patients and identify areas for improvement in their processes.

• The percentage of successful surgeries is the proportion of procedures that were completed without complications or adverse events.
• Surgery centers can use this metric to measure the quality of their services, identify areas for improvement, and benchmark their performance against industry standards.

How To Calculate KPI

To calculate the percentage of successful surgeries, divide the number of procedures completed without complications or adverse events by the total number of procedures performed and multiply the result by 100.

Calculation Example

Suppose a surgery center completes 500 procedures during a given period, and out of them, 475 are successful, and 25 have complications or adverse events. The percentage of successful surgeries for this period is calculated as follows:

KPI Advantages

• Helps surgery centers to measure the quality of their services accurately.
• Assists in identifying areas for improvement in their processes.
• Enables benchmarking of performance against industry standards.

KPI Disadvantages

• Does not take into account the severity of complications or adverse events.
• Does not provide insights into the causes of complications or adverse events.
• May be influenced by factors outside the control of surgery centers, such as patient comorbidities or surgical complexity.

KPI Industry Benchmarks

• The industry benchmark for the percentage of successful surgeries is above 95%.

Tips and Tricks

• Regularly monitor and track the percentage of successful surgeries to ensure high-quality patient care.
• Implement quality improvement initiatives to address areas for improvement identified by this metric.
• Compare your center's performance against industry benchmarks and seek ways to improve if necessary.

Patient satisfaction rate measures the level of satisfaction patients have with their experience at the ambulatory surgical center. It looks at various factors, such as quality of care, communication with medical staff, and overall experience.

Tracking patient satisfaction rate is important for gaining insight into the quality of care provided at the ambulatory surgical center. By measuring patient satisfaction, the center can identify areas for improvement and make informed decisions about how to enhance the patient experience.

The formula for calculating patient satisfaction rate is as follows:

Suppose there were 50 patients who visited an ambulatory surgical center last month. Out of those, 40 patients reported that they were satisfied with their experience. To calculate the patient satisfaction rate for the month:

• Provides insight into the quality of care provided at the ambulatory surgical center
• Helps identify areas for improvement
• Can increase patient loyalty and retention
• Subjective and may vary based on individual patient expectations
• May not accurately reflect the quality of care provided
• Positive responses may be biased due to social desirability

The average patient satisfaction rate for ambulatory surgical centers in the US is around 80%. However, this can vary depending on the region, size of the center, and other factors.

Tips & Tricks

• Encourage patients to provide feedback through surveys or feedback forms
• Regularly review patient satisfaction data to identify trends and areas for improvement
• Communicate with patients and address any concerns promptly to improve satisfaction

Average length of stay (ALOS) in recovery is a key performance indicator (KPI) that measures the average amount of time patients spend in a recovery room after a surgical procedure. It is an important metric for ambulatory surgical centers (ASCs) as it indicates the efficiency of the surgical process and the quality of care provided.

ASCs can use ALOS to assess whether they are providing timely and effective care to patients. A high ALOS may indicate poor recovery processes, which could lead to patient dissatisfaction, lower patient volume, increased costs and decreased reimbursement.

How to Calculate KPI

ALOS can be calculated by dividing the total number of minutes patients spend in recovery by the total number of patients. The result is then converted to hours or days to obtain a meaningful measure.

ALOS = (Total minutes in recovery / Total number of patients) / 60

Suppose an ASC had 50 patients who spent a total of 5,000 minutes in recovery. The average length of stay would be calculated as follows:

ALOS = (5,000 / 50) / 60 = 1.67 hours

• Helps identify areas for process improvement and cost savings
• Can be used as a benchmark to compare performance against industry standards or other ASCs
• Improves patient safety and satisfaction by facilitating prompt recovery and discharge
• May not be useful for ASCs that have particular surgical specialties or that cater to specific patient populations
• Cannot fully measure the quality of care provided or patient outcomes
• Does not account for individual patient circumstances and differences in recovery times

KPI Industry Benchmarks for the KPI: 'Average length of stay in recovery'

The Healthcare Financial Management Association (HFMA) recommends that ASCs aim for an ALOS of less than 2 hours as a best practice. However, industry benchmarks vary by surgical specialty and patient type, so it is important for ASCs to research and compare their performance against relevant peer groups.

• Use ALOS data to track recovery time by surgical procedure and surgeon to identify areas for process improvement
• Consider implementing standardized care protocols and discharge criteria to reduce ALOS and improve patient outcomes
• Use patient education and communication to set expectations for recovery time and discharge

The number of surgical procedures performed per month KPI measures the quantity of surgeries performed in an ambulatory surgical center (ASC) within a specific timeframe.

By tracking the number of surgical procedures performed per month, ASC managers can identify trends in the volume of surgical procedures over time, determine if surgical caseload is increasing or decreasing, and plan staffing and scheduling accordingly.

To calculate the number of surgical procedures performed per month KPI, divide the total number of surgical procedures performed in a month by the number of calendar days in the month.

(Total number of surgical procedures performed in a month) / (Number of calendar days in the month)

Suppose an ASC performed 500 surgical procedures in the month of March, which has 31 calendar days. The calculation for the number of surgical procedures performed per month would be:

500 / 31 = 16.13 surgical procedures per calendar day

• Allows ASC managers to track surgical volume trends over time
• Helps managers plan staffing and scheduling based on surgical caseload
• Enables managers to monitor ASC performance and make data-driven decisions
• Does not reflect the complexity of surgical procedures performed
• Does not account for surgical procedures cancelled or rescheduled
• Does not consider patient complexity or acuity

KPI Industry Benchmarks for the KPI: 'Number of surgical procedures performed per month'

According to industry benchmarks, a well-performing ASC should aim to perform at least 300 surgical procedures per month. However, the number of surgical procedures performed per month can vary depending on the size of the ASC, the types of procedures performed, and the region where the ASC is located.

How to Improve the 'Number of surgical procedures performed per month' KPI

• Offer more surgical procedures or expand the types of procedures offered
• Increase the number of surgeons working at the ASC
• Implement more efficient scheduling procedures to maximize utilization of operating rooms

Average surgical wait time is a key performance indicator (KPI) used to measure the time patients typically wait before receiving an ambulatory surgical procedure. This KPI is relevant to facilities that provide same-day surgeries such as ambulatory surgical centers (ASCs) and short-stay hospitals. The wait time includes the time between patient arrival and administration of anesthesia, but excludes the time the patient spends in the pre-operative area.

The average surgical wait time KPI can be used to improve patient care by reducing the time patients spend waiting for a surgical procedure. Long wait times can cause anxiety and inconvenience for patients, and may negatively impact the reputation of the facility. Additionally, the KPI can provide insights into the efficiency of operations and scheduling at the facility, which can help optimize resource utilization and increase profitability.

