ASC vs office

[Yo GabbaPentin]

Trying to figure out where I should do most or all injections. I am part of a large multispecialty group and not an owner of ASC yet.

Realized that I'm getting charged significant overhead. I am paying about $2000 per month for X-ray tech, $3000/month supplies, $600 meds, $500 c arm rental, $200 c arm maintenance, $1250 rent JUST FOR THIS room. This is on top of $4000 for office rent, which is separate and fixed. I am only doing about 10 injections per week in this room right now and have no access to any sedation. Could bump it to about 30 per week.

So for those of you out there with better number skills than mine.... Would I be better off just going to ASC and not have to worry about all the damn overhead?

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[powermd]

Trying to figure out where I should do most or all injections. I am part of a large multispecialty group and not an owner of ASC yet.

Realized that I'm getting charged significant overhead. I am paying about $2000 per month for X-ray tech, $3000/month supplies, $600 meds, $500 c arm rental, $200 c arm maintenance, $1250 rent JUST FOR THIS room. This is on top of $4000 for office rent, which is separate and fixed. I am only doing about 10 injections per week in this room right now and have no access to any sedation. Could bump it to about 30 per week.

So for those of you out there with better number skills than mine.... Would I be better off just going to ASC and not have to worry about all the damn overhead?

That's $11550/mo. Assuming $300/injection on average assuming you do some higher value procedures to balance out the $140 Medicare LESIs, you're making in the ballpark of 12K in fees. How is this arrangement at all worth it?

 

[Yo GabbaPentin]

Right now I'm doing about 10 per week on office and 10 at ASC. I really just started in December so still building volume.

 

[Yo GabbaPentin]

Anyone? Where do the majority of you all do injections if you don't currently have ASC ownership interests? Do you still make more in office after having to pay overhead?

 

[pmrmd]

Your situation is BS. A complete joke. I should hope you can get out of it. Rent is too high, rad tech salary too high, supply cost too high. $5250 in rent? That's insane, especially if you are part of a group. You are buying the building for someone, but it isn't you. $3000 for supplies is what I spend on two offices and an ASC. Rad tech? In an office? Do it yourself, I do. I don't know how you sit down because there is a giant pole up your arse. There isn't a good place for you to do injections really. Your office expenses are too high and your ASC revenues will be too low.

 

[Yo GabbaPentin]

My situation is fluid and the management had this all set up based on previous guy. Situation is fluid. So best choice would be to lower costs in office rather than just do everything at ASC? When you have ownership in ASC, is the profit from facility fee worth doing more there or are you always better off doing in office?

 

[Aether2000]

In the face of rapidly collapsing reimbursement, the situation described is unsustainable financially. Need to re-negotiate all aspects of the office procedure contract.

 

[bronchospasm]

There is an alternative to the rad tech... It's called a foot pedal. Train your MA to move the C - arm. Your rent is too high. Most office space is about $15-18 per sq foot per year. You are paying 62 K a year on rent. It takes 3-4 years to pay off your investment in an ASC. Who knows what will happen till then. Best bet is to lower costs and do procedures in office and optimize your time by seeing office visits in between procedures.

Same boat as you. Started in September end. Doing 35-45 procedures a week. Bought C-arm, table and Stryker multigen- no loans

Costs as follows:
Rent : $2000
MA x 3 : $11 per hour: $5000 per month
Supplies : $1500-2000

 

[hyperalgesia]

There is an alternative to the rad tech... It's called a foot pedal. Train your MA to move the C - arm. Your rent is too high. Most office space is about $15-18 per sq foot per year. You are paying 62 K a year on rent. It takes 3-4 years to pay off your investment in an ASC. Who knows what will happen till then. Best bet is to lower costs and do procedures in office and optimize your time by seeing office visits in between procedures.

Same boat as you. Started in September end. Doing 35-45 procedures a week. Bought C-arm, table and Stryker multigen- no loans

Costs as follows:
Rent : $2000
MA x 3 : $11 per hour: $5000 per month
Supplies : $1500-2000

Seems like things are going pretty well... Are you glad you went on your own vs with that other dude?

 

[Yo GabbaPentin]

FWIW I'm in a large multispecialty group and on salary+RVU bonus. When I become partner it will be strictly eat what you kill and group takes a small %. I need to make this situation viable prior to getting to that point. When I become partner I also get opportunity to buy in to the ASC which is why I'm trying to figure out if it is worth doing things there in the future.

I'm looking for a lightly used crystal ball if anyone has one.

 

[drusso]

FWIW I'm in a large multispecialty group and on salary+RVU bonus. When I become partner it will be strictly eat what you kill and group takes a small %. I need to make this situation viable prior to getting to that point. When I become partner I also get opportunity to buy in to the ASC which is why I'm trying to figure out if it is worth doing things there in the future.

I'm looking for a lightly used crystal ball if anyone has one.

I agree with the other observations. People (your employers) aren't being transparent with you.

 

[Pacman27]

Not trying to hijack the thread, but for those of you that do procedures in the office vs ASC are you able to negotiate higher rates with the insurance carriers???

I do all of my procedures in my office and some of my contracts are still below medicare rates, but beggars cant be choosers. However, when I speak to some of the primary care docs with capitated contracts they love the fact that I am able to save them a ton of money.

Also, I have my MA trained great and I just use the foot pedal most of the time. On occasion she slips and hits the button before I get in the room. There are def areas you can slim down on cost.

 

[lonelobo]

Not trying to hijack the thread, but for those of you that do procedures in the office vs ASC are you able to negotiate higher rates with the insurance carriers???

I do all of my procedures in my office and some of my contracts are still below medicare rates, but beggars cant be choosers. However, when I speak to some of the primary care docs with capitated contracts they love the fact that I am able to save them a ton of money.

Also, I have my MA trained great and I just use the foot pedal most of the time. On occasion she slips and hits the button before I get in the room. There are def areas you can slim down on cost.

If you don't you need to be getting higher rates otherwise why are you doing them in an office if an ASC is available?

Your argument to the Carriers for higher rates is that you can still save them 75%-100% of costs doing them in your office, if they don't at least listen
they are just plain dumb.

 

[bronchospasm]

Seems like things are going pretty well... Are you glad you went on your own vs with that other dude?

I am glad that I did not join that D'bag. Guess I dodged that bullet... Can't thank everyone on this board enough. They have always come through with the right advice ...