Pre-Operative Testing Services

July 21st, 2017

A new trend is occurring where more doctors are demanding that the Ambulatory Surgery Center provides Pre-Operative Clearances for patients or coordinates a specific office to do so for them.  It is surprising when we see that many patients today seek out the specialist they need to correct their problem and don’t have a primary care physician that they see.  Because of this, the surgeons want us to set up clearances within the center just like the hospital does.

There are some obvious advantages to creating a pre-surgical testing department.  First, you will not be depending on anyone to get the results you need for your anesthesiologists to approve the case...

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Insurance Companies Dictating The Place Of Service

July 7th, 2017

Multiple experts in the industry have predicted for some time that this truly is the time for Ambulatory Surgery Centers to grow and become the main provider for all outpatient surgery. We have been told the reason for this would ultimately be economics. Well, here in the northeast this has now started to become a reality.

Many of the major insurance companies started with the self-funded plans they administered, contacting surgeons and telling them the procedure should be done in an out-patient center.  However, now they are reviewing precertification requests from surgeons and having them rejected if the place of service is a hospital and not an ambulatory surgery center...

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Organizational Readiness for Surveys

June 23rd, 2017

We all know that surveys occur once every three years and the Medicare deemed surveys have a 30 day window.  The biggest mistake I see freestanding Ambulatory Surgery Centers do is push three years of logs and work into three weeks.  This can be dangerous because of validation surveys and patient complaints (even unwarranted), can trigger surprise visits by the Department of health, CMS or the accreditation body you use.  But putting the surprises aside, as a small business, the cost of those three weeks can be very expensive.

Administrators and owners need to be disciplined to allow their staff the time each week to maintain all regulatory compliance issues.  It is important that they take five minutes to fill this log out or count responses back from the infection surveys...

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Improper Implementation Of EHR Systems Is Causing Liabilities For Physicians

June 16th, 2017

Meaningful use is a term that is now coming back to haunt many doctors who implemented Electronic Medical Records and took the government subsidy.  At current tally, CMS is estimating that at least 12% of the implementations were done wrong or did not continue to follow the protocols correctly that entitled doctors to the money. At present, the government is looking at the potential of asking for $729,000,000.00 back from the physicians.

The sad issue is that the guidelines to implement were very clear once you pick one of the approved programs. Laziness is why they find themselves in the current situation.

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Starting an ENT Program in Your ASC

June 13th, 2017

When exploring new specialties to enhance your surgery center, many people look at ENT as a lucrative program. In many instances it is, but you must do your homework first. Depending on the surgeon and types of cases they perform, it could very easily turn into a money pit in draining your resources.

First, you need to do some detective work and see what ENT surgeons are available and would be willing to try your center out. The best source for this information is to go to the vendors and see who is busy, efficient and perhaps looking for an opportunity. If you have established your vendor relationships correctly, they will want to help you, as you will be buying their products as your program takes off...

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New York ASCs band together to prepare for healthcare’s changes

June 8th, 2017

Right now is an exciting time in healthcare, especially for Jeffrey Flynn, administrator of New York City-based Gramercy Surgery Center and CEO of Gramercy Healthcare Management, LLC. Despite the barriers to overcome in successfully tying payment to value, healthcare is trending in that direction and many payers and unions are seeing the cost savings opportunities surgery centers present.

"Unions are pushing their people to go to surgery centers after seeing the cost factor and the [lower] infection rates. Unions are self-funded and they want to use us because we are less expensive," Mr. Flynn says. "Some major payers are telling their doctors they want cases done in surgery centers."

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Using Data to Drive Decision Making – Understanding Your ASC’s Cost per Minute

June 2nd, 2017

Its 7:30 am on the busiest surgical day of the week, the first case of the day in OR 1 is scheduled for 1 hour, and there are 6 other cases to follow. Cut time has been missed by 15 mins; the case ends up taking 1 hour 30 minutes.  The next case scheduled to start at 9 am, doesn’t start till 9:30 am and the day continues to lag behind. A day that had surgery ending at 5 pm doesn’t end till 7:30 pm, with the last patient discharged at 8:15 pm.  This is a familiar scenario even some of the most efficient ASC’s experience.

