Ambulatory Surgery Center Development and Support

Feasibility Study

A detailed feasibility study is the first step toward making an informed decision about building a surgical center.


Without hard facts and evidence up front, time and effort could go toward a fruitless and often expensive experience. No one is served by putting together a project that does not meet the needs of physicians and the community.  Toward that end Earnhart & Associates undertakes a highly specialized study that will answer important questions that allow your organization to foresee the benefits or difficulties of a freestanding surgical facility.

As you’ve contemplated the possibility of a new surgical center, important questions may have already arisen:
How much does it cost to build?

  • How many cases will make a surgery center profitable and what kind of return on investment can we expect?
  • What kind of partnership structure is best for us?
  • Will the physicians use it?
  • How do we make it accessible to both the physicians and patients?
  • How do we deal with Stark?
  • What are the governance issues?
  • Who will manage the center?

These and dozens more are typical and appropriate questions that Earnhart & Associates understands are pivotal to a well planned venture. Like you, working on successful projects is our only option, therefore we thoroughly investigate the potential of your proposed surgical center and use the most penetrating and objective evaluations to arrive at decisions.
A feasibility study will begin with three to five days of gathering information and interviewing individuals and physicians within the organization. After thoroughly analyzing conditions and making an accurate assessment of the viability of your proposed facility, Earnhart & Associates will be able to recommend the partnership structure to be used as the investment vehicle.

Turnkey Ambulatory Surgery Center Development

We manage every step of the labor intensive job of building your new surgical center from creating the legal partnership to hiring staff to marketing the new facility.

Developing a surgery center, either for a physician group, a hospital, or both, is a long and labor intensive process requiring over 1,100 individual forms and 1,700 man-hours of effort!  The typical development process can take between four to eighteen months to completion and involves activities as varied as creating legal partnerships, hiring staff  and  marketing the new facility.

There is no magic about the development of a surgery center. But it does require a strong ability to identify, analyze and solve problems, meticulous attention to detail and a through understanding of all aspects of the legal, technical and management areas of building a facility. There are virtually hundreds of steps involved and many issues that will arise along the way. Can you do it yourself? Certainly! The question is, how much time can you afford to devote to a project that will consume your energy, stretch your administrative capabilities and still continue to manage your healthcare business?

When we say we provide a “turnkey project,” we mean just that. After a detailed feasibility study we manage every step of the project beginning with creating a legal structure and ensuring financing.  We take care of virtually every detail from recommending architectural firms to medical staff by-laws. At the end of the project, you have a Medicare Certified ASC that is designed to be cost efficient, properly staffed, and meets the needs of your community and users.

Hospital / Physician Joint Ventures

Earnhart & Associates is the leader in the successful process of putting surgeons and hospitals together in new surgery center joint ventures.  For over 17 years we have been working with both groups to combine the best of all worlds in the area of ambulatory surgery facilities.

Developing a surgery center, either for a physician group, a hospital, or both, is a long and labor intensive process requiring over 1,100 individual forms and 1,700 man-hours of effort!  The typical development process can take between four to eighteen months to completion and involves activities as varied as creating legal partnerships, hiring staff  and  marketing the new facility.

There is no magic about the development of a surgery center. But it does require a strong ability to identify, analyze and solve problems, meticulous attention to detail and a through understanding of all aspects of the legal, technical and management areas of building a facility. There are virtually hundreds of steps involved and many issues that will arise along the way. Can you do it yourself? Certainly! The question is, how much time can you afford to devote to a project that will consume your energy, stretch your administrative capabilities and still continue to manage your healthcare business?

When we say we provide a “turnkey project,” we mean just that. After a detailed feasibility study we manage every step of the project beginning with creating a legal structure and ensuring financing.  We take care of virtually every detail from recommending architectural firms to medical staff by-laws. At the end of the project, you have a Medicare Certified ASC that is designed to be cost efficient, properly staffed, and meets the needs of your community and users.

Ambulatory Surgical Center Management & Management Oversight

An investment in top quality management is an investment in the success of the facility. Providing your staff and board an objective and knowledgeable assessment of where you need to be as your project grows.

The typical surgery center is a multimillion dollar investment, a business entity and a relevant addition to any community providing jobs and healthcare to a significant number of citizens. The management of an ambulatory surgery center is complicated.  It is highly regulated and has complex compliance issues that, if not followed, can result in criminal prosecution.    The partners in such facilities generally have additional practices and healthcare businesses that demand their attention and the added responsibility of managing a surgical facility can be overtaxing.

Part of our development plan is to secure the right people and train them to effectively apply sound management principles. Time and training is required to mold the staff into a cohesive team and management is required to put out fires on a daily basis.  An investment in top quality management is an investment in the success of the facility.

One option toward that end is to retain the services of Earnhart & Associates ASC Management Services.  We can design this option around the needs of the partnership and provide the level of involvement you desire.  Once your surgical center is operative, we can continue to stimulate efficiency and effectiveness, handling every issue from managed care contracting to personnel issues to profit and loss statements.  Our on-site manager will successfully define, measure, and increase productivity, all the while promoting your organization policies, the quality of your ASC and its reputation.

Full management services are often not necessary, however, and we can adjust the scope of service to a short-term option with our management oversight service.

Office-Based Surgery Center

As more procedures are pushed into a lower cost environment an office-based surgery center may be the best option for your practice.

There is increasing pressure from Medicare and other insurance providers to push more procedures into a lower cost environment.  If the newest Medicare legislation affects you it may be time to consider an office-based surgery center to enhance your practice growth potential through cost saving efforts.

Earnhart & Associates can provide you with the same thorough service for your office based surgery as we do for Ambulatory Surgical Centers.  We work with you to assess your current needs and propose a plan of action which is timely, realistic and appropriate for proposed surgery suite.

State and federal regulations to insure the safety of patient’s health and safety are becoming increasingly strict concerning office based surgeries, and EAI can guide you through the maze of standards and practices to ensure that you meet appropriate patient safeguards.

Alternative to Joint Ventured Ambulatory Surgery Center? Oh, Yes!

Sometimes it does not make fiscal sense to develop a free-standing surgery center.  Check it out – this could be for you!

Sometime developing a free-standing joint ventured surgery center does not work or make fiscal sense.  This could be for the surgeons or the hospital. Earnhart & Associates understands that dilemma.
There are alternatives that Earnhart & Associates are currently doing for a number of our clients.  These options do not require a financial investment for either the hospital or the surgeons.  They provide the assurances the surgeons demand in efficiency but maintain hospital reimbursement rates.

Troubleshooting

Do you sometimes lie in bed at night and think that something is just not right with your surgery center?

Do you sometimes lie in bed at night and think that something is just not right with your surgery center? Do you look at your Profit and Loss Statement and wonder how you compare with other facilities? Is your “same store growth” going in the wrong direction? Are the profits what you thought they would be? Is your staffing too high or too low? Are you paying too much for your supplies? Is it time to employ anesthesia or keep them on a fee-for-service arrangement? Sometimes you just need know where you stand.

Earnhart & Associates can assist you in answering these questions and more. In the majority of cases we can answer your questions with a one or two day visit to your center. We are going to ask for some information before we get there – talk to individuals once we arrive – then give you a detailed exit summation that same day! We’ll tell you our opinion of your facility, based upon our observations, experiences, and like facilities across the country. Our fee is flat rate, not an open-ended hourly rate. You know the total fee before we begin.

Give it some thought because sometimes you just have to know.