New Piedmont Outpatient Surgery Center The First of Its Kind in North Carolina
New Piedmont Outpatient Surgery Center Is the First of Its Kind in North Carolina “The demonstration project is to determine whether single-specialty ambulatory surgery centers are a good way to
Two orthopedic practices were selected for the Charlotte and Triangle regions.
address the rising cost of medical care. In my opinion, this is a
“We were the David and Goliath story,”
pretty big segment.” – Ronald B Shealy, M.D., F.A.C.S.
says Cheryl Fatzinger, Piedmont Ear, Nose
The new Piedmont Outpatient Surgery Cen-
The expectation is that the Single Specialty
ter L.L.C. in Winston-Salem will be opening
Ambulatory Surgery Demonstration Project
this month with great expectation.
– the first of its kind in North Carolina – will exceed the clinical criteria for cost efficien-
It is North Carolina’s first ambulatory sur-
cies, while ensuring quality care. It could
gery center wholly dedicated to ear, nose
potentially lead to changes that will pave
and throat services and owned by oto-
the way for more single-specialty, physician-
laryngology specialists. The $2.1 million,
owned ASCs to open across the state.
9,489-square-foot facility is owned by the physicians of Piedmont Ear, Nose & Throat
“The cost of health care is an important na-
Associates (PENTA).
tional issue, and the ambulatory surgery center is one of the ways that costs can be low-
It also is one of three separately licensed
ered,” says Ronald B. Shealy, M.D., F.A.C.S,
single-specialty ambulatory surgical facili-
the Piedmont Outpatient Surgery Center’s
ties in the state opening as part of a five-year
medical director. “We can offer the exact
demonstration project launched by the
same services as a hospital, and we can do it
North Carolina Department of Health and
more efficiently and at a lower cost.”
Human Services, Division of Health SerCouncil. The project is designed to improve
All Sights Are Set on Demonstration Project
health care safety, quality, access and value.
PENTA was selected to participate in the
vice Regulation, State Health Coordinating
demonstration project for the Triad region.
& Throat Associates practice administrator. “We were in competition with two orthopedic practices, one backed by Baptist and one by Novant. We weren’t backed by anything but our own gumption.” The North Carolina Department of Health and Human Services selection process gave priority to facilities owned wholly or in part by physicians. “Giving priority to demonstration project facilities owned wholly or in part by physicians is an innovative idea with the potential to improve safety, quality, access and value. Implementing this innovation through a demonstration project enables the State Health Coordinating Council to monitor and evaluate the innovation’s impact.” “Doing a single-specialty project gives you an apples-to-apples comparison,” says Dr. Shealy. “If I am doing the full range of procedures within a specialty area, I can be more selective in the types of supplies, instruments and specialized staff I utilize, and I will require fewer of them.” “The fact is, we will be able to monitor patient progress from the time they call to make an appointment to the time they are discharged from our practice, and that will include the surgical experience,” says Ms. Fatzinger. “We will now be able to evaluate every single aspect of each patient’s care.”
Each member of the Piedmont Outpatient Surgery Center team has extensive ENT training and expertise, and a customer-service focus. Taken from the January edition of The Triad Physician
According to Dr. Shealy, there has been considerable regional interest in the dem-
onstration project since selection of participants in 2009. “I don’t think there is any question that our other specialty colleagues support us. Almost every day at the hospital somebody asks us, ‘How’s it going? How far along are you?’” says Dr. Shealy. “Certain specialties lend themselves to ASCs, not only otolaryngologists and orthopedists, but ophthalmologists and oral surgeons,” says Ms. Fatzinger. “I’m sure they’re going to be watching this with keen interest.”
State-of-the-art ENT surgery suites are specially designed for improved outcomes and efficiencies.
PENTA Is a Leader in Quality ENT Care
hearing aid service has won the Winston-
ear surgeries, septal deviation repairs, nasal
Salem Journal’s Readers Choice Award for
reconstructions and skin lesion removals.
Piedmont Ear, Nose & Throat Associates
Best Hearing Care.
Approximately 90 percent of all surgical ENT procedures are outpatient, according
was formed in 1999, with the merger of two
to Ms. Fatzinger.
practices and five physicians. Today, PEN-
“We are the best in the area, without ques-
TA is comprised of nine otolaryngologists,
tion and we are the biggest ENT practice
one physician assistant and a team of audi-
in the region,” says Dr. Shealy. “We offer
POSC is specially outfitted for ENT proce-
ologists. They provide the full complement
as many ENT services as possible. The sur-
dures. All 14 new staff members were care-
of ear, nose and throat services at its main
gery center is just another way of serving
fully screened and selected for their ENT
office in Winston-Salem and satellite offices
the community at a much lower cost.”
surgery experience, a reported average of 12 years. Each also has pediatric expe-
in Kernersville and Mount Airy. Subspecialties include neuro-otology; pediatric ear, nose and throat (ENT); and facial plastic and reconstructive surgery. On-site computed tomography scanning, allergy testing and treatment, and hearing aid sales and service are among the practice’s ancil-
“We can save hundreds, if not thousands, on just one case. So this is a huge opportunity to lower the cost of health care for everyone in North Carolina.” – Cheryl Fatzinger, Piedmont Ear, Nose, Throat & Associates practice administrator
lary services. For the past five years, the “Exceeding expectations is the overriding
rience, in addition to adult care, which is
goal of our practice, and the ASC will be an
important for a practice in which 51 percent
extension of that,” says Ms. Fatzinger. “We
of the patients are children. “Even the anes-
constantly evaluate and implement new
thesiologists we will be using on a routine
ways to increase customer satisfaction. Our
basis are highly trained and experienced
quality assurance program also includes
in pediatric anesthesiology,” says Brandi
a patient advocate on the staff, and I don’t
Cunningham, Piedmont Outpatient Surgery
know of many practices that actually pro-
Center administrator.