How many know what it really cost them? Not just what the possible overtime for staffing or medical supplies cost, but a true picture of total cost?

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Reality Is Setting In For Out-Of-Network Ambulatory Surgery Centers

May 25th, 2017

There was a unique opportunity for out-of-network surgery centers to move with the times back in 2013.  Sadly, most of them out of stubbornness or greed did not recognize the future and missed their opportunity.  It was then, that many insurance companies were willing to listen to the services you offer in comparison to hospital outpatient departments and were willing to give you favorable contracts with very realistic carve outs to perform your cases.  The process was a long one, but centers that did so found themselves with very stable models with room to grow by the mid- 2016.

As difficult as it was for ASC owners and management teams to face, survival over the next several years was the ultimate goal.  Those of us that took that difficult step are now thriving. 

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Making Your Scheduling Team A Marketing Asset

May 19th, 2017

The relationship between most hospital scheduling departments and the doctor’s office is at best described as hostile. Offices send items in and hospital departments claim they never received them. When the doctor shows up for surgery, there are at least four copies sent on different occasions in the chart.

Unfortunately, in the typical Ambulatory Surgery Center, the relationship is better, but only civil. Let there be a problem and both sides tense up for the blame game. This is bad for your business and most administrators think their scheduling coordinator is very efficient and immediately assume it’s the doctor’s office.  Let’s face it, mistakes do happen on both sides and if the proper relationships are established, problems get solved and not blown out of proportion.

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Integrating Urology Into Your ASC

May 11th, 2017

When selecting new specialties to integrate into your center many people immediately over look urology because as a specialty it tends to be very heavy dependent on Medicare as a payer mix.  However the efficient center should not pass up this option without carefully examining the potential.  Though the first assumption that it will be 75 to 80% Medicare is correct, this is a specialty that in most of its procedures requires very low cost supplies and the cases are completed in less than an hour.

There is also another source of cases through this specialty that is a definite advantage. The lithotripsy procedure to break up kidney stones gives you a special edge in Medicare approved surgery centers...

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Advocating for Higher Rates with Infection Control Data

May 4th, 2017

In working with individual ASCs, we have always pushed for the center to offer as many specialties that it can safely and financially handle.  Insurance payers are willing to listen if you can show them that you are truly an alternative to the hospital outpatient department and can provide them a savings in what they are paying you. Though this is an effective method of advocating for higher rates, your infection rate is now becoming a very powerful tool in the negotiations.

Insurance payers are now also focusing in on the cost of treatment for post-operative hospital acquired infections. Medicare has been looking at this for a number of years and trying to determine what financial role the hospitals should be responsible for in these infections...

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Keeping Efficiency In Your ASC

April 27th, 2017

To run a successful Ambulatory Surgery Center, we all know that efficiency plays a major part in achieving that goal. Turning over an Operating Room in a 12 – 15 minute time frame is what we all strive to achieve and when we reach that goal, it feels like we reached the mountaintop. The biggest challenge we have to recognize is that we have to maintain that efficiency level. Months and years of complicity is our greatest enemy against staying atop of the mountain.

A few years ago, I visited the administrator of an ASC who by all accounts ran a very tight and efficient ship. She was the right kind of administrator because she frequently left her administrative area to greet and listen to what the surgeons had to say.  The surgeons’ comfort level with her was apparent.

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Getting Your Pre-Op/Post Calls Up To a 99% Success Rate Without Significant Costs

April 20th, 2017

At most surgery centers, the pre-op and post-op phone calls are left to the nurses to do in the afternoon or in between their duties during the day. This causes situations where the patient arrives at the center for surgery but because they missed their pre-operative call, had neglected to mention a significant enough condition that warrants a same day cancellation in the pre-operative area. Even under the best intentions, there are times when the nurse calls, leaves a message, the patient returns the call but there is no nurse available to take the call and the issue goes undetected. Post-Operative phone calls face the same problem and can result in having an angry patient.

