1. What services does ASCOA provide?
ASCOA forms equity partnerships with physicians and hospitals to start, acquire, turnaround, manage and recruit for ambulatory surgery centers. Partners can expect superior patient care with outstanding financial returns.
2. Are there any other benefits of a surgery center beyond financial returns?
Many ASCOA partners say they would operate at the center if they were an owner or not. They feel the “non-financial” benefits outweigh the “financial” benefits. ASCOA centers average 8-minute turnovers between cases. In addition, as an owner, the surgeon has control over staffing, supplies, equipment, etc. Patients often prefer the comfortable outpatient setting more than the hospital, so satisfaction is increased. ASCOA centers average 98% satisfaction rate among patients.
3. How does ownership and governance work in an ASCOA surgery center?
The limited liability company is the typical legal structure of the center with its board of directors governing it. Typically, the ASC ownership structure is 70% physicians and 30% ASCOA. In a Hospital-Physician Joint Venture the ownership structure is 50% physicians, 25% Hospital and 25% ASCOA.
4. What is ASCOA’s track record?
ASCOA has thrived in every trend over the last 25 years in the ASC industry. Of the more than 65 centers that ASCOA has formed, acquired or turned around, none has ever failed. No partner has ever lost the initial investment in an ASCOA center. This fact has earned ASCOA the distinction of the most successful and experienced ASC company in the industry.
ASCOA’s successful track record reflects a proven methodology that includes efficient design; sound fiscal management; economies of scale of a large network of facilities; experienced decision-making; a proven operating model; and the agility to stay ahead of industry trends.
5. How is ASCOA different than other ASC companies?
ASCOA develops and manages ASC nationwide. The company has developed over 65 ASCs and has a proven reputation for running some of the most efficient and profitable surgery centers in the industry.
ASCOA’s founders are surgeons and operated successful ASCs before starting the company. Since 1997, ASCOA’s leadership has assembled the most talented, energetic and integral team of development, operations and financial professionals in the country. ASCOA’s team has consistently led in industry association activities and affected responsible policy-making.
ASCOA was also founded with the personal capital of its principals. ASCOA maintains its independence as a private company without any venture funding.
6. How is ASCOA compensated?
ASCOA invests as a minority equity partner in every center. ASCOA contributes capital and receives profit distributions based on its percentage of ownership. ASCOA also earns a management fee for its ongoing operational support. Unlike other companies, ASCOA neither charges a development fee nor manages centers that it doesn’t own.
The ownership percentage that ASCOA has in the center is typically one-third higher than many of its competitors. ASCOA is uniquely positioned to provide commensurate financial strength and return on that equity to the center. ASCOA centers have led the industry in outcomes and profitability. In short, the additional ownership is worth the value created for the partnership.
7. How often will the center distribute to its shareholders?
ASCOA centers typically distribute profits monthly at board meetings (attended by all partners).
8. In a Hospital-Physician Joint Venture, is partnership in the ASC only available to physicians associated with the hospital?
No. Typically, more than 50% of the surgeon partners are “non-hospital” physicians.
9. What happens to my shares in the ASC when I retire?
Shares owned by retiring physicians are purchased at the current fair market value of the center (typically 3X earnings). The shares may be purchased (equally) by the remaining physician partners or sold to a new partner.
10. How does ASCOA operate the centers it owns?
For each center in which it has ownership, ASCOA manages the site and operations, conducts staff training and in-services, provides policy/procedure manuals and updates, staffs the ASC for maximum efficiency, and maintains ongoing regulatory compliance.
Acting as shareholder and ASC manager, ASCOA invests large amounts of time on site and serves as Interim Administrator during the recruitment process. Once hired, the Administrator reports to the Center’s Board of Directors (on which ASCOA holds a seat) and to ASCOA directly.
11. Does ASCOA only help get the center up and running? What long-term value does ASCOA add beyond the initial turnaround or development?
ASCOA’s development team provides expertise in all aspects of ASC development. ASCOA’s operations team oversees the ongoing day-to-day clinical and business operations of the center. This ensures the implementation and ongoing use of ASCOA’s procedures and best practices to maximize patient satisfaction, physician success and financial return. ASCOA also continues to recruit the best surgeons to the center.
12. How does ASCOA approach financial management?
ASCOA performs a comprehensive list of financial services for each center including feasibility studies, pro forma analysis, project financing (based on limited recourse sources), financial management and payer contracting. Profits that impressively outperform industry averages result when ASCOA brings these services to each center.
13. How does ASCOA deliver outstanding quality of care?
ASCOA also maintains active certification and compliance with the industry’s myriad of governing organizations. Additionally, through its sheer volume of ASC projects, ASCOA generates internal benchmarking data to judge efficiency in each center.
At ASCOA facilities, quality is assured because each center submits to rigorous oversight. To participate in and receive payment from the Medicare or Medicaid programs, ASCOA facilities maintain active certification and comply with quality standards set forth by the Health Care Financing Administration (HCFA). Additionally, all ASCOA facilities conduct peer-reviews of clinical care and submit to inspection by the Accreditation Association for Ambulatory Health Care (AAAHC) or Joint Commission on Accreditation of Healthcare Organizations (JCAHO).
Physician-owners control clinical standards, staff, and policies. Every facility has a Quality Assurance Committee, chaired by the Medical Director and supported by the surgeon partners as part of a Continuing Quality Improvement process.
14. What specialties are best for an ASC?
ASCs can serve a variety of specialties including Orthopedics, Ophthalmology, Podiatry, General Surgery, Gynecology, Neurology and Spine, Otolaryngology, Gastroenterology, Urology and Pain Management.