Ambulatory surgery centers (ASCs) have consistently been a source of strong merger and acquisition (M&A)过去十年的交易活动. 作为ASC管理公司, bet8网站备用, 私募股权(PE)公司实施稳健的ASC扩张战略, 收购ASC的需求正在增长, and this interest has translated to strong transaction multiples being paid for premium assets.
这可以使卖家处于有利地位. 但是,为您的ASC获得最优惠的价格需要大量的准备, 重点是优化你的业务, 以便将您的ASC打包为优质资产. Below are three steps to maximize your ASC’s valuation and facilitate a smooth transaction.
1. 优化你的管理式医疗计划
A carefully crafted managed care strategy can have a profound impact on the performance of an ASC. 为了有效地最大化您的ASC价值,请确保:
- The local market reimbursement landscape is understood and factored into 付款人 negotiations. 市场差异, 付款人, 和bet8娱乐线的期望, 知道你的机会在哪里是很重要的.
- 合同是经过专业评估和谈判的. Engage in 付款人 negotiations to address foundational items such as multiyear standard cost-of-living increases and adequate reimbursement for implants, and pursue carve-outs for procedures that are high cost and or have inadequate rates in your contracts. 网络内中心将可以访问更多的容量, which will generally drive more revenue into the ASC and will reduce risk for buyers. Assess affiliate and assignment language to ensure favorable terms are present when the facility is acquired and reimbursement is not put at risk.
- 一个更新的,适当的费用表是目前 and correctly loaded into the billing system to enable maximum revenue capture and to avoid underpayments that are below contract allowed amounts.
- 在谈判期间,开发了一个付款人储蓄的商业案例. 与付款人的讨论通常会超出预期的时间范围. 作为ASC运营商或投资者, be sure to bring a sound business case to 付款人s at least six months prior to the contract termination date. Highlight important metrics such as cost comparisons between ASC and hospital-based services, 可迁移到ASC的额外病例量, 质量结果, 病人满意度也很高. 任何支付者和收入集中度都应该被评估.
优化您的ASC管理式护理计划将提高收入, EBITDA利润率, 以及企业价值的提升.
2. 高效办公,提高财务绩效
最大化ASC运营推动财务绩效. 这涉及两个核心功能:
财务责任
设置, 跟踪, and driving accountability through tactical day-to-day financial goals is essential to realizing the value of the managed care plan. The business office should conduct audits to ensure the ASC is being paid in accordance with the allowed amounts for commercial 付款人 contracts and government 付款人s and determine whether any claims are being paid at 100% of charges. 当索赔以100%的费用支付时, it’s an indication that the ASC’s charge master is not adequate to capture the revenue due from the 付款人. This presents an immediate opportunity to increase cash flow and improve revenue and EBITDA.
It is also critical that the business office has complete fee schedules and payment logic from the 付款人 and that the contracts are loaded into the billing system. 这种方式, allowed amounts can be verified against payments and addressed with the 付款人s if payments are below those amounts. Often 付款人s do not load contracts correctly or update their fee schedules in their claims processing systems to reflect contract terms with annual escalators.
最后, establish goals and targets for key operating statistics that will maximize overall value for the center. 需要监控的标准商务办公室指标包括但不限于:
- 应收账款天数(A/R).
- 90天以上的应收帐款.
- 坏账余额和冲销百分比.
- 否认率.
- 放弃索赔的天数,以衡量向付款人付款所需的时间.
另外, 可以执行编码质量审计以改进收益获取, 编码合规, 编程教育.
运营效率
除了开票和收款, 财务业绩受到运营效率的高度影响. 最大化操作性能可以包括:
- Measuring OR scheduling performance to ensure cases are not turned down and the appropriate time is allotted for a case; assessing OR turnover time to identify opportunities to enhance efficiency; and reviewing the effectiveness of process improvement programs.
- 评估员工水平并定期审查政策遵守情况.
- Monitoring first case on-time starts (FCOTS) to identify opportunities to reduce delays in the start of a case, and assessing block time utilization and policies to enhance optimization of OR utilization.
- Reviewing patient and physician satisfaction scores to determine opportunities for improvement.
Optimizing financial performance also includes 跟踪 operational costs (e.g., 工资及福利, 药物, medical supplies and implants) and utilizing preference cards to understand your direct costs. Engaging with physician stakeholders will help identify opportunities for improvement and enable effective implementation of plans that will drive efficiency, 降低成本, 整体财务表现. 向你的合作伙伴展示这些节省带来的经济影响, which can result in additional EBITDA and consequently a higher price for your ASC, 能有效地改变行为吗.
3. 了解关键事务注意事项
Sellers should evaluate three key components when preparing for an ASC transaction:
- 买家池. It is important to consider the goal and post-transaction strategy of the ASC when assessing a buyer. Understanding the ultimate value of the selected equity partner is critical to a positive long-term relationship. Is your partner in this for the long term or a quick flip—and why should you care?
- ASC运营和费用分配. 在准备事务时, it is important to decouple direct ASC expenses from shared staff or overhead allocations. 在FMV评估期间, clear delineation of expenses and overhead will be critical to forecasting future operating performance.
- 长期盈余质量(QofE). QofE refers to the long-term sustainability of reported earnings in the historical financial statements. Optimized managed care contracts and an efficient business office will display the strength of negotiated contracts and revenue capture that drives top-line P&L性能. 至少12至24个月的稳定,高效的性能是最佳的.
Committed, unallocated capital (“dry powder”) by PE firms is approaching record levels of 2万亿美元. 加上侵略性M&ASC管理公司和bet8网站备用的战略, 预计ASC交易市场将保持强劲. Improving ASC valuation through managed care and revenue optimization strategies is a proven way to drive healthy operating and financial performance.
收购ASC的需求正在增长, and this interest has translated to strong transaction multiples being paid for premium assets.
为您的ASC获得最优惠的价格需要广泛的准备, 重点是优化你的业务, 以便将您的ASC打包为优质资产.
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2023年6月13日出版