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The Alternative to the Hospital Outpatient Department

April 14th, 2017

In the infancy of our first ASC we didn’t truly grasp how diversifying specialties would impact our ability to thrive in a marketplace where Freestanding Multispecialty ASC’s were far and few between. In 2009 we learned very quickly that it was no longer viable to be over 50% of any given specialty, we needed to make a concerted effort to recruit a wide range of physicians that covered a diverse specialty mix.

With this driven commitment over the last 8 years, we now have 13 active specialties, which dramatically impacted the utilization of our centers. The increase in volume and diversity of specialties offered was also a strategic negotiating tool when it came to contracting with payers. We were able to showcase to each individual payer the true benefits of our Multispecialty ASC’s versus the HOPD.

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Cancer Care in the Ambulatory Surgery Center Setting

April 6th, 2017

Several ambulatory surgery centers around the country have active cancer treatment programs.  These centers are able to provide Breast Cancer Services such as lumpectomies and Simple Mastectomies.  The true benefit to the patient is that they are in a private environment with much lower infection rates compared to the chaotic setting of a hospital.  Patients very often are able to be treated faster in these settings. John Kehoe, MD, has been a Breast Cancer Surgeon in New York City for over 30 years.  This is his experience in what he can offer to his patients in the ambulatory surgery center setting.


Renee and Eileen: Breast Cancer Treatment at the Speed of Light

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Large Growth in Ambulatory Surgery Centers over the next 7 years

March 30th, 2017

All of us who are involved in outpatient surgery are at the crossroads of healthcare’s future in this country.  Large hospital systems and individual smaller hospitals are now looking toward ambulatory surgery centers as a way to deliver healthcare at a more affordable cost.  Many of these institutions are seeing their own outpatient surgery departments as money losers and are now trying to figure out ways to turn these situations around.  The obvious answer has been staring them in the face for some time.  Free-standing Ambulatory Surgery Centers don’t have to be the enemy of the hospital but should be their little brothers in the future.

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Why IPAs & unions approach this New York-based ASC administrator in droves

October 18th, 2016

A new trend is taking hold in the state of New York as commercial payers increasingly understand the value of ambulatory surgery centers. As administrator and vice president of business development of New York City-based Gramercy Healthcare Management that oversees Gramercy Surgery Center, Jeffrey Flynn, CASC, has had more independent physician associations approach him in the past two months about transitioning cases to the surgery center. IPAs haven't historically worked with ASCs as many surgery centers were out-of-network and could face backlash from payers. Recently, however, many payers are driving IPAs to surgery centers because ASCs present a significant cost-savings opportunity while also providing high quality services.

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Administrator tip of the day: Gramercy Surgery Center’s Jeffrey Flynn discusses contracting with insurers & maintaining relationships with hospitals

May 17th, 2016

Jeffrey Flynn, administrator for New York-based Gramercy Surgery Center, explains how multispecialty ASCs can obtain better insurance rates and why ASCs should foster good relationships with hospitals. "To date, insurance companies are well aware of the differences between in-network ASC rates and HOPD rates. Hence, insurance companies are more open to communicate or negotiate with ambulatory surgery centers that offer multiple specialties, whereas ASCs with only few specialties often find it difficult to keep payors interested. Multi-specialty ASCs can educate and collaborate with payors and reach favorable results more efficiently."

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Your golden ticket: 5 tips for obtaining a CON in New York City

April 19th, 2016

New York City-based Gramercy Surgery Center's Jeffrey Flynn has been through the trenches with the state's certificate-of-need process, and has come out equipped with the knowledge and skill-set to develop successful centers. "After 10 years, patients still approach me about cutting corners," says Mr. Flynn, Gramercy's administrator and vice president of business development. Patients may refuse to be weighed, or want to forgo other measures that may ultimately compromise a center's license. "If a patient wants to cut a corner, that is a patient you don't need. Your CON is your golden ticket that you have to maintain," Mr. Flynn adds.