To calculate the average surgical wait time , take the total time patients waited for a surgical procedure during a specified period and divide by the total number of procedures performed during that period. This can be expressed mathematically as:

Suppose an ASC performed 100 surgical procedures during a week, and the total wait time for all the procedures was 200 hours. The average surgical wait time for the week would be:

• Helps improve patient satisfaction by reducing wait times
• Provides insights into scheduling and resource utilization
• Enables benchmarking against industry standards and best practices
• May not reflect the full patient experience, as it only measures time spent waiting for a surgical procedure
• Does not capture factors outside the facility's control, such as delays caused by insurance pre-authorizations or transportation issues
• May be impacted by staffing levels and scheduling practices

KPI Industry Benchmarks for the KPI: 'Average surgical wait time'

According to the Ambulatory Surgery Center Association (ASCA), the median average surgical wait time for ASCs in 2019 was 27 minutes. However, benchmark data should be interpreted with caution, as facilities differ in their patient populations, procedures offered, and operational practices.

• Track wait times by procedure type to identify patterns and opportunities for improvement.
• Consider implementing a pre-operative assessment process to identify patients with special needs or medical conditions that may require additional time or resources.
• Communicate wait times to patients and their families to manage expectations and reduce anxiety.

The Percentage of patient referrals KPI measures the fraction of new patients that were referred by other physicians or healthcare facilities.

The Percentage of patient referrals KPI helps measure the effectiveness of your marketing and referral outreach programs. It provides insights into how your practice is perceived by other healthcare professionals, and ultimately, helps grow your business.

To calculate the Percentage of patient referrals KPI, divide the total number of new patients referred to your practice by the total number of new patients seen during a specific time frame.

KPI formula:

• (Number of new patients referred / Total number of new patients) x 100 = Percentage of patient referrals KPI

Let's say your practice received 100 new patients during the past month, and 40 of those patients were referred by other physicians or healthcare facilities. Then, you can calculate your Percentage of patient referrals KPI as follows:

KPI example:

• (40 / 100) x 100 = 40% Percentage of patient referrals KPI
• Measures the strength of referral programs and outreach efforts
• Indicates the perception of your practice among other healthcare professionals
• Does not account for patient referrals outside of healthcare professionals
• The KPI may be influenced by external factors, such as a physician retiring or moving away from the area

KPI Industry Benchmarks for the KPI: 'Percentage of patient referrals'

Industry benchmarks for the Percentage of patient referrals KPI vary by location and specialty. However, a general rule of thumb is that a Percentage of patient referrals KPI between 30-40% is considered good, while a KPI above 50% is excellent.

• Partner with other physicians and healthcare facilities to expand your referral network
• Implement patient satisfaction surveys to identify areas for improvement and increase referrals
• Track your Percentage of patient referrals KPI over time to identify trends and adjust outreach efforts accordingly

Number of insurance providers accepted is a key performance indicator (KPI) that measures the number of insurance providers that have approved the services provided by an ambulatory surgical center (ASC).

This KPI is important for ASCs as it helps identify the level of acceptance they have in the market. A high number of insurance providers accepting an ASC indicates that the center provides quality services and has a good reputation in the industry. This can help attract more patients to the center, leading to increased revenue.

To calculate the number of insurance providers accepted KPI , you need to divide the total number of insurance providers that have approved the services provided by the ASC by the total number of insurance providers that were contacted.

Suppose an ASC contacted 20 insurance providers and received approval from 15 providers. To calculate the number of insurance providers accepted KPI:

• Helps identify the level of acceptance an ASC has in the market.
• Can help attract more patients to the center, leading to increased revenue.
• Provides a good way to track and measure the success of marketing efforts and quality of services.
• May not be applicable for ASCs in areas where insurance providers are limited.
• Does not provide insight into the reasons why certain insurance providers do not approve of the ASC's services.
• May be affected by external factors such as changes in insurance policies and market trends.
• The average number of insurance providers accepting an ASC ranges from 60-80%, depending on the location and size of the center.
• High-performance ASCs typically have acceptance rates of 80% or higher.
• Low-performance ASCs typically have acceptance rates of less than 60%.
• Monitor the number of insurance providers accepting your center regularly to identify any trends or changes in acceptance rates.
• Build relationships with insurance providers to increase acceptance rates.
• Identify reasons why certain insurance providers do not approve of your center's services and work to address those issues.

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What to know before investing in a surgery center

Physicians who buy into these facilities receive a share of the value and, depending on the facility will be required to invest some of their own surgical expertise there.

© thithawat - stock.adobe.com

The decision to buy into a surgery center can be daunting at any stage of your career as a physician. It is critical to understand whether this decision is something you can realistically take on, given your current financial state.

What is a surgery center?

While you likely already know what a surgery center is if you are looking into buying one, it always helps to have more information, especially where investments are concerned. Surgery centers, also known as ambulatory surgery centers (ASCs), are licensed outpatient facilities that are predominantly physician-owned. They are licensed, freestanding entities generally smaller than a hospital and often specialize in a particular procedure. Due to the outpatient categorization for the procedures provided at these facilities, patients are in and out in a single day. There is generally no need for an overnight stay.

Surgery centers are typically offered to physicians entering practice in the first 2-3 years. Physicians who buy into these facilities receive a share of the value and, depending on the facility will be required to invest some of their own surgical expertise there.

What are some of the benefits of buying into a surgery center?

Income potential and profit

As long as you own the facility, there will always be profit potential. However, this does rely on multiple factors including community need, facility efficiency, inclusivity (accepting more types of insurance), and more.

With profit potential in mind, another benefit to note is that once you pay off your loan/note on the business, you will continue to receive an income from it. While the initial investment may be a hefty financial lift, think of the longevity of the business and the profit you will see over time. Just make sure you are prepared to hold out for a couple of years before the profit from the business really starts coming in. With all investments, there are risks, but in this case, if you play your cards right, you may be in for a huge financial benefit.

Flexibility

A huge benefit to owning your own surgery center is the flexibility that it allows you to have. Think about it: you could invest in a surgery center close to your home or the hospital/clinic where you spend most of your time (if the opportunity is available). As a result, there comes an ease of location, and your commute may decrease when you have to spend a percentage of your time there.

Moreover, buying into your own facility means you can specify your hours of operation. You can create designated or preferred times to see your patients and/or perform surgeries, whereas hospitals are typically unable to offer that benefit.

Now that we've looked at some of the most common benefits of buying into a surgery center, it's time to consider the potential cons.

What are some of the cons of buying into a surgery center?

