whenever possible. In fact, one of Ohio Surgery Center's major payers
was directly responsible for the facility's influx of total thyroid cases.
The payer actually came to the surgeons in the facility's ENT group
with data on what surgeons were doing what at the hospital and gave
them an incentive to migrate a certain percentage of them to the sur-
gery center. This need gives you some leverage. But if you're going to
add this procedure at your facility, you need to do your homework,
know your costs and negotiate heavily with your payers about carve
outs in your contracts. "For us, reimbursement wasn't just X-percent-
age of Medicare," says Ms. Walton. "Our payers were very willing to
work with me on costs and gave me really good reimbursements
because they were still paying a third or even a fourth of what it costs
to have these procedures done in a hospital."
5. Robotic hernia
repair. It wouldn't
be right to talk new
procedures without
mentioning robotics
— and robotic her-
nia repair, inguinal
hernias in particular,
are increasingly
being done on an
outpatient basis. For
good reason. Price,
the ultimate barrier
for most hospitals and ASCs, isn't quite as restrictive as it was just a
few years ago. Granted, the $1 million to $2 million upfront cost and
$100,000 annual maintenance costs make the robot seem out of reach
6 4 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J U L Y 2 0 1 9
• MARKETING MARVEL While the upfront costs and maintenance of the robot are
indeed steep, the ability to handle cases robotically instantly makes your facility more
marketable.
Florida
Hospital
Tampa
