Ancillaries: How To Do It Properly Douglas W. Lundy, MD, MBA, FAOA, FACS Orthopaedic Trauma Surgery Resurgens Orthopaedics Atlanta, Georgia
Ancillaries: How To Do It Properly
Douglas W. Lundy, MD, MBA, FAOA, FACSOrthopaedic Trauma Surgery
Resurgens OrthopaedicsAtlanta, Georgia
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Ancillary secrets• Nirvana is a rock group• Carefully consider the options• Be transparent in your
ownership• Do not change referral
patterns• Do not go down the primrose
path
Only on Saturdays…• Nirvana is a rock group• Carefully consider the options• Be transparent in your
ownership• Do not change referral
patterns• Do not go down the primrose
path
Ancillaries• ASC• Rehabilitation services• MRI• Radiology (x-ray)• DME• Risk contracts• EMG/NCS• Rx• Property ownership
ASC• Georgia Law:– Multispecialty CON– Single-specialty CON– Letter-of-Non-Reviewability
• CON threshold on 1 July 2021 is $3.395 MM
• Very complex rules with lots of compliance issues
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Physical/Occupational Therapy• One of the most
common ancillary services.
• Generally 1-2 therapists per MD.
• 25%-30% margin.
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MRI/Imaging• Most common scenario:
– Practice owns the magnet (technical fee).
– Teleradiology performs professional services.
• Investment - $250k to $1MM+.• Medicare typically pays $350-
$500 for facility fee.
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If you have Ancillary Services…• Ensure that you are providing
a value to your patients – use common sense.
• Consider other ancillary sources for patient benefit.
• Watch the finances of these services carefully.
• Monitor usage.
If you are considering Ancillary Services• Strongly consider a reputable
third-party administrator.• Review contracts carefully.• Carefully consider the risk that
you are willing to assume.• Ensure that you are providing
value to the patient and the payer.