Upfront financing

The first big con is financing the upfront cost. Though this is to be expected with any investment, it can be a big deal, especially if you are just starting out as a physician and are taking on the brunt of massive student loan debt and other early costs. Having a sound investment strategy can make all the difference in this situation.

The potential for loss

To reap the benefits of investing in a surgery center, you have to really embrace the management side of owning a business. Poor management of your surgery center can hurt its overall profitability. Someone has to manage and run it as well as set up agreements with medical providers and insurance companies. Is that going to be you? Is there existing staff from a previous owner? Will you have to hire new employees? Having the proper management and administrative staff in place is absolutely worth it.

A few additional common instances of poor management that can affect your surgery center's profitability are below:

• The lack of insurance inclusivity - A big perk for patients is the lower cost of the surgery center. From a management side, you need to be willing to negotiate with a wide array of insurance companies to ensure that patients who come in can get the care they need at your facility.
• Inefficient Scheduling - How efficient is the scheduling at your facility? Are there gaps in the day that could be filled with surgeries? Are you getting to patients fast enough? Efficient scheduling is essential to your profit strategy.

Money restraints

This is a big one and can be an issue, particularly if you are buying a new facility vs. an older, more established one. If the pro forma is not what you anticipated and you are not receiving the payout you initially thought you would, this could slow your facility growth (you can't add another surgery room without money). You commonly see this with new facilities where there is no historical pro forma information. Consider making projections based on what you perceive as the worst-case scenario in your first couple of years until you can generate some established data to draw from.

Also, consider the potential for your facility to decrease in value. For instance, if it is run poorly and improperly maintained (e.g., out-of-date technology, basic structural issues), the value of your investment may decrease, causing you to see a smaller return on investment.

Selling complications

Prepare yourself for the possibility that your facility may not be easy to sell. Remember, someone has to be in a position to buy you out, or the surgery center has to buy it back from you. The person needs to be able to finance it and must be qualified to buy it.

Another factor to consider is that ownership of the facility may not be as straightforward as you would hope. If physicians all bought in at the same time, they could have equal shares. If older physicians invested earlier, they could have more shares than others.

Also, consider that you may not be buying into everything. (Ex. If the surgery center owns the building, you want to be able to buy into that as well). Ideally, you want to have the practice and facility. The surgery center would typically own the building, not lease it, but you need to consider that as a potential setback.

While upon first glance, it would seem like the 'cons' of buying into a surgery center far outweigh the 'pros,' remember that much of your surgery center's success depends on how it is run, the preliminary steps you take for inclusivity (insurance), and your own financial planning. Working with a financial professional experienced in physician's affairs can help you maximize your investment.

Questions doctors should ask before investing in a surgery center

Investing in a surgery center can be an intriguing opportunity for a physician, but it's crucial to ask some essential questions first.

1. Who owns the surgery center and who makes decisions?

First, determine who owns the surgery center and who calls the shots. Is it run by doctors, hospitals, or outside investors?

Knowing if doctors have a say in how things are run is vital. However, this doesn't mean the physician ownership group always needs to be in the majority, but it's imperative to know who the other business partners are and whose vote counts the most.

2. What's the money situation?

Before diving in, take a good look at the finances. How much money will you need to invest? What's the expected return on investment?

Make sure you understand the financial side of things, including costs and potential earnings. Often, you'll be given a "pro forma," an official-looking record of financial projections. Understand that a pro forma is just a guess of what might happen and includes a lot of assumptions.

Ask what assumptions were used and think critically about what risks could threaten those assumptions.

3. How do they ensure good care at the surgery center?

Quality care is crucial. Ask about the center's track record for patient safety and satisfaction. Are they following all the rules and regulations?

Also, find out what they're doing to improve care over time. You want to invest in a center committed to giving patients the best care possible.

4. What Is the plan for the profits?

Lastly, make sure you understand the plan for the profits. Do the majority of owners want to accelerate debt repayment? Do they plan to distribute the profits to all the owners?

Understanding the plan for the profits is crucial if you expect to finance the buy-in through a loan. There can also be confusing tax implications if the profits are used to pay off surgery center debt instead of shared with owners.

Bonus questions for yourself

• How would this fit with your current financial priorities?
• Do you have a good plan for your student loan debt?
• Do you have enough cash and liquidity built up for emergencies?
• If you need to borrow money for the buy-in, how will the timing and amount of the loan payments fit within your cash flow?

Planning your investment strategy for surgery centers

The biggest thing to keep in mind when buying into a surgery center is that you must be financially prepared if you don't see a payout for a few years. These opportunities are called investments for a reason. If you are patient and diligent about the needs of your facility, then over time, you should see some sound returns.

Shane Tenny, CFP® , is the managing partner and a financial planner at Spaugh Dameron Tenny, LLC.

Securities, investment advisory and financial planning services offered through qualified Registered Representatives of MML Investors Services, LLC. Member SIPC. Supervisory office: 4350 Congress Street, Suite 300, Charlotte, NC 28209, (704) 557-9600. Spaugh Dameron Tenny is not a subsidiary or affiliate of MML Investors Services, LLC or its affiliated companies. CRN202705-6513994

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30 Tips for Designing and Building an Ambulatory Surgery Center

