Surgical Centers
Become a
Limited Partner
This is a great starting place and in fact, prior to buying in, you can bring cases to test the process, personnel, and equipment with just staff privilages and without first commiting to an investment. The first concern is about you feeling the facility is a safe enviroment for you and your patients. Then we recommend considering the following and more about this type of opportunity:
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Know who's in the partnership, their specialties, and the type and volume of cases they bring
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Is the facility profitable and why, and what does that mean for you
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Does it make good financial sense to buy-in
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Is the facility Medicare certified and otherwise out-of-network, or has it contracted with most all payors
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If contracted, what are the allowable rates that they expect to receive for your cases
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If out-of-network, what are the fees your patients will be billed for the services provided
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If out-of-network, get clear on their patient balance billing policies and possible issues your patients may have and how your office staff is to handle questions
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Know who if any with equity in the partnership are non-income producing, like non-physician owners or corporate partners, and their role, equity and ownership
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Ask for a 12 month recent schedule of distributions back to the Limited Partners and get clear on the amounts and frequency
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In terms of a percentage of equity, measure the return on your investment in a facility as compared to the S&P 500 or some other measure
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Be concious about how you leave the partnership and how the non-compete clause, if any, may effect you
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Beware of offers and financial incentives outside of Stark Law provisions
Lease a day or two
Billing and EHR systems are not always a one-size fits all solution. Some practices and Facilities have unique requirements or business rules that when managed and integrated into the billing system, drastically increase performance and the ability to get claims paid the first time billed. PSB uses a programmable database system in addition to its billing system, to enable complex task management, statusing, exception reporting, and other valuable features not available to most.
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What do you wish a billing/collection system could do for you?
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What information and informatics are you missing and what would you like to have?
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What processes in your practice need tracking and administration that are beyond the billing system capability?
Acquire, Build
& Manage
Is there a nearby facility to purchase and that can be made to meet your needs? Have you figured out the case volume and type needed to make a profit? How much equipment and experienced personnel will you need to make a venture like this work? Are you better off buiding a new facility and do you need governance structure to bring all the pieces together? PSB has approached and come through this process many times and can be immesaurably valuable at all stages and from planning to completion, and thereafter.
A facility owned by a hospital or corporate entity usually has at least 51% of the equity and doesn't bring any surgical cases or revenue. Their in-network with payers and usually at slightly higher rates than freestanding ASC's can negotiate. However, their operating costs are usually higher and in order to be profitable need a very high volume of cases that are closely managed to profitability when on a slim margin. Equity buy-in is usually higher than most feestanding facilities. Careful analysis and a cautious approach is best and PSB can help you to navigate.