Could office-based procedures be the key to growing your practice?

a young physician in a lab coat with a stethoscope standing in front of a grey background

There is understandable excitement when you launch your practice. Everyone is rowing together to attract patients, negotiate fair contracts with payers, integrate with the community, and optimize workflow and care delivery to make your group successful.

Inevitably, though, you move beyond those salad days and get into the meat of operating a physician group practice. In addition to your fulltime job as a physician, you may oversee HR, recruitment, billing, purchasing, negotiations, or office management. Or, possibly a few of these.

That is all to say nothing of growing your practice. Despite your busy schedule, you and your physician partners are hungry for ROI and if you delay growth, you create a vacuum that can easily be occupied by your competitors. According to a study by Fortune Business Insights, the 2020 market for physician groups was valued at $249.8 billion and is projected to grow at a CAGR of 1.9% through 2028.

While there are many forms growth can take for a physician group, it is critical to understand the state of your practice to inform your strategy. Data on revenue, profit, patients, and more will help you understand if the time is right and the resources in place to support your growth.



Office-based Options

Office-based surgeries and procedures are far from novel approaches to care. Physicians, to some degree or another, have always taken care of smaller procedures in the office setting.

Today, though, there are many more-complex procedures – across a variety of specialties – that can be safely, conveniently, and affordably performed in a physician’s office or clinic as opposed to an HOPD or ASC. Vein ablation, colonoscopy, polypectomy, dental implants, and balloon sinuplasty are all routinely performed in physician’s offices and clinics.

Facilitating the shift in sites-of-service have been advances in surgical equipment, minimally-invasive procedures, and anesthesia and sedation. The benefits of this move out of HOPDs and ASCs are many. Payers lower their costs by excising facility fees. And patients enjoy the savings and the convenience of having their procedure performed efficiently by a staff they are comfortable with in a familiar location.

With the office setting now being more actively supported by payers, incentives for physicians to move procedures to offices have grown during the past few years. For example, in 2021, Blue Cross Blue Shield of Illinois increased reimbursements for gastroenterology and some musculoskeletal procedures by 15% if performed in office.

As such, office-based procedures present physician groups with an excellent avenue for growth. If procedures are already part of the practice, removing those that can be performed in the office from the HOPD and ASC is a quick way to boost the bottom-line. The hassles of scheduling within limited blocks, delays due to cases running late or emergencies, facilities not having adequate staffing, travel time, and the overall bureaucracy at facilities you don’t own and can’t control, disappear when physicians control the space where they operate.


Key Considerations

Anesthesia can prove an elusive piece creating a successful strategy. Most practices do not want the cost or headaches that come with recruiting, managing, and retaining an in-house anesthesia provider to assist with procedures. Outsourcing anesthesia is an easier solution, however, finding the right anesthesia partner is critical.

While there are a multitude of ambulatory anesthesiology firms in major markets, there are again many considerations that must be made when choosing which one is right for the practice.

  • Are procedures serviced by a physician anesthesiologist or a CRNA?
  • Does the provider also send an RN to assist with preop and recovery?
  • Are anesthesia monitoring equipment, medications, and supplies provided, or does the practice need to provide them?
  • Is the anesthesia provider in-network with insurance carriers? How does the anesthesia provider handle billing insurance carriers and patients?
  • What is the plan-of-action should there be an emergency or need for transfer to a hospital?
  • What level of perioperative screening does your anesthesia provider offer?

A turn-key anesthesia partner helps with direct cost savings and reduced clinical and administrative resources from a financial standpoint. They can relieve physicians of the burden of hiring any staffing anesthesia personnel. Additionally, many offer the medications, equipment, and supplies associated with a variety of anesthesia and sedation models. That not only boosts revenue but also gives physicians less to worry about in a time- and resource-intensive industry. Many full-service anesthesia partners bring with them tested emergency readiness plans and arrive equipped with crash carts and defibrillators.

Special approaches and postoperative care are needed for office-based procedures so that patients can head home in a reasonable timeframe. Physicians should look for an anesthesia partner that guarantees patients receive the best anesthetic plan and medications during the surgical procedure for their short- and long-term wellbeing. That allows patients to experience a more positive sleep, awakening, and recovery process since issues including post-operative discomfort, memory loss, and nausea are avoided.

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