B&B + ASC Ownership?

[klumpke]

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A question as I start interviewing with some practices- I am planning to mainly stick to bread and butter procedures. All included, I'd prefer to stick to TFESI, ILESI, MBB/RFA, SI, peripheral joints, and maybe add in orthobiologics. If this was the full spectrum of what I'd be doing, would I still be given the option of ASC ownership? I know there is that anti-kickback rule that says >30% of procedures would have to be in the ASC. Are B&B procedures often still done at an ASC in these circumstances or are these classified as office-based?

Thanks so much, I really appreciate it!

 

[Status Sciaticus]

you could, but theyre not really profitable procedures in the ASC due to the increased overhead. So any ASC giving you shares would not be getting a good ROI. Maybe some on the RFAs.

 

[RoloTomassi]

Depends a lot on your contracts, payer mix. The margins for us are much better than if we did in office. We run the surgery center pretty lean and efficiently, not much more overhead than in office. Actually faster than office since there's 2 rooms. Your procedure mix should have no bearing on whether partnership is offered though.

 

[mille125]

Depends a lot on your contracts, payer mix. The margins for us are much better than if we did in office. We run the surgery center pretty lean and efficiently, not much more overhead than in office. Actually faster than office since there's 2 rooms. Your procedure mix should have no bearing on whether partnership is offered though.

I agree with this...

 

[mille125]

A question as I start interviewing with some practices- I am planning to mainly stick to bread and butter procedures. All included, I'd prefer to stick to TFESI, ILESI, MBB/RFA, SI, peripheral joints, and maybe add in orthobiologics. If this was the full spectrum of what I'd be doing, would I still be given the option of ASC ownership? I know there is that anti-kickback rule that says >30% of procedures would have to be in the ASC. Are B&B procedures often still done at an ASC in these circumstances or are these classified as office-based?

Thanks so much, I really appreciate it!

They can be done in both places. How they are classified depends on site of service.

 

[Dr. Ice]

Margins for bread and butter shots in asc still better than something like ortho. Depends on the “type” of asc. Ortho would welcome it, a pure pain group with ownership may poo poo bread and butter if they are doing a lot of stim, etc

 

[BobBarker]

No, I wouldn’t offer ownership in an ASC for someone doing basic procedures only. Margin is ok for RFA but everything else is bad. Can’t do major joints and SI joint in the ASC typically.

 

[mille125]

No, I wouldn’t offer ownership in an ASC for someone doing basic procedures only. Margin is ok for RFA but everything else is bad. Can’t do major joints and SI joint in the ASC typically.

HOPD's get much more. for bread and butter procedures.

 

[PinchandBurn]

A question as I start interviewing with some practices- I am planning to mainly stick to bread and butter procedures. All included, I'd prefer to stick to TFESI, ILESI, MBB/RFA, SI, peripheral joints, and maybe add in orthobiologics. If this was the full spectrum of what I'd be doing, would I still be given the option of ASC ownership? I know there is that anti-kickback rule that says >30% of procedures would have to be in the ASC. Are B&B procedures often still done at an ASC in these circumstances or are these classified as office-based?

Thanks so much, I really appreciate it!

30% of medicare. Not 30% of everything..

 

[klumpke]

30% of medicare. Not 30% of everything..

Oh really? So one could hypothetically just schedule their Medicare procedures at the ASC?

 

[PinchandBurn]

Oh really? So one could hypothetically just schedule their Medicare procedures at the ASC?

Correct

 

[IYKYK]

I second the fact that B&B procedures do not make as much money in the ASC due to increased overhead.

Do you guys sedate patients in the ASC?

 

[Dr. Ice]

When I was part of an asc, the ortho guys tried to tell me that scs trials that I was doing were just “ok” cause they paid well but cost a lot. And I was thinking to myself..bro you’re ortho your margins suck and that’s why this asc is tanking.

Think they would have much rather me do 40 B&B procedures there a day

 

[jsaul]

its a volume game for B&B at the ASC. they like 20 esi's a day.