ASC Management Book Contributors Discuss the Importance of Education in the Field

book-cover-1Recently, The Ambulatory M&A Advisor welcomed Robert Zasa, Managing Partner and Founding Partner of ASD Management as an Editorial Advisor to the publication.  Aside from his work with ASD Managment and The Ambulatory M&A Advisor, Zasa and his brother Joseph Zasa, also a Founding Partner of ASD Management, recently authored and published their first book, “Developing and Managing Ambulatory Surgery Centers”.

Joesph Zasa helmed the project and brought on several professionals involved in the ASC industry as contributors to numerous chapters of the book.

Stephen Dobias, principal at Somerset CPAs has been in the industry 28 years.

“I started out as most do in the accounting profession doing the nuts and bolts of what makes all of us who we are today, i.e. tax, accounting etc.  Over the course of my first three or four years as a CPA, my focus shifted to physicians.  Many of the physician practices we were working with were looking at additions of ancillaries to their practices which included surgery centers.  Accordingly, we developed a book of business focused on surgery centers,” Dobias says.

On his involvement in the production of the book, Dobias says his company has have done a lot of work with the Zasas over the years and when Joseph gave Dobias a call to say he was writing a book, Dobias complimented him on the efforts and during the course of the call, Zasa asked if Somerset CPAs would be willing to provide input on financial matters that he was writing about in the book.

Dobias says the backbone of any ASC once up and operational is its financials, and that is what he focused on in his contribution to the book.

“Our work as a firm over the years with Joe and Bob Zasa has been to compile the information provided to us to allow the surgery center to analyze its financials in a timely fashion.  We get the receipt information, billing information, case information, and all of the affiliated costs…we boil that down into an income statement balance sheet, cash flow statement and turn it over to the management team.  They then do additional benchmarking/dashboard indicators that are important to them.  We give them the information in a format that makes it workable on their side.  Our role in the book was primarily the role that we play in many of their surgery centers, and that is the nuts and bolts accounting and tax work that goes into any and all surgery centers around the country,” Dobias says.

“I think the book did a great job of summarizing in a nutshell, the information that is often not under one roof.  The Zasa brothers did a great job in assimilating a book in a fashion that allows for a reader to pick it up and go to the portions of the book that apply to their particular situations.  It is a great book to immerse yourself into the entire process.”

Amber Walsh, partner, healthcare department chair at McGuire Woods has been a healthcare and regulatory transactional attorney for nearly her entire almost 15 year career.  She has focused on different healthcare sectors, but a big portion of her work has always been in the ASC industry alongside Scott Becker and other attorneys at McGuire Woods.
“We have known and worked with Joseph and Robert Zasa for many years.  We have been one of the law firms that works with their affiliated ASCs.  We were very honored when they asked us to contribute.  Scott Becker and I contributed the legal chapter.  The chapter addresses a number of regulatory concerns from the perspective of management companies, hospital investors and physician investors,” Walsh says.
“I think this will be a great tool for people who either have healthcare industry backgrounds and are breaking into the ASC industry, or who have been in the ASC industry for a while but are reassessing best practices and ways to increase efficiency, compliance, and profitability of their centers.”

Aaron Murski, Managing Director, VMG Health believes that the book is unique for a couple of reasons.  It is very comprehensive, and it is very practical and precise.  It is a no nonsense book with content that has been developed through practical experience.  From that perspective, Murski think it is unique; adding that education in the ASC industry is important no matter how it is given.

“I think it is super important, especially in the last three to five years in what everyone refers to as “the era of healthcare reform.”  It has become more to those that have long been in the industry and understand the value proposition of ASCs and strategically where they fit within the continuum of care.  I think as demographic changes continue to happen, healthcare continues to come under scrutiny from a cost perspective,” Murski says.

“Triple Aim continues to be pursued at the Federal level.  I think anyone on the health system side, investor side, or actual operator side of things could use a good first hand experience in education.  For those that have been in the industry a while, it can also be extremely helpful as a refresher in some areas; especially if there are certain areas from an operational perspective that only come up once every five to ten years.  I think the book is going to cover topics like that and really be a resource.”

Charles Dailey, Vice President, Development for ASD Management explains that the founders of the company and a chosen support team from the industry wrote the first comprehensive book on ASC operations titled Developing and Managing Ambulatory Surgery Centers.

“We felt there was a gap in the conversation about a systematic approach for developing and managing ASCs. Many articles have been published every year, but few describe a proven, systemic approach written by people who are successful developers and operators of surgery centers. There was a need to present all elements of ASC operations in one text. This belief, along with the long-time ASC experience, was the genesis of the book,” Dailey says.

“The central theme of the book is defining the operational functions of an ASC that support its prime directive-exceptional patient care and safety. Just as in building a house where one must lay a solid foundation, the authors feel that the foundation of an ASC dedicated to patient care and safety will be the supporting operational system. While no two ASCs are the same, and each has its own personality, all must operate from a solid operational foundation. While the operational system is the foundation, the people responsible for patient care (physicians, anesthesia providers, clinical and business office staff and management) are the walls that bind. The system begets structure and attracts the right people who, in turn, establish a pathway to developing a winning culture. The result is increased profitability and a surgery center providing access to affordable and more personalized care for the community,” Dailey says.

According to Dailey, education on the topic of ASC management and development is needed for all involved in a surgery center project. Education empowers all involved… establishes expectations and aligns all stakeholders developing and implementing a proven operational system. This provides the ASC its best chance to be economically successful.

If you have an interest in learning more about the subject matter covered in this article, the M&A process or desire to discuss your current situation, please contact Blayne Rush, Investment Banker at 469-385-7792 or





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