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Gramercy Surgery Center hosts 1st Ablatherm Robotic HIFU prostate ablation: 5 key notes

March 7th, 2016

The first prostate ablation treatment with the Ablatherm Robotic HIFU was performed at the Gramercy Surgery Center in New York. Here are five things to know:
  1. Ivan Grunberger, MD, chief of urology at New York Methodist Hospital and professor of clinical urology at Weill Cornell Medical College, performed the procedure. Judd Boczko, MD, assistant clinical professor of urology at New York Medical College practicing with Westmed Medical Group, assisted in the procedure.

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First Patients Treated With EDAP’s Ablatherm® Robotic HIFU in New York

March 7th, 2016

The global leader in therapeutic ultrasound, today announced the first prostate ablation treatments performed at Gramercy Surgery Center in New York, NY, using the Company’s FDA-cleared Ablatherm Robotic HIFU. Dr. Ivan Grunberger, Chief of Urology at New York Methodist Hospital and Professor of Clinical Urology at Weill Cornell Medical College, performed the procedures. He was assisted by Dr. Judd Boczko, an Assistant Clinical Professor of Urology at New York Medical College who practices with Westmed Medical Group. The Ablatherm Robotic HIFU used is owned by American HIFU, LLC, who have mobilized it to provide HIFU access to select urologists and clinics throughout much of the United States.

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Challenges driving innovation for ASCs — 8 key observations

November 5th, 2015

Here are eight observations from Jeffrey Flynn, COO and administrator of Gramercy Surgery Center and Gramercy Healthcare Management in New York City on the biggest challenges and opportunities in the ASC field today.
  1. Consolidation within the industry changes cost per case.When device companies merge with each other, the implant costs could fluctuate. In one example, Mr. Flynn noticed the implant for an orthopedic case went from the contracted $110 per implant to $450 per implant after two companies merged.

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Gramercy Healthcare Launches ASC OR optimization solution — 5 things to know

October 7th, 2015

Gramercy Healthcare is launching a copyright-registered operating room optimization solution designed for ambulatory surgery centers. Here are five things to know about SURGERY ON TIME — the platform designed for improving ASC efficiency:
  1. SURGERY ON TIME is a web-based scheduling system for single or multispecialty surgery centers with a calendar integrated system designed for improved organizational communications across the ASC's board. The platform allows multiple users to schedule specialized cases.

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Gramercy Healthcare Aiming for $50 Million Ambulatory Surgery Center Industry

October 6th, 2015

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Breaking tradition: 4 potential ASC partners not to discount

September 11th, 2015

Partnerships are essential to ASC survival. Hospitals, health systems, management companies, physicians and even private equity firms are common options, but surgery centers can find fruitful relationships in unexpected places. Here are four out-of-the-ordinary partners that can prove beneficial for ASCs.

1. Academic medical centers. Academic medical centers do not necessarily have to own a stake in a surgery center to be a valuable partner. Magna Surgical Center in Chicago founded a program a bariatrics program in 2001 in partnership with the University of Illinois at Chicago. The multidisciplinary ...

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Gramercy Surgery Center Recognized by Becker’s ASC Review

August 26th, 2015

Gramercy Surgery Center, under Gramercy Healthcare's management, has been recognized by Becker's ASC Review as one of the top 15 ambulatory surgery centers in New York.

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Gramercy Surgery Center, AABP Anesthesiology partner — 3 things to know

June 3rd, 2015

Gramercy Surgery Center in New York has entered into a strategic partnership with AABP Anesthesiology for anesthesia and pain care services. Here are three things to know:
    1. Gramercy Surgery Center includes more than 350 credentialed physicians. It has treated more than 20,000 patients since its opening in 2006.
  1. The surgery center is managed by Gramercy Healthcare Management, a healthcare management and consulting company.

