Hospitals aren’t the only place where outpatient procedures can take place. Learn more about the revolutionary concept behind this surgery specialist and how it compares with alternative choices.
Just a few decades ago, people who were told they needed surgery automatically assumed it would be performed in a hospital.
As the trend toward increased outpatient surgeries expanded, on the strength of evolving technology in the form of minimally invasive equipment and methodology, limited-focus surgery centers such as Rockford Ambulatory Surgery Center (RASC) were developed. They began to flourish when patients discovered the value, convenience and ease of having procedures performed there rather than at hospitals.
RASC has been serving Rockford and its surrounding communities since August 1994. Since that time, more than 90,000 patients have had procedures performed in its state-of-the-art facility at 1016 Featherstone Road, just off Guilford Road on Rockford’s east side.
Dr. Steve Gunderson, CEO and administrative medical director, says one of the reasons patients appreciate having their surgery there is that the preoperative process has been streamlined and can be completed on the telephone.
Additionally, patients are not subjected to routine laboratory testing or pre-op X-rays. “Studies have shown that routine lab and X-ray examinations don’t provide a significant cost-to-benefit ratio and generally only result in additional cost for the patient,” says Gunderson. “There may be an incentive to subject patients to unnecessary studies in a more vertically integrated health care environment, but that cost is eliminated at RASC.”
These are just a couple of reasons why outpatient surgery at RASC is cost-effective for the patient and insurance carrier. Everyone covered by an insurance plan must contend with deductibles and coinsurance amounts. Depending on the patient’s health plan, the out-of-pocket savings could be 30 percent or more compared with the same procedure, performed by the same surgeon in the hospital setting. More savings and more attention to patients are added benefits at RASC.
“Our focus is directly on the patient,” adds Dr. George Arends, clinical medical director and anesthesia care team supervisor. “State-of-the-art equipment and highly trained staff to assist the surgeons allow for efficient surgical care to be delivered using the most recent advanced techniques. Attention to cost and quality results in a 99.9-percent rating for patient satisfaction.”
One might wonder why many patients who need outpatient surgery have their procedure performed in the hospital setting when there are so many benefits from scheduling them at the surgery center. Gunderson explains that when a hospital system becomes vertically integrated and the surgeons are employed by the hospital, there is a large incentive to refer the patients to the more expensive setting. He adds that independent surgeons are becoming less common because the trend is toward hospital employment of the surgical staff.
“Patients may automatically assume that, because the doctor is affiliated with a hospital, they don’t have a choice other than to have their procedure done in that particular hospital,” Gunderson says. “In the majority of cases, that isn’t true. Patients do have a choice and it’s important that they are made aware of this so they may exercise that choice.”
RASC provides the surgical setting and the necessary equipment to handle almost every kind of outpatient surgical procedure. This includes ear, nose, throat, dental and eye surgeries; general surgery; hand and other orthopedic surgeries; and gynecological, cosmetic, foot and pain management procedures.
“The surgery center is in-network with most health insurance plans, which make us a viable choice for most patients,” Gunderson says.
It’s important to understand what a freestanding ambulatory surgery center does. Procedures include everything from simple “lump and bump” removal to laparoscopic and arthroscopic surgery utilizing sophisticated equipment to perform surgery using less-invasive means. Robotic surgery is not currently performed at RASC.
“We’re not allowed, by law, to keep surgical patients more than 23 hours and 59 minutes,” Gunderson says. “If for any reason a patient needs postoperative monitoring or additional treatment, he or she is transferred to a hospital for that care. However, proper preoperative screening and selection of patients makes this an infrequent occurrence.”
Pain management services at RASC are performed by anesthesiologists specially trained in the treatment of pain caused by illness or injury as well as chronic pain. Conditions such as back and neck pain, chronic regional pain syndromes, cancer pain, shingles and other pain associated with health conditions are some of the more common causes.
Arends says that, by far, the most frequently performed surgeries at RASC are related to eye and vision problems.
RASC was the first facility in Rockford to offer laser-assisted cataract surgery using the Alcon LenSx Laser assisted cataract platform as well as the Alcon ORA system, which uses wavefront aberrometry data in the measurement and analysis of the refractive properties of the eye intra-operatively during cataract surgery to aid in proper lens selection. In addition, the surgery center is the first facility to offer the Iridex Laser for non-invasive treatment of glaucoma. Oculoplastic procedures including blepharoplasty and eyelid surgery are frequently performed at the center for functional and cosmetic reasons.
Patient convenience starts with RASC’s parking lot, which is compact and close to the front door. For patients with disabilities, this proximity makes it easy to access RASC without walking great distances and without the need for valet parking. Once inside, patients find a cozy waiting area with a living room atmosphere, including a fireplace.
“We actually have two waiting rooms, which cuts down on a clinical or crowded feel,” says Gina Hartman, RN, director of nursing. “The atmosphere is comfortable and inviting. Another reason why patients are more relaxed is that RASC has chosen a select group of professional nurses and surgical techs who work closely with each other every day. This provides the patient with a sense of safety and security and a feeling of familiarity.”
Another advantage to choosing RASC is that it’s more time-efficient, points out Bev Knautz, business office manager. “Most hospitals want patients there two-plus hours before surgery,” she says. “Here, they come in an hour before. Patients are in and out more quickly. And our surgeries are almost always started on schedule, while surgeries in hospitals can be delayed because of emergencies.”
Gunderson says the primary goal at RASC is to provide the highest-quality outpatient surgical and pain management services for the best value to patients, customers and community.
The surgery center has been innovative in bringing lower costs, new technology and innovative procedures to the region for the past 20 years.
“The most recent endeavor is the development of a ‘bundled fee schedule,’” Gunderson says. “Very near completion, we have developed a payment methodology that will bundle the facility fee, surgeon’s fee, anesthesia provider fee, labs, pathology and supplies all into a single fee. Kind of like one-stop shopping.”
In many cases, the full bundled fee is well below the hospital outpatient surgery facility that doesn’t include the surgeon, anesthesia provider, labs, pathology and other supplies.
“Hospitals tend to unbundle most of their fees, which results in significantly higher prices. One of our primary goals, from the beginning, was to provide the same high-quality outpatient surgical care as the hospitals, at a lower cost,” Gunderson says. “We believe this may be an attractive option for the companies in our community who self-insure their health care plan.”
As more and more patients become aware that they have a choice in where to have their surgeries performed, RASC will continue to enjoy an expanding patient base and be able to add even more equipment, technology and outpatient procedures to its already substantial list of services.