This article was written by Arthur E. Casey, CASC, Senior Vice President of Business Development, Outpatient Healthcare Strategies . In my 20-plus years of involvement with ASC operations, I have never seen two ASCs designed exactly alike, and none of the 150-plus I have visited or worked with was perfectly designed. Everyone has things that work well and don't work well from a design and construction perspective. While perfection is likely an unobtainable goal, if you are planning to design and build a new ASC, there are certainly things you should consider before breaking ground on the project that will help put you — and your new facility — in a better position for success. Based on my experiences, here are 30 tips for designers and developers of new ASCs. 1. Get the physicians' input up front. When I go to develop a facility, I interview each physician that will work there, whenever possible, and talk to them about their workflow, how they like to interact with patients, their equipment needs, etc. The more you can learn about what the physicians like and dislike, the better you can address these needs during design of the ASC. 2. Commit time to research. If you can spend significant time conducting research into your needs and options, you will put yourself in a better position to make educated decisions and provide guidance to your architect. When interviewing architects, ask if they have learned from their mistakes by visiting any of the facilities they designed to see what worked well and what did not. More importantly, when checking references of an architect, request a floor plan from the reference to review while asking the reference questions such as, "From the way your ASC was originally designed, what did the architect do that was good and what doesn't work? What is your flow like? Have you had to do any workarounds? What is your supply storage like? Where is your equipment storage and how does it work?" Ask the questions that speak to issues important to you, your physicians and what you want to achieve with your design. The key is identifying the most important things to you and then building for those priorities, especially if you have to build into an existing MOB and your footprint is somewhat determined for you. You need to make sure what's most important to you is done best. 3. Review multiple designs. Don't just consider one architect or look at one layout. You will want to look at multiple architects and their layouts. This is not only for cost comparison; as you view different designs for your ASC, you can identify the best of each layout and work with the architect you choose to integrate those elements into your final design. 4. Plan for a realistic case volume. I always tell physician partnerships that when they're thinking about developing a new ASC, determine where they are today with their case volume and cut that number in half. From that standpoint, build the ASC with an objective of reaching the number they think they have today. The reality is they're probably not going to be anywhere close to that volume figure from the beginning. This is an important consideration so they do not build the facility too small or too large to accommodate unrealistic volume. 5. Understand your structural opportunities and limitations. Building an ASC as a standalone facility in its own building is much easier from a design perspective, since you can essentially create the building — its shape, use of space and workflow — any way you want. This model seems to be more common in more rural and suburban settings vs. the typically more dense metropolitan setting. In metropolitan areas, you're probably going to develop a new ASC in an existing office building and/or an MOB that may be under construction. In this scenario, you tend to run into more obstacles with your design plans, from structural beams and posts you have to work around to the pre-determined physical footprint of the building. The optimal design opportunity is with a standalone facility because you can create the building to match the floor plan and closely mimic what you're trying to achieve. However, this option is more expensive, and the reality is that for most new ASCs, you don't need a facility large enough to justify investing in construction of a whole new building. 6. Understand your patients to plan your lobby. When considering the size of your lobby, it is helpful to know the patients who will use it. In markets with a larger percentage of minorities and individuals on the lower end of the economic scale, I have observed an increase in the number of people in the lobby. This may be attributable to a family-oriented culture and/or patients with family members who have no other place to go. In situations like these, you might have patients coming in with several family members, and will want to plan a lobby that is large enough to accommodate a greater number of visitors. The same logic is true for ASCs planning to perform pediatrics. These young patients will often come in with a mother and father, and sometimes siblings and grandparents. Note: If you're treating children, you must take into consideration the potential for a crying child in all areas of your patient flow: in pre-op, recovery and your lobby space. In addition to speaking with your physicians about their patients, consider visiting their offices on busy days to assess how many people join patients for an office visit. This will provide you with a better understanding of what you're likely to see in your ASC's lobby. 7. Place business office staff near patient check-in. You will want your business office close to where you check in patients. In the event that you have multiple patients checking in at one time, a member of the business team will then be in a position to step out from a cubicle to assist with check-in and help ensure there is never a long line of patients waiting for processing. 8. Position the scheduler(s) close to ORs. Scheduling, in my opinion, needs to be very close to the ORs, or at least where schedulers can easily reach the clinical manager or nurse manager if there are questions and/or problems with the schedule. This close proximity will allow staff members to more easily address concerns. Placing schedulers in the front of the building and far from ORs will require them to call back to the clinical area for assistance. It is easier for a manager to look over a scheduler's shoulders at the schedule rather than needing to log in at a separate computer station to view the schedule and assess the situation. 9. Keep medical records storage room small. I'm not a proponent of large medical records storage rooms. More facilities are going to an electronic version. You will want enough room to store no more than a year's worth of charts at a given time. It will help to learn your anticipated case volume and to assume you will need a paper chart for each case for a year. Make sure you have space large enough to accommodate just that much paper; if you make the room any larger, it's likely you will use the space to stock other items that should go elsewhere. 10. Who gets the corner office? Carefully select who receives an office and where offices are placed. I am not a proponent of many offices in an ASC. I think there is a tendency to overbuild offices, which typically results in leadership spending too much time in the office and not enough attention to where they should be. Obviously, it is necessary to provide the administrator with an office; just make sure it is not isolated and inconvenient for staff to visit. You also do not want it situated off the OR hall because the administrator will find it challenging to accomplish what is needed when faced with numerous possible distractions. The nurse manager typically needs an office or private space where counseling can take place, and take care of required paperwork. Your nursing manager's office should not be in the administration area as that should be a fair distance from the ORs. Make sure the nursing manager's office is close enough to the ORs or clinical area to assist in monitoring the flow and be readily available to step out and assist if needed. Does a medical director need an office? In my opinion, no. But do physicians need a workspace for everyone to use? Sure. Will that space be different from where they will dictate? It should be. The business manager and other business office positions do not require a private office. The use of alcoves and/or cubicles with sound dampening features provides more flexibility to make changes to the layout. 11. Make sure pre-op can accommodate case volume. This is an instance where doing your homework and research up front by speaking with the initial physician investors is going to be critical. I recommend you do your best to learn exactly which procedures the physicians intend to perform, how many procedures they can perform in a day and the average length of time for these procedures. This information will help provide a framework to help determine how many pre-op stations and recovery bays your ASC should have, which requires knowledge of the types of procedures your physicians will perform. It's not uncommon to see a four-OR/procedure room with 4-6 pre-op bays. This ratio can work, and will often meet building requirements, but is likely to present challenges for fast-paced ASCs with high volume of shorter cases. For example, if your ASC performs ophthalmology procedures, they can often schedule as many as 15-20 cases per day or more. Ophthalmology patients will often take longer to admit because they're often on more medications or have longer patient histories to review. However, the procedural flow of these patients is usually very quick, especially when you have ophthalmologists who can perform cataract procedures in 10-15 minutes. If your pre-op time is twice that long — 20 minutes, for example — and you only have 1-1.5x pre-op rooms ops per OR, you will face a situation where patients will become backlogged as pre-op team members work to get patients through their process and into the ORs. A similar problem faces ASCs performing a large volume of gastroenterology and pain procedures. These procedures also tend to be very short in the actual length of procedure. The time between the first patient entering the OR and the next patient being fully prepared for surgery is fairly short. You will want to make sure you have enough pre-op spaces available so patients are ready to go into the procedure room or the OR, once the physician is ready for the next case. The time in between cases becomes even shorter when physicians are flipping rooms. You need to make sure you have enough pre-op spots to accommodate the anticipated physicians' flow and their preferred practice patterns. 12. Determine whether you want patient lockers. I'm not a proponent of the lockable locker for patients. There was a time when most facilities had lockers for storage of patients' belongings. Once patients locked the locker, we pinned the key to the lock to the patient's gown. That way, we knew those belongings essentially always stayed with the patient. The reality is if the recovery room is not close to the lockers, you now need a staff member to go over to the locker, gather all of the belongings and bring them back, or if, during surgery, the gown is removed, and you now have to go search thru the laundry to retrieve the key These issues seem to negate the concept of securing and locking the patient's belongings. More and more facilities are going with the approach of putting the patient's belongings in a bag, making sure the bag stays with the gurney and the gurney stays with the patient. 13. Decide if enclosed rooms for pre-op assessment are necessary. There are two different mindsets on how to handle pre-op assessment and confidentiality concerns. Many people feel you need to have enclosable rooms with the ability to shut the door to ensure privacy. These are great, but they really eat up significant space — more space than I would argue is necessary. They also make it more difficult to keep track of what's happening with patients behind closed doors: are they dressed, do they need help, etc. Conversely, the other option is bays with curtains separating one bay from the other. This scenario is not really conducive to privacy. A third option — and possibly the best depending on your circumstances — would be an amalgamation of the two described above. You could have bays, but with hard, full walls to help with confidentiality and privacy, and still have curtains for the front for privacy while changing. This option typically gives you the best of both scenarios. Make sure that you install enough bumper protection in these bays to keep the ASC looking pristine, and not have your walls dinged up from being hit by the equipment. Note: Regardless of which model you choose, it is very important to have a restroom located near the pre-op bays. You don't want patients walking down a long hallway in their gown to use the bathroom. 