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Gramercy Surgery Center and AABP Enter Strategic Partnership

June 2nd, 2015

NEW YORK, June 2, 2015 /PRNewswire/ -- Gramercy Surgery Center, the leader in multi-specialty ambulatory surgery centers in the New York Metro area and AABP Anesthesiology (AABP), the pioneer in integrative pain care treatments, announced that they have entered a strategic partnership in providing anesthesia services and pain care treatments for patients at Gramercy Surgery Center.

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Gramercy Healthcare Enters Queens Market

May 14th, 2015

Gramercy Surgery Center, the leader in multispecialty ambulatory surgery center, opened the doors on its brand new satellite facility in Queens, NY. Located right off the Exit 24 on the L.I.E., the 11,000-square-foot facility with 35 parking spaces will provide more than 50 jobs to the Queens Community.

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Gramercy Surgery Center to house Brachytherapy Center of Excellence

April 21st, 2015

Gramercy Surgery Center in New York has partnered with CivaTech Oncology to open a brachytherapy center of excellence. The new center will be housed in the Manhattan surgery center, as well as the center's new 11,000-square-foot location in Flushing, N.Y. The center will feature CivaString and CivaSheet brachytherapy technology. Gramercy Surgery Center was one of the first outpatient centers to perform brachytherapy.

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CivaTech Announces NYC Brachytherapy Center of Excellence

April 21st, 2015

Gramercy Surgery Center and CivaTech Oncology are proud to announce their partnership to form the first-of-its-kind Center of Excellence—a regional flagship care provider and training site for CivaString and CivaSheet brachytherapy technology. The Center will be based at of Gramercy Surgery Center in Manhattan as well as its brand new 11,000 sq. ft. ambulatory surgery center in Flushing, Queens, which is slated to open its doors and perform its first operation later this month.

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Gramercy Healthcare Featured on Becker’s ASC Review

April 3rd, 2015

The landscape for ambulatory surgery centers is challenging. Especially for centers in certificate-of-need states. Especially for centers in large metropolitan areas. Especially for centers traditionally relying on out-of-network contracts. Yet Gramercy Surgery Center, based in New York City, experienced success despite these odds to grow from a multispecialty surgery center to a multi-location provider that also includes a management company arm.

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Gramercy Healthcare Collaborating with Hyperbaric Medical Solution

March 3rd, 2015

Gramercy Healthcare is pleased to continue its relationship with Hyperbaric Medical Solutions. This innovative company provides state-of-the-art Hyperbaric Oxygen Therapy (HBOT) at its free-standing facility at 160 East 32nd Street NY, NY.

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GSC-Queens Grand Opening Dinner Success

February 24th, 2015

The GSC-Queens Grand Opening Dinner and Open House Tour was a success, as area surgeons flocked to see Queens County’s newest healthcare destination.

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5 Out-of-the-box ideas for ASCs to collaborate with hospitals (but stay independent)

February 6th, 2015

A lot of ambulatory surgery centers pay lip service to developing cordial relationships with hospitals and physician groups in their local area, but few actually pursue them in a way that makes a difference. Gramercy Surgery Center in New York is one that does. Gramercy Surgery Center is a multispecialty ASC in New York City's Manhattan borough — one of the toughest places to run an effective ASC. Yet, Jeffrey Flynn, COO of Gramercy Surgery Center and the newly-launched Gramercy Healthcare Management was able to partner with surrounding hospitals to show the ASC's value and prevent hospitals from blocking their expansion.

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5 Fresh ideas for differentiating your ASC

January 26th, 2015

Here are five new services that will differentiate your ambulatory surgery center from COO of Gramercy Surgery Center and Gramercy Healthcare Management Jeffrey Flynn.
  1. Add lap band.Gramercy is the first surgery center in New York to implement a lap band program. "It's a safe procedure and a relatively small feat," says Mr. Flynn. "Given the issues with gastric bypass and malpractice risk, ASCs that want to reinvent themselves have to look at new procedures and this could be one of them."
Although obese patients are typically considered "high risk," when the procedure can be done outpatient at the hospital it can also be done at the surgery center. Keep patient selection tight and form a good relationship with hospitals in case a transfer is necessary.

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