Becky Ziegler-Otis, CASC

Ambulatory Surgical Center of Stevens Point in Stevens Point, Wisconsin, recently entered into an agreement to participate in Trilogy Health Solutions’ workers’ compensation cost-containment solution, WC Bundled Payments. This agreement gives residents of Stevens Point and employers in the area access to transparent, all-inclusive pricing for orthopedic care. Becky Ziegler-Otis, CASC, ASCA Board member and director of operations for revenue cycle at the ASC, recently talked with ASC Focus Editor Sahely Mukerji about the way the center’s prior experience with bundled payments helped prepare it to participate in this program.

Q: Tell me about your surgery center.

Becky Ziegler-Otis (BZO): The Ambulatory Surgical Center of Stevens Point began its operations in 2006 as an independent, surgeon-owned, multispecialty center. Since opening its doors in 2006, the center has experienced steady yet consistent growth and continues to provide exceptional care to the community and surrounding areas. Our tag line is “Skill, Care, and Comfort Beyond Your Expectations.” This describes exactly how we go about our surgical center business.

Current specialties at the ASC include orthopedics, podiatry, urology and ophthalmology. The surgical center has two operating rooms and performs approximately 1,200–1,300 cases per year. It employs approximately 25 employees, including both clinical and nonclinical staff and full-time, part-time and casual-status employees. The surgical center is located in central Wisconsin and is an innovative, state-of-the-art facility. We are proud to share that the ASC was an early adopter in performing total joint replacements starting in 2010 and continues to do these procedures today. The center was named by Newsweek as one of the top surgical centers in Wisconsin for 2021.

Q: What made the surgery center a good candidate to participate in WC Bundled Payments?

BZO: The center was well-poised to participate in the WC Bundled Payments program due to experience it already had with other bundling activities.

The center began using bundled payment strategies with entities outside its existing market several years ago, reaching out to patients who travel from 2–2½ hours south of the surgical center and 2–2½ hours west of the center. Establishing these relationships was critical to being able to hone our processes to be a good candidate to participate in WC Bundled Payments.

Q: What steps were involved in the process?

BZO: Before deciding to participate in bundling, it is important to determine if it is a fit for your center. Some factors include leadership alignment, determining what procedures or specialties to bundle, having accurate and current case costing information and, of course, having the time and resources to devote to the project.

One also needs to find a partner to work with and one that aligns with your center’s vision and strategy. In my mind, it is not a race to the bottom pricewise but, rather, should provide high-quality, safe and efficient care at a valuable price. And it is important the value is provided to all involved: the patient, the payer and the providers alike.

Q: Was it difficult to agree on the bundled pricing?

BZO: Bundled pricing requires time and effort. One needs to be acutely aware of current case costs so that you can work collaboratively through the pricing aspect, which must meet the needs of the center, the surgeon and the anesthesia provider. Once you know what you need pricewise, you need to collaborate with the vendor/entity you are working with, and the negotiations involved at this step can take some time and effort too. There may even be times when you cannot agree. In those situations, one needs to be prepared to agree to disagree and walk away from an agreement.

Q: What would you tell other ASCs considering bundled pricing?

BZO: ASCs are well-poised with the ability to provide a bundled payment strategy that can be leveraged as a financial opportunity. Although these arrangements might not be right for everyone, done properly and with stakeholder alignment, I believe ASCs can arrive at a program that provides great value to the patient, the payer and the surgical center.