14. Allocate appropriate and adequate nursing desk workspace. If you are planning to keep patient charts at the nurse's desk, you will need to consider what this will do your workflow. Physicians, including anesthesiologists, will likely want to have easy access to the charts. In a busy ASC, this may result in several physicians and staff members working at the desk at the same time, so the workspace will need to be big enough to accommodate a significant number of people. But you will want to avoid making the space so large that physicians are far away from their patients when viewing charts. 15. Identify which specialties will go in which ORs. Identifying which ORs will be primarily used for which specialties is very helpful from a design perspective. For example, if you're building a three-OR facility and plan to running ophthalmology out of 1-2 ORs, orthopedics in 1-2 ORs and pain in one OR, you're going to want your phacoemulsification system and microscope close to the ophthalmology rooms and storage for the C-arm close to the OR. If you're doing orthopedics in the same rooms as ophthalmology, for example, you will want a place to store the microscope or phacoemulsification machine However, moving equipment inordinately increases the likelihood of them being damaged or falling out of calibration, requiring increased maintenance. 16. Don't build ORs too small. One of the biggest problems I see in existing facilities is ORs that were built too small or not designed for the types of procedures performed in today's ASCs. For example, consider a big orthopedics case that needs a C-arm, and all of the carts and towers required. Try to perform one of these cases in a small or poorly designed room and it will become tight very quickly. With the advent of spine and other procedures requiring big equipment and more people, you need ORs large enough to maneuver in and accommodate several pieces of (often big) equipment. 17. But don't build ORs too large, either. Conversely, I have seen ORs that were up to twice the size they should have been. You must be reasonable in the assessment of how large to build your ORs. Should you build them to meet minimal code? Absolutely not! However, somewhere between that absolute minimum and doubling the size of the room, probably in the range of between one-and-a-third to one-and-a-half times the minimum. You want to have them large enough to accommodate the C-arm, microscopes, cart movement, the ability to switch from the left to right side of the patient, additional equipment (related to the specific specialty), etc. In some of the larger cases, you will need to accommodate more people — an extra physician, an equipment rep in the room, etc. It is extremely important to design the OR space to fit everyone and everything that needs to be there. 18. Don't place your ORs near the property line. You will want to build your ASC so that you can expand if you max out OR capacity several years down the road. Avoid placing your ORs on the sides of your building near property lines, where expansion into the space is not permitted. Flip the direction around so you have the ability to expand, for example, into the parking lot. 19. Consider future expansion "next door." If you're building the ASC in an MOB, and will occupy space on the same floor as other businesses, expansion will most likely occur by your taking space from the business "next door" if it becomes available as opposed to adding on to the building. As such, you will want to place your ORs or other clinical areas where expansion is most likely to occur along the walls you share with other businesses. There are many people who are proponents of the concept of building out but not equipping an extra OR up front during construction. This may be a good idea, or you may end up paying rent on space for the next 10 years unnecessarily. Plan carefully. Note: While you may never expand your ASC, you don't want to close off that opportunity. I come into facilities that are maxed to capacity and really need to look at ways of expanding. Unfortunately, layout makes it difficult to add new ORs without essentially shutting down operations and starting from scratch, which is cost-prohibitive. If you have an existing operation running, you're never going to just close down and remodel your whole facility for six months and then reopen. Plan carefully. 20. Keep anesthesia out of the corner. It is critical for your anesthesia provider to move around the OR and not be stuck in a corner near the gas outlets. If the anesthesiologist has limited mobility in the OR, you will need to position the patient around the anesthesiologist rather than designing the OR in such a way for anesthesiologists to move around and do what they need to for patient care. In small centers, if your lead anesthesiologist is the medical director and someone needs to speak with him or her or during a procedure, if he or she is in the corner of the OR, staff members will need to navigate the room to get over to the anesthesia cart. This isn't conducive to good flow. Anesthesia providers are a crucial and critical part of the operative team, and you need to consider their placement and location just as much as the placement of physicians and scrub techs. 21. Avoid built-in cupboards in ORs. In many ORs, I see amazing built-in cupboards designed to house supplies for the OR. From an operations standpoint, I am vehemently against these cupboards in the OR, primarily for two reasons: 1) They're never designed in a manner to stock what you really need in a manner that you need; and 2) You end up having multiple locations for the same supply item. From a cost and inventory standpoint, it becomes extremely difficult to know how much of a given supply you have on hand if you, for example, have a specific type of suture in four different ORs. Add this to your main storage stock, and you end up with five locations for one type of suture. Invariably, you will purchase five boxes of something to stock the four ORs and the main stock, when in reality you'll only go through one box in the next six months. That becomes problematic from a cost standpoint and in terms of inventory outdates, and it's a challenge to manage all of this from an operational perspective. I believe facilities should maintain supplies in 1-2 locations, maximum. If ASCs do a good job of picking cases and making sure preference cards are as complete as possible and kept up to date, they should have 99 percent of supply items necessary for any case picked for the room from these 1-2 locations, thus eliminating the need to stock those supplies in the OR as well. 22. Plan for gurney flow and storage. Gurneys travel throughout the ASC, and it's critical when planning the building's layout to determine which path will permit the best flow for gurneys. The gurneys bring the patient from pre-op into the OR, then from the OR into recovery, then back to pre-op for the next patient. They also need to be cleaned before another patient is placed upon them. You need to determine how your flow is going to work relative to those gurneys and how far they have to go to get from one destination to another. If there isn't enough storage space for unused gurneys, they may clutter the OR hall, which causes potential problems with fire safety. They may also become stacked in a corner, which makes it difficult to get the right gurney to the right patient and keep flow moving. It is valuable to build in alcoves for gurney storage, but this space should only used to store the gurneys. 23. Plan for sufficient OR equipment storage. Sufficient equipment storage outside of the OR is extremely important. Unless you're planning to equip your center so every room has its own tower, its own C-arm and every piece of equipment for every specialty you're doing, you have to store that equipment somewhere. Some facilities will have a space for the gurney and separate space for equipment overflow where they store C-arms and towers not in use. 24. Build equipment storage that addresses your physicians' needs. As mentioned earlier, it's valuable to learn which equipment the initial physician users will need; this will help ensure you're building enough storage space for the equipment you will purchase. 25. Design practical storage rooms. Design your equipment storage in a manner that ensures the equipment is easily accessible. Building a single, large, square storage room is usually not practical, as pieces of equipment will inevitably end up stuck in the back and sides of the room and accessing them will require emptying out much of the supply room. Long, narrow spaces in which you can access any space without emptying the room is much more beneficial from a storage standpoint. 26. Carefully consider other storage needs. While storage for surgical equipment is important, it's not the only storage you need to consider. You may want a storage area for all of your anesthesia supplies, and you need a storage area for your pharmaceuticals. The rules for storing pharmaceuticals now require ASCs to secure everything from IV solutions to syringes, in addition to making sure all medications are secure. Many facilities plan poorly to address these requirements; they typically put medications in a closet-type area, and then realize that there's no room left to stock IV solutions and syringes. This means they are forced to find another secure location, which may present challenges from a convenience and cost perspective. With so many items requiring storage, designers of a new ASC may be inclined to plan for extra storage. The danger with this is if there is unassigned storage space, the space is unlikely to remain unused for long and may become the home for random pieces of equipment and storage overflow. Building appropriate-sized storage rooms for specific purposes is extremely important. 27. Place processing near supplies and receiving. I believe purchasing should be placed close to where supplies are received and stocked. It shouldn't be up in the business office area if receiving is in the back of the building and the supply room is nearby. Purchasing needs to be located close to where most of the purchasing- and storage-related work will take place. 28. Value the importance and needs of sterile processing. The sterile processing room(s) in your ASC will be extremely important. Your instrument trays need to be stored in a room where humidity can be controlled and monitored, so it can't be right around the corner or in the same room as your autoclaves. When you open the autoclaves, steam rushes out, and you will face the constant problem of trying to monitor humidity levels. You will also want your sterile processing room near your ORs for convenience, designed so you have appropriate storage for your supplies and built large enough to accommodate personnel and instrument trays. The number of trays you need to sterilize will increase if your case volume is high. 29. Strategically place physician dictation alcoves. It's not uncommon to see really nice alcoves for physician dictation built in the OR hall or in recovery rooms. Unfortunately, these alcoves are often rarely used because their location doesn't work well with physicians' flow. When interviewing physicians, try to determine their preferences for where they like to dictate, and plan the alcoves accordingly. 30. Save space with one break room for physicians and staff. I'm not a proponent of separate lounges for physicians and staff. I think it's extremely important that everyone works together to encourage a team mindset. Separate lounges only encourage a separation between the two teams and foster an "us vs. them" concept. I'm not a proponent of tiny staff break rooms, either. You need a room large enough to accommodate at least one-third of staff plus physicians and anesthesia providers. During lunch breaks, you will likely have as much as one-third or more of your staff at lunch, so make sure there's enough space to accommodate this number of team members, physicians, anesthesia personnel, and possibly a vendor or two, comfortably. Although not a requirement, break rooms often will be used to host staff meetings, so if you plan to do so, you should also have enough space to accommodate staff members for training and in-services. Conclusion Overall, the long and the short of planning for the development of an ASC comes down to information data collection, planning and establishing the key points and issues and ultimately determining what is most important to you, your physicians and your patients. Arthur E. Casey, CASC, is senior vice president of business development for Outpatient Healthcare Strategies ( www.outpatienthcs.com ), a provider of healthcare management consultancy services for ambulatory surgery centers, hospitals and physician group practices based in Houston.

