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A piece of the action: Indiana's surgery centers want to remain part of the cost solution.

There's been so much talk lately about what can be done to fix health care, some people have forgotten how much already has been done.

Players in the surgery-center business like to think they already are part of the solution to the problem of runaway health-care costs. Now they're hoping the politicians molding health reforms will acknowledge their role in the cost-efficient, quality-oriented health-care system of tomorrow.

"In the long run, I think health reform is going to be very favorable for ambulatory-surgery centers," says Judy Rodocker, administrator of the two Indianapolis Surgery Centers. Indeed, how could the nation's attempt to get more health care for less money not smile upon these institutions, whose charges have been found to run nearly 50 percent less than those at hospital-based outpatient-surgery centers?

What worries some in the surgery-center business is the uncertainty about how they'll fit into the managed-care plans that would be set up under some of the current health-reform models. They already have been shut out of some managed-care deals.

"The biggest concern most surgery centers would have is that many hospitals have basically cut freestanding centers, such as ours, off from being able to offer care to patients with certain insurance," Rodocker says. "They want to be in the running to be those hospitals that are chosen."

Mary Schafer, administrator of Premier Ambulatory Surgery of Fort Wayne, says health reform could mean a number of things for freestanding centers such as hers, which is the nation's second-oldest. On the positive side, she says, the government could be so convinced of the benefits of freestanding centers that it would make certain they continue to be available as health-care options. On the other hand, "hospitals might say 'we can do all of the services and do them all at a reduced fee.' Already, there are national contracts that exclude surgery centers."

Surgery centers here haven't been shut out as frequently as those in some other areas of the country, but that may be due in part to the fact that managed care hasn't caught on as quickly in Indiana as it has elsewhere. When it does, it might favor outpatient surgery centers that have some direct link to hospitals, leaving freestanding centers searching for a piece of the action. And there are a lot of freestanding centers out there, Schafer notes. In Fort Wayne, for example, Premier is joined by three freestanding centers that are owned by doctors themselves.

Should freestanding surgery centers be left out of the picture, it won't be for lack of interest among doctors and patients. Those in the business feel certain their service is popular with doctors and patients alike. "We offer such a convenient and comfortable setting for patients, and overhead is nothing like in a hospital setting," Rodocker says. "Doctors love to come to freestanding centers."

How can surgery centers ensure their place in the health-care system of the future? Education is one answer. They are working hard to make everyone aware that ambulatory-surgery centers can offer quality care that's less expensive yet more convenient and comfortable. For one thing, says Schafer, there's a national association of ambulatory-surgery centers that is working Capitol Hill hard these days. "We're also talking to physicians and insurance carriers, and we have to get the message out to the lay person, too," Rodocker adds. "It's going to save doctors and their patients money."

Surgery centers will need a lot of lobbying for their message to be heard on the Hill. "Hospitals are going to have a lot more money to do a lot more lobbying," Schafer acknowledges. "They have a lot more clout."

Still, those who operate surgery centers remain hopeful that they'll be an important part of whatever health reforms come out of Washington. To them, it simply makes sense. Says Sharon Dodds, business director at the Indiana Surgery Center in Indianapolis, "We fit in as the goal of what reform is to be--very cost-efficient, patient-centered facilities."
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Title Annotation:Hospitals & Clinics
Publication:Indiana Business Magazine
Date:Nov 1, 1993
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