Situation

Plaza Ambulatory Surgery Center (Plaza ASC) is a multi-specialty outpatient surgery center with more than 50 participating physicians and physician partners serving the Portland, Oregon area. A group of 26 individual physicians opened Plaza ASC in 2014. Joint venture partners include Regent Surgical Health, a leader in ASC joint venture management, for management support, and Providence Health and Services – Oregon (PH&S-O), a not-for-profit network of hospitals, health plans, physicians, clinics, home health services, and affiliated health services, also, the largest private employer in Oregon.

Located on the Providence Portland Medical Center campus, Plaza ASC’s mission is to provide patients with an affordable, high quality outpatient surgery experience in a convenient location. Its proximity to and partnership with the 483-bed Providence hospital helps fulfill that mission. Regent contributed structural guidance to the formation of the joint venture, helping to solidify a shared vision for Plaza ASC, which now offers orthopedics, including a total joint program, general surgery, ENT, spine/neurosurgery, pain management, GI, podiatry, urology, and gynecology. Regent continues to provide the management expertise that allows the two other partners to focus on their own strengths.

“This partnership brings direct benefits for our patients and physician partners and to the entire community here in the Portland area,” says Dr. Justin Rufener, board president at Plaza ASC. “It has been really enjoyable to be part of the process of developing the Plaza ASC and to watch it become successful. We’ve had great support from Regent, and Providence has been an excellent hospital partner. ”

Solution

Regent Surgical Health was integral in the formation of the Plaza ASC joint venture, both in terms of solidifying the final group of physicians that would represent the best range of medical specialties for success, and throughout the construction and the implementation phases of creating the new ASC.

“We wanted a management company that would bring a successful operating model to this ASC,” says Miriam Odermann, Chief Executive – Ambulatory Services at PH&S-O. “Regent was asked to develop the pro forma, provide payer contracting, recruit the ASC’s administrator involving the Board of Managers, and assist with the development and implementation of operations.”

Leveraging its experience developing, managing and owning joint venture ASC/partnerships, including currently 23 ASCs, 17 of which are joint ventures with leading hospitals, Regent helped ensure positive hospital-physician teamwork and mutual trust, developing policies for the new center, procedures for clinical care, instrumentation and equipment procurement, and providing oversight for the hiring of Plaza ASC’s leadership. In addition, Regent brought hands-on design and development expertise to the table, as well as the administrative and operational expertise needed to ready the new center for licensure and accreditation.

Once the new center was open, Regent continued to provide management guidance that has helped Plaza ASC grow from fledgling new opportunity to what it is today, an ASC success story consistently delivering quality care while also achieving best practices for successful business operation.

Results

As a result of positive teamwork between all three players in the joint venture, Odermann says Plaza ASC has developed strong relationships across the board, evidenced by a high level of engagement across all classes of owners, excellent participation in regular Board meetings and trust among partners. All of these lead to a refined ability to discuss critical components that affect the success of the ASC, and to effectively address any issues or concerns that arise.

In its first two full years of operations, Plaza ASC has enjoyed an impressive rate of growth. In terms of the number of patient cases, the center performed 2,772 surgeries in 2015, its first full year in operation, and continues to serve more and more patients with quality surgical care. In fact, the stretch goal for total number of cases projected for 2016 is 3,800-4,000 cases. Actual growth is bearing out that projection, with August volume of 360 cases.

What are the keys to the center’s success? According to Regent’s VP of Operations, Anne Roberts, Providence has been a great hospital partner. “Providence understands the importance of offering an alternate site of service for patients who qualify for outpatient surgeries, and has been instrumental in identifying cases better served by the ASC versus hospital,” she says. Being able to move appropriate procedures to a more efficient site of care is good for the hospital as well – enabling better stewardship of health care dollars being spent through their in-house health plan.

For example, Providence identified an opportunity to move its ophthalmology cases from the main campus to the ASC and, by October of this year, will have shifted most of those cases to Plaza ASC. “The great thing about Providence is they aren’t just a passive participant,” Roberts says. “They’re active at the board level, and they truly see the ASC as part of their whole system for providing optimal care.”

The physicians involved in Plaza ASC have enjoyed many benefits as well. “Working in an ASC offers a very collaborative environment for them, and it’s also extremely efficient. They can serve 7 or 8 cases in the time it takes for 3 or 4 in other settings,” Roberts explains. “In addition, they are very happy with the quality of care they’re able to provide, and enjoy having a voice and being part of operations at the facility level. They’re involved in decisions about those things that impact the quality of their experience, which creates a very positive culture and work environment.”

Regent’s role in helping the Plaza ASC physicians and Providence hospital leadership collaborate to meet their common goals has been essential to the success of this efficient, high quality ASC joint venture. Regent’s sound oversight lets each of the partners rest easy, thanks to an experienced eye over both patient care and operations that results in high patient satisfaction, physician satisfaction and business success.

“This was PH&S-O’s first “on hospital campus” joint venture ASC,” says Odermann. “It serves as a model for future developments on other hospital campuses within PH&S-O.”

Regent Surgical Health was proud to serve as the ASC joint venture management partner.