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Carpal Tunnel Surgery

Cataract removal, rotator cuff repair.

Source: Centers for Medicare & Medicaid Services (CMS) 2024 Procedure Price Lookup Comparison File , Carpal Tunnel Surgery (CPT® 64721), Cataract Removal (CPT® 66984), Rotator Cuff Repair (CPT® 29827)

Surgery Centers by the Numbers

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Medicare procedures performed

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Medicare colonoscopies are performed in ASCs

Source: Centers for Medicare & Medicaid Services (CMS) Physician/Supplier Procedure Summary (PSPS) data, 2019 to 2021

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For the OAS CAHPS survey, what statement are facilities using to gain consent to share the information with your vendor? We are planning on putting this in our registration process. We have HST eChart and Practice Management. ------------------------------ ... Read more

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For those of you still using a paper charting system: How are you verifying the completion of your medical records within 30 days? ------------------------------ Heather Cortez, RN Quality, I.P., and Risk Manager El Dorado Surgery Center Placerville, ... Read more

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Procedures Commonly Performed at Ambulatory Surgery Centers

Common Gastroenterology ASC Outpatient Procedures

Screening guidelines

Endoscopies and colonoscopies are health screenings that have preventive care benefits. A colonoscopy and upper endoscopy can identify and even treat conditions in the digestive system. For instance, if a patient has had constant digestive symptoms, the procedures can reveal illnesses like Crohn's disease or ulcerative colitis.

More importantly, these procedures can correct polyps, stop bleeding or help screen for cancers. The U.S. Preventive Services Task Force recommends colon cancer screening beginning at age 45.

Colonoscopy

Considered the gold standard for colon cancer screening , a colonoscopy is a minimally invasive procedure to assess and treat issues in the large intestine, including the colon and rectum. The doctor will use a colonoscope, a snake-like tool with a light, camera and surgical instruments for removing any polyps. The procedure itself takes less than 30 minutes. Colonoscopies are typically done every five to 10 years, depending on the patient's age, risk factors and family history of colon cancer.

Upper GI endoscopy

Medically known as an esophagogastroduodenoscopy, this procedure visually examines your upper digestive system. This includes your esophagus, stomach and beginning of the small intestine (duodenum). Your health care provider may recommend an upper GI endoscopy to investigate certain digestive symptoms such as chronic heartburn, nausea, difficulty swallowing and gastrointestinal bleeding.

Tissue samples (biopsies) may be collected to test for conditions that might be causing anemia, diarrhea, bleeding and inflammation. Sometimes tools are passed through the endoscope. For example, to cauterize a blood vessel to stop bleeding, widen a narrow esophagus or remove a polyp.

Appendectomy

An appendectomy is a surgery to remove the appendix, which is located in the lower right side of the abdomen. This is usually performed as an urgent or emergency procedure to treat appendicitis, a condition when the appendix becomes infected.