vide this service.” “Even though we are being cost effective on
Medical Community Is Quick to Support Cause
the choices we make, we are by no means
PENTA is opening Piedmont Outpatient
care. We offer the same standards of care, if
Surgery Center (POSC) for patients who re-
not better, than patients receive at a hospi-
quire ENT surgical services but not a hospi-
tal,” says Ms. Cunningham.
taking any short cuts with our standards of
tal stay. That is often the case for tympanosPost Anesthesia Care Unit
tomies (tube insertions), tonsillectomies,
The new staff members previously worked
adenoidectomies, sinus surgeries, middle
in area hospital surgical services areas, as
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•
www.pentafpsc.com
well as with PENTA physicians. “So they know our physicians, they know our staff and they are aware of our patient population,” Ms. Cunningham says. The strategic hiring approach is to ensure the new POSC health care team functions at a higher level than is possible within a hospital, Ms. Cunningham says. “It all makes us more efficient, because everyone knows what to expect and what is expected.”
Improved health care outcomes and efficiencies, in addition to patient satisfaction, are central to Piedmont Outpatient Surgery Center.
Ms. Cunningham notes that POSC was able to fill all ASC positions without having to
“The demonstration project is to determine
petition for patients is keener in other states.
advertise. “Licensed professionals, such as
whether single-specialty ambulatory sur-
It has a lot of employees on its Blue Cross
registered nurses, who are specialized in a
gery centers are a good way to address the
Blue Shield health plan. It’s interested in
field such as surgical services, are notori-
rising cost of medical care. In my opinion,
looking at ways to lower insurance premi-
ously in short supply, and we had no prob-
this is a pretty big segment. The surgical
um money. I hope that’s what the demon-
lem filling any of our positions. I think it’s
costs and expenses to the medical system
stration project will prove,” says Dr. Shealy.
because our surgeons have such a good
are pretty significant. Even nowadays, costs
reputation throughout the hospital system
on an outpatient basis are still fairly expen-
“It’s been a really incredible experience,
for patient care. We, literally, have had peo-
sive. There should be a break in there for
getting the CON through all the planning,
ple calling us from the day they heard about
procedures that can be done routinely,
design and construction. We’ve learned a
the new ASC.”
safely, easily,” says Dr. Shealy.
lot from this. It’s not inconceivable for other physicians to do it, as well. I hope you’ll
Even other surgeons have been inquiring.
“Often the benefit of cost savings goes back
see more of this type of initiative going on,
“Any board-certified ENT surgeon is wel-
to the patient, because if insurers were to
for all of the good things that it does,” Dr.
come (to apply for open-access privileges).
save money, theoretically, the premiums
Shealy says.
It’s one of the demonstration project crite-
would be less and would then support a
ria, and we would welcome them,” Ms. Cun-
downward trend (in health care costs).
ningham says.
That’s why it is so amazing to all of us, that insurance companies are not knocking
Insurance Companies Slow to Join Initiative
down our door.”
According to federal data, Medicare patients
Opening a medical facility, such as an
who have a procedure at an ASC pay an aver-
ASC or radiology center, requires a cer-
age of 41 percent less out-of-pocket expense.
tificate of need (CON), and each state has
Out-of-pocket expenses for other insurances
its own laws governing them. According
depend on a patient’s insurance plan.
to Dr. Shealy, North Carolina’s are among the toughest in the country. “That’s why
“We can save hundreds, if not thousands,
you don’t see an XYZ outpatient medical
on just one case. So this is a huge oppor-
facility without having ‘Novant’ or ‘Baptist’
tunity to lower the cost of health care for
attached to it. It’s too expensive, cumber-
everyone in North Carolina,” says Ms. Fatz-
some and difficult. All Novant or Baptist has
inger. “Hopefully, we can get insurance
to do is oppose (the CON).”
companies on board and negotiate fair reimbursement rates, but right now, that’s not
By contrast, South Carolina’s CON regula-
happening. We will still be able to achieve
tions are less cumbersome or expensive,
cost savings for the patient by filing ASC in-
he says. As a result, the state has more pri-
surance claims on an out-of-network basis.”
vately owned centers. “The state of North Carolina has woken up to the fact that com-
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•
www.pentafpsc.com
Piedmont Ear, Nose & Throat Associates • Winston-Salem office 110 Charlois Blvd Winston-Salem 27103 (p) 336-768-3361 (f) 336-768-4131 • Kernersville office 280-C Broad St Kernersville 27284 (p) 336-993-2366 (f) 336-993-4158 • Mount Airy office 423 S South St, Ste 204 Mount Airy 27030 (p) 336-786-7366 (f) 336-786-9675
Piedmont Facial Plastic Surgery Center 110 Charlois Blvd Winston-Salem 27103 (p) 336-749-0311 (f) 336-768-4131
Piedmont Outpatient Surgery Center 2465 Hanestown Lane Winston-Salem 27103 (p) 336-201-0003 (f) 336-464-0736