OASC | BUSINESS TOOLS

OOSS Raises the Bar for Benchmarking

The organization’s new, more robust survey platform is a powerful tool for your ASC and the entire industry.

By Desiree´ Ifft, Contributing Editor

Since 2007, the Outpatient Ophthalmic Surgery Society (OOSS) has been the only entity to conduct a benchmarking survey to help ophthalmic-focused ASCs assess and improve their performance. Today, it remains the sole purveyor of this valuable information. Furthermore, the format of the survey and the quality of the resulting data have improved substantially. The new OOSSMark ASC Performance Metrics program is a shift to a cloud-based survey platform that employs more powerful analytics and enables custom reporting capabilities for participating ASCs.

The new platform facilitates numerous benefits, including:

■ Simplified reporting process. Survey respondents can provide their facility data in less time.

■ Faster turnaround of results. The survey now runs continuously. As soon as data collection closes for a given year, it opens for the next year. Results are posted as soon as a minimum number of facilities have provided sufficient data so that accurate and useful statistics can be presented (typically requires a minimum of 100 facilities). Participating ASCs have 24/7 access to the results.

■ Year-to-year comparisons for ASCs. The survey platform accumulates historical data for participants and enables them to track year-over-year performance on each benchmark beginning with year-end 2012 results.

■ Finer analysis of data. As participation in the survey expands, data can be broken down more precisely by facility characteristics, such as volume, geographic location and CMS region. In addition, each ASC can see how its performance on each metric compares with the best performers nationally.

■ Identification of trends. Historical data can be used to frame expectations and make projections about the future.

■ Comprehensive industry insights. The survey results reflect the quality of service provided by ophthalmic ASCs across the country and can be used to convey a reliable and accurate understanding of the industry to outside entities, such as governmental oversight agencies.

How the Benchmarking Program Works

ASCs that choose to be part of the OOSSMark ASC Performance Metrics program complete the annual survey online. They receive a Quick Guide Tutorial and Worksheet to assist them with compiling the necessary information about their facility. They can collect the information in advance and complete the survey as time provides.

As has always been the case, OOSS member ASCs help to define which performance metrics the survey tracks based on what information is most useful to them for monitoring their own performance and comparing it with their contemporaries across the country. (See “Metrics Currently Being Tracked”) The metrics tracked are periodically refined and expanded. For example, in the near future, more detailed metrics related to premium IOLs and new data points pertaining to femtosecond laser use will be added.

Once a participating ASC has satisfactorily completed the survey, it has access to the overall survey results. It sees its own performance on each metric charted alongside the performance of ASCs in the 25th, 50th and 75th percentiles (Figure 1). It can also monitor its percent change year over year on each metric, in which percentile its change falls and how it compares with the rest of the reporting ASCs (Figure 2).

Figure 1. The OOSS benchmarking survey results show an ASC its own performance on each metric alongside the performance of all ophthalmic-focused ASCs in the 25th, 50th and 75th percentiles.

Figure 2. ASCs that participate in the OOSSMark ASC Performance Metrics benchmarking program can monitor their year-over-year performance on a variety of metrics and compare their performance to the national data.

The survey program is open to all ophthalmic-only ASCs and ASCs for which ophthalmic surgeries are the primary component. Beginning in January 2015, only OOSS member facilities will be able to participate. (See “Continuing to Receive Essential Data”)

The Value of Benchmarking

Albert Castillo, Member Services Consultant for OOSS, knows firsthand how benchmarking tools can help pave the way to excellence and success for an ASC because he’s also the administrator at San Antonio Eye Center. The San Antonio Eye Center was founded in 1981 by Dudley Harris, MD, who had been performing outpatient surgeries even before he could be paid for doing so. His ASC was the first ophthalmic surgery center in Texas and among the first eight in the country to eventually be certified by Medicare. Today, the facility has four co-owners and seven surgeons who use it 4 days a week. Castillo relied heavily on the OOSSMark ASC Performance Metrics to help the ASC reach that point. “It was the primary tool I used in discussions with potential new owners,” he says. “For a time, we weren’t running at full capacity but we were employing full-time staff. The survey data allowed me to illustrate for the surgeons that we could keep the staff and bring in more surgeons without adversely affecting other key benchmarks, such as increasing overhead costs.”

Castillo explains that an increasingly important issue for the San Antonio Eye Center and other ASCs around the nation is positioning and managing the business in the context of managed care organizations. “Reimbursement tends to be lower in areas where many managed care companies are operating, but because we have the performance metrics at our disposal, we know whether or not there’s room to improve key financials, such as our cost per case, so as we’re negotiating our contracts, we know what we can and cannot accept as reimbursement,” he says. Castillo also cites a recent specific example of how benchmarking data led to a concrete improvement in performance for the San Antonio Eye Center. The OOSS survey data revealed that the center’s 12% rate of procedures canceled prior to the patient’s arrival was well above the average rate of 2.20% (Figure 3). “Once we discovered the problem, we took a much closer look at that 12% of cases,” Castillo says. “We learned that 50% of those patients canceled prior to surgery for other health-related issues, something we wouldn’t be able to do much, if anything, about. However, the other 50% canceled because they had difficulty getting in to see their primary care physician to be cleared for cataract surgery. This prompted us to ask ourselves three questions:

Figure 3. Once the San Antonio Eye Center was aware its cancellation rate was well above the national average, it was able to pinpoint why. It simplified its surgery clearance requirements and hired a physician assistant to perform the clearance exams on-site, which reduced the cancellation rate and improved the patient experience.

1) What exactly are we requiring for clearance of our cataract patients?

2) Is what we’re requiring in line with what other ASCs require? (knowing, of course, that some requirements are mandated)

3) What can we do to bring our percentage in line with that of our colleagues nationwide?”

The bottom line for the ASC was that it was able to simplify its surgery clearance requirements. In addition, the decision was made to bring in an ancillary provider (a physician assistant) who works in the practice performing history and physical examinations to determine whether patients can undergo surgery. Patients who don’t have multiple, major health problems can see the practice’s PA for clearance. The paperwork is all in-house, and patients no longer need to make an additional appointment with a primary care doctor. Castillo notes that the changes significantly improved the ASC’s efficiency, reduced its number of cancellations and improve the overall experience of patients.

“This was a perfect example of how benchmarking empowers an ASC to identify and solve a performance issue,” Castillo says. “It helps facilities answer all types of questions. Is our staffing level appropriate? Are salaries in line with national norms? Can we further optimize utilization of the facility? You can see whether your center is an outlier on any given metric, figure out why and what you can do to change it. With the new OOSSMark ASC Performance Metrics program, the ease of use, the number of issues we can analyze and the ways in which we can analyze them are all better than ever.” ■