Endoscopy of the pancreas or bile duct

This procedure is referred to as endoscopic retrograde cholangiopancreatography, or ERCP. It is an endoscopic procedure to look for issues such as blockages, infections, stones or tumors in the biliary and pancreatic ducts. It combines X-ray and an endoscope, a long, flexible, lighted tube. The scope is guided in the mouth, down the throat and into the first part of the small intestine. Dye is injected to highlight organs and other features on the X-ray.

Gallbladder removal (cholecystectomy)

The surgical removal of the gallbladder is a common treatment of painful gallstones . Symptoms of gallstones include intense stomach ache, nausea and yellowing of the skin and eyes.

Surgery on the esophagus, stomach or small intestine

This includes a broad list of possible outpatient surgeries. Some of the most common include surgery to treat a hiatal (stomach) hernia , to treat persistent gastroesophageal reflux disease or to remove precancerous or other abnormal tissues (lesions) from the digestive tract.

Common Orthopedic and Spine ASC Outpatient Procedures

Fracture or dislocation treatment of the arm, wrist and hand

Treating fractures or dislocations involves realigning broken bones or correcting bones at the joint in the arm, wrist and hand. Depending on the severity of the problem, these treatments can be done through casting and splinting, but surgery may be needed for complex fractures to implant screws, plates or rods.

Suitable candidates: Patients with acute fractures or dislocations to the arm, wrist or hand that impair function or cause pain from sports injuries, falls or other types of accidents that do not require additional complex surgical treatment.

Injection for back pain

Injections for back pain, such as epidural steroid injections, target inflammation around spinal nerves. Herniated discs, spinal stenosis and degenerative disc disease are all common causes for back pain that can be treated with steroid injections. These treatments typically offer pain relief for a few months, but the exact duration will depend on the patient, cause and severity of the pain.

Suitable candidates: Patients experiencing chronic back pain from conditions like these that have not found relief with medications, physical therapy or other types of conservative treatments.

Knee arthroscopy

Knee arthroscopy is a minimally invasive surgical procedure that allows doctors to insert a small camera to view the knee joint without making a large incision. Common for treating meniscal tears, anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL) injuries and joint inflammation, it's widely performed due to the high incidence of knee injuries and conditions.

Although most people are able to go home on the same day as the surgery, full recovery after the procedure often depends on the type and severity of the condition treated, ranging from a few weeks to several months.

Suitable candidates: Patients with joint conditions – such as meniscus tears, ACL or PCL injuries, cartilage damage or other knee-related pain – who have not responded to nonsurgical treatment – including rest, physical therapy, medications and injections – for reducing inflammation.

Hip replacement

Hip replacement surgery involves replacing the damaged hip joint with an artificial one in individuals with severe arthritis or injury that is causing significant pain and mobility issues. It is one of the safest and most common joint surgical procedures in the U.S., with more than 450,000 hip replacements performed annually in the country, according to the American College of Rheumatology.

In addition, current techniques for hip replacements allow the artificial joints to last for at least 20 years, providing a long-term solution for those suffering from hip arthritis.

Suitable candidates: Patients with advanced end-stage joint disease – including osteoarthritis , rheumatoid arthritis, previous joint injuries and fractures and other inflammatory joint problems – in the hip who have not had success with non-surgical treatments.

Knee replacement

Knee replacement surgery involves replacing the damaged or diseased knee joint with an artificial one. It's particularly common among older adults with osteoarthritis. An estimated 790,000 total knee replacements procedures are performed yearly in the U.S., according to the American College of Rheumatology.

Thanks to current techniques for knee replacements, artificial joints can last for at least 20 years, providing a long-term solution for alleviating pain and improving function and mobility in those suffering from knee arthritis .

Suitable candidates: Patients with advanced end-stage joint disease – including osteoarthritis, rheumatoid arthritis , previous joint injuries and fractures and other inflammatory joint problems – in the knee who have not had success with non-surgical treatments.

Spinal fusion

Spinal fusion is an outpatient surgery that permanently connects two or more bones (vertebrae) in the spine to improve stability, correct deformities or reduce pain. Spinal fusion is indicated for conditions such as severe spinal stenosis (narrowing of the spinal column caused by arthritis), scoliosis or other abnormal curvatures of the spine, a weak spine caused by infections or tumor, or injury or fracture to the bones in the spine – all of which can cause chronic pain.

Typically, the surgeon will use a graft (such as bone or an artificial bone substitute) to fuse the bones together permanently. Metal plates, screws or rods might also be used to hold the bones together.

Spinal fusion is typically performed simultaneously with other spinal surgeries, such as discectomy (removal of a herniated disc) and laminectomy (removal of the vertebral bone, known as the lamina). Although a spinal fusion is common, it is still a major surgery with significant recovery time of several months.

Suitable candidates: Patients with severe spinal stenosis, scoliosis, fractured bones from traumatic injury or degenerative disc disease.

Fracture or dislocation treatment lower leg, ankle and foot

This treatment involves repairing injuries to the bones and supporting structures in the lower leg, ankle and foot. Common in athletes and those involved in high-impact accidents, the treatment aims to restore function and stability from ligament damage or dislocated bones in the lower extremities.

While nonsurgical techniques (such as casting and splinting) are used, surgery using pins, plates, screws or rods to stabilize the bone is often required for more severe cases in order to restore function and alleviate pain in the affected area. To improve recovery, rehabilitation physical therapy and rehabilitation exercise are often prescribed after the initial treatment to strengthen the surrounding muscles and improve range of motion.

Suitable candidates: Patients with fractured or dislocated bones from accidents, falls or sports injuries who do not have other injuries that require major surgeries or have any complicated factors.

Fracture or dislocation treatment knee

This treatment involves repairing injuries to the knee's bones and supporting structures. Common in athletes and those involved in high-impact accidents, treatment aims to restore knee function and stability from ligament damage or dislocated bones.

Shoulder arthroscopy for rotator cuff repair

Shoulder arthroscopy may be recommended for various shoulder problems, such as a torn or damaged cartilage ring or ligaments, a torn or damaged biceps tendon and a torn rotator cuff. The rotator cuff is made up of a group of muscles and their tendons surrounding the shoulder joint. Rotator cuff repair is a minimally invasive surgery that involves creating a small incision to insert a tiny camera, called an arthroscope, and miniature surgical instruments.

Rotator cuff muscles, tendons or cartilage can tear from age and repeated overhead motions, such as painting, carpentry and certain sports. These injuries can cause dull aches, recurrent pain, limited mobility and muscle weakness. Using arthroscopy for rotator cuff repairs or tendonitis usually relieves the pain, but you may not regain all of your strength.

