A successful ophthalmic practice must balance the delivery of patient care with sustainable cost containment. Achieving this requires more than isolated cost-cutting measures; it requires deliberate strategies that increase efficiency while preserving the quality of care. Over the past several years, our practice—the Vision Surgical Center in Jeffersonville, Indiana—has identified and implemented 4 strategies that have benefited our operations: engaged leadership coupled with staff buy-in, employee retention efforts, strategic staffing models, and proactive contract management. Together, these initiatives have enabled our practice to adapt to evolving economic pressures while maintaining our commitment to quality care and positive patient outcomes.

Engaged Leadership Coupled With Staff Buy-In

Leadership in the ambulatory surgery center (ASC) must maintain a continuous understanding of the practice’s financial performance. This is achieved through regular involvement in financial review meetings, ideally once a month, to evaluate trends against budgeted expectations. Consistent oversight allows leadership to recognize opportunities for improvement and implement necessary adjustments.

Staff buy-in is equally important in maintaining financial alignment. To achieve this, leaders must remain open and transparent with their team. We have found that touch-base meetings and routine discussions with our supply manager are key to evaluating inventory levels and identifying cost-saving opportunities. Another strategy implemented at our center is an operational dashboard that displays current surgical volume, patient satisfaction scores, and staff turnover rate. Providing a monthly visual analysis of operational data enables team members to see key performance indicators, allowing them to understand the rationale behind the decisions made within the practice.

Reducing Turnover Through Workforce Engagement

Staff turnover can place a significant financial strain on any organization. Beyond the direct costs of recruiting, hiring, and training, turnover can reduce productivity, weaken staff morale, and create a cycle of ongoing openings.

Identifying opportunities to improve retention and employee engagement is a critical step in reducing staff turnover. In addition to maintaining an open-door policy and consistent communication among leadership and staff, the Vision Surgical Center uses an interactive employee recognition program. The program enables employees to recognize one another’s contributions and earn points for their achievements. Every 10 points earned equates to $1.00, which employees can redeem at any time. This approach not only reinforces positive behaviors, but also promotes employee morale and workforce engagement, both of which are extremely important for long-term retention.

Strategic Staffing Models

ASC leadership should regularly evaluate the current staffing model to ensure that it aligns with operational needs. Leaders should consider surgical volume, case mix, anticipated patient acuity, physician preferences, turnover times, and specific staffing requirements of preoperative, intraoperative, and postoperative areas. Identifying high-volume and low-volume days, as well as seasonal fluctuations, can help determine when additional staff are needed and when a leaner staffing model is appropriate.

Maintaining a roster of pro re nata (PRN) staff has helped our practice contain labor costs by reducing payroll during low-volume days, limiting benefit packages, and decreasing the need for overtime. 

Cross-training employees has also been an effective cost-reduction strategy. Expanding an employee’s skill set has the potential to improve job satisfaction and reduce turnover. It also increases staffing flexibility by allowing team members to move among preoperative, intraoperative, and postoperative roles based on daily operational needs. 

Challenges to this approach may include staff resistance and the initial investment of time and resources required for training. Clearly communicating the expectation for cross-training during the initial interview process is important so that candidates understand the expectation from the beginning. Cross-training should be viewed as an investment in employee development rather than a way to reduce labor costs.

Proactive Contract Management

Reviewing contracts plays an important role in cost containment because it helps ensure that an ASC is receiving the best value for the services it needs while also confirming that vendors are following the agreed upon pricing and terms of the contract. At our center, the director of nursing and assistant director of nursing are responsible for overseeing contract reviews and monitoring vendor performance. Contracts are reviewed on a quarterly basis, at minimum, with particular attention to vendor performance, spending trends, and opportunities for improvement.

To support this process, we maintain a contract review form for each vendor. This provides a consistent method of evaluating performance, documenting concerns, reviewing pricing and services, and identifying opportunities for improvement. The documentation allows leadership to track vendor performance over time and provides a reference when contracts are renewed or renegotiated.

Focusing on high-cost items such as laundry services can be valuable when looking for opportunities to reduce expenses. Services should be evaluated regularly to ensure that they remain appropriate for the center’s current patient volume and operational needs. Even small pricing adjustments, billing discrepancies, or changes in service levels can have a significant impact on overall expenses. Identifying and addressing these issues early can result in meaningful savings over time.

Conclusion 

Cost containment measures must remain a priority for every successful business. Achieving sustainable cost containment requires thoughtful decision-making that supports both the financial stability of an organization and the delivery of quality patient care. Through engaged leadership, employee retention efforts, strategic staffing, and proactive contract management, we have been able to successfully adapt to the financial challenges of the health care system while maintaining our overall commitment to high-quality care. 

Kristopher Pugh, MD, is an ophthalmologist and physician leader at Vision Surgical Center in Jeffersonville, Indiana, with a focus on delivering high-quality ophthalmic care. He reports no financial disclosures.

Amanda VanHoose, BSN, RN, is the director of nursing at Vision Surgical Center in Jeffersonville, Indiana, where she oversees nursing operations and supports initiatives focused on quality patient care, staff engagement, and operational efficiency. She reports no financial disclosures.