From an administrative perspective, physician-owned ASCs must develop strategies to accomplish critical business and financial tasks in order to succeed. Day-to-day administrative functions must be performed by the owners of physicians or the staff they employ. Contracting with insurance companies can be a difficult process. Medical centers may find this particularly challenging due to their small size and the lack of expertise of an experienced ASC management company or hospital. Nevertheless, there are great benefits to doctors` ownership, such as autonomy and control. This typically results in a clinical environment with a high quality of care for patients and comfort for physician owners (24). There is a flatter hierarchy that can lead to better patient access to medical operators who have direct knowledge of the patient`s clinical situation and control of the care environment. Medical entrepreneurs often drive innovation and progress. The development of the ASC market creates newer and more creative models, such as a three-way joint venture between the doctors, the management company and the hospital system. All three parties bring something to the company.
Physicians are the primary producers and their involvement in the property is critical to success and clinical supervision. Experienced management companies can bring their expertise in financial, surgical and physician recruitment. As hospitals are increasingly involved in the ASC environment, they are getting involved in this type of business and are likely bringing better contracts for greater financial stability and are willing to hand over equity to a management company for their greater expertise and experience for operational success. The second model is a joint venture between physicians and a CSA management company. The actual execution of this model varies considerably depending on the majority shareholder. Physicians may still hold most of the equity and thus have control over management decisions, but they have the expertise of an ASC company to assist with execution, contract awarding, revenue cycle management, and various other key issues. Some CSA management companies engage in joint ventures with physicians and control the majority of owners. In such situations, asc can offer greater advantages to increase its market share and turnover. Make sure that the management agreement complies with the current recommendation law (most likely kickback status). The usual requirements apply: management fees must be set in advance, be in accordance with fair value, be economically reasonable and disregard the volume or value of recommendations. The interesting topic is the percentage of remuneration. Most administrative costs are a percentage of the area`s net revenue or revenue.
However, the Kickback Safe Harbor does not allow compensation in percentage. If you want a percentage of compensation, you won`t receive the Safe Harbor benefit, which means you don`t meet the general kickback requirements. This should not be a problem until the manager is a source of recommendations. On the other hand, you might have a problem if the manager conducts marketing activities aimed at generating patients for the ASC, or if the manager is owned by doctors who can give or receive transfers (for example.