Suitable candidates: Patients with recent rotator cuff injuries or those with symptoms that have lasted 6 to 12 months, a large tear, significant muscle weakness or loss of function.

Total shoulder replacement

Also referred to as shoulder arthroplasty, total shoulder replacement surgery replaces the damaged shoulder joint with artificial implants typically made of either metal or plastic. The damage to the shoulder joint can lead to pain, aches, weakness and stiffness that impair an individuals’ range of motion and affect their quality of life.

The procedure is indicated for severe arthritis or significant joint damage that has not had success with medications, offering significant pain relief and improved function for those affected. Although it's less common than hip or knee replacements, it is still a widely performed procedure, with approximately 53,000 people in the U.S. undergoing the surgery each year, based on statistics from the Agency for Healthcare Research and Quality.

Suitable candidates: Patients with severe osteoarthritis, rheumatoid arthritis, untreated rotator cuff injury or severe fractures.

Common Eye Surgery ASC Outpatient Procedures

Cataract surgery with lens implant

Cataract surgery is a surgical outpatient procedure to treat cataracts, a condition in which the cloudy area of the eye is removed and replaced with a clear artificial lens, known as an intraocular lens. It is one of the most common ophthalmological procedures in medicine, as it affects more than 20.5 million Americans over the age of 40, with approximately 6.1 million Americans who have undergone the procedure, according to the American Academy of Ophthalmology.

Suitable candidates: Those who have cataracts causing visual impairments that hinder their daily activities, such as reading, driving or recognizing faces. Age and the presence of cataracts are not the sole factors that determine the need for surgical intervention. Instead, doctors will typically recommend cataract surgery based on how the symptoms impact an individual’s quality of life and their ability to perform daily tasks.

Surgical retina and vitreous procedures

Surgical retina and vitreous procedures are specialized surgeries to treat conditions that involve the retina, the light-sensitive layer of tissue at the back of the eye. These include retinal detachment, macular degeneration and diabetic retinopathy.

Procedures involving the retina include:

• Laser photocoagulation . This is used to seal or “weld” weakened blood vessels in the retina by sealing them together to prevent fluid from leaking under the retina.
• Scleral buckle. Scleral buckle procedures treat retinal detachments and correct vision by placing a silicone band around the sclera, the exterior part of your eye, to reattach the retina to the interior wall of the eye.
• Photodynamic therapy (PDT). For patients with age-related macular degeneration, a PDT treatment uses light in combination with a light-sensitive drug to destroy abnormal blood vessels in the retina.
• Vitrectomy. This surgery removes the vitreous, the gel-like fluid between the lens and the retina in patients with diabetic retinopathy, certain types of retinal detachment, problems from cataract surgery and other retina-related issues. Once the vitreous, scar tissue and any foreign objects are removed from the eye, the eye is filled with either a saline solution or a bubble made of air, gas or oil to keep the retina in position.

Suitable candidates: Patients with retinal detachment, age-related macular degeneration, diabetic retinopathy and other retina-related conditions.

Glaucoma surgery

Glaucoma comprises a group of eye conditions characterized by damage to the optic nerve that leads to progressive vision loss if left untreated. Affecting approximately 3 million Americans, glaucoma is the second leading cause of blindness around the world, according to the Centers for Disease Control and Prevention. However, with surgery, doctors can manage and treat glaucoma by reducing pressure in the eye to drain excess fluid from the eye.

Surgical techniques include laser and incisional surgery to either improve the natural drainage pathway in the eye or create a new, small hole to allow fluid to drain more effectively.

Suitable candidates: Patients with open-angle, normal-tension, angle-closure, congenital or other types of glaucoma.

Corrective eye surgeries

Corrective eye surgeries are designed to improve vision and reduce – or completely eliminate – the need for glasses or contact lenses. In particular, laser-assisted in situ keratomileusis, more frequently referred to as LASIK , is a commonly performed eye surgery that consists of cutting a thin flap on the outer of the eye to expose the cornea, which is then reshaped to allow light to properly enter the eye and correct vision.

Suitable candidates: Those with nearsightedness, farsightedness or astigmatism.

Common Urology ASC Outpatient Procedures

Endoscopy of the urethra and bladder

An endoscopy of the urethra and bladder is a common diagnostic procedure. Also called a cystoscopy, it is used to directly examine the urinary tract and is typically done to investigate symptoms, such as blood in the urine , painful urination and an overactive bladder. It can also be used to look for bladder cancer and bladder stones, determine the cause of chronic urinary tract infections or to diagnose an enlarged prostate.

A long, flexible, lighted tube, called a cystoscope, is inserted into the urethra and guided into the bladder. The cystoscope also enables the doctor to access the area with surgical instruments – to remove tissue for a biopsy, for example. A simple outpatient cystoscopy can take five to 15 minutes.

Suitable candidates: A cystoscopy may be advised if your health care provider thinks you have a problem of the urinary tract, such as a tumor or polyps in the bladder or damage caused by frequent urinary tract infections.

Transurethral surgery (TURP) for enlarged prostate

Transurethral resection of the prostate (TURP) is the surgical removal of part of the prostate gland. It’s a common surgery used to treat urinary problems caused by an enlarged prostate. A surgeon will trim away prostate tissue that's blocking urine flow. The procedure takes about 60 to 90 minutes. Because of swelling that blocks urine flow, you'll have a urinary catheter in place – typically for at least 24 to 48 hours until swelling lessens and you're able to urinate on your own.

Suitable candidates: Transurethral surgery is considered an effective treatment choice for men who have moderate to serious urinary problems that haven't gotten better with medicine.

Vaginal prolapse repair

Also referred to as pelvic organ prolapse , this condition involves loose muscles in the female pelvic floor that results in prolapse (or dropping) of the bladder, uterus, intestines, rectum or a combination of these organs into the vagina.

Pelvic organ prolapse (POP) occurs in up to 50% of women who have undergone childbirth. It may or may not be associated with symptoms. For severe cases of POP, organs may push out of the vaginal opening. Women with symptoms may experience feeling of pelvic pressure or fullness, organs bulging out of the vagina, leakage of urine , difficulty completely emptying the bladder, problems having bowel movements and lower back pain.

The goal of reconstructive surgery is to restore organs to their original position. This is the most common type of pelvic organ prolapse surgery. Some types of reconstructive surgery are done through an incision in the vagina. Others are done through an incision in the abdomen. There is no guarantee that surgery will relieve all of your symptoms. Also, new problems may occur after surgery, such as pain during sexual intercourse, pelvic pain or urinary incontinence. Recovery time varies depending on the type of surgery. You usually need to take a few weeks off from work.

Suitable candidates : If you have POP symptoms, and they interfere with your normal activities, you may need treatment. Nonsurgical treatment options usually are tried before surgery.