Case Study: Imaging Group Develops Ambulatory Surgery Center

Case Study: Imaging Group Develops Ambulatory Surgery Center

Avanza capabilities at work: Strategic Planning, Partnership Development and Facilitation, Program Design, Implementation, Operations and Evaluation, Payer Contracting,


A large Midwest imaging group set out to develop a de novo ambulatory surgery center (ASC). This ASC would provide vascular and interventional radiology services.


With the ASC nearly completed, the imaging group's legal counsel expressed concern that the group was making decisions that could cause the partnership to experience significant difficulty passing regulatory surveys due to noncompliance, delays in opening, overspending, and design and operational shortcomings. These decisions were largely attributable to the group's lack of experience with developing an ASC and trying to take it on without assistance.

The attorney advised the partners to engage with Avanza Healthcare Strategies because of the company's extensive experience working with medical groups to develop ASCs, including those providing vascular and interventional radiology services. Also, the fact that Avanza did not require equity in the project was a positive to the physicians.


  • Conducted on-site meetings with key stakeholders to assess the project to-date; provide insight concerning facility design, organizational structure and operations; and identify regulatory risks and concerns.
  • Created detailed operational project plan coinciding with the construction timeline. This plan outlined tasks, timelines and responsible parties through the opening of the ASC. This kept the group on task and focused.
  • Worked with newly hired administrator to review the project plan and all licensing, accreditation and pre-opening requirements to determine appropriate roles and responsibilities throughout facility development. Helped the administrator customize the Policies and Procedures provided by Avanza as well as assisting her in understanding the surveyor expectations.
  • Worked with leadership to develop a robust proforma, which was lacking.
  • Helped select an appropriate ASC IT system. The partners intended to implement the same system as was used in their practice, which would have led to compliance problems.
  • Recommended an independent life safety assessment by an experienced ASC life safety professional, which identified several issues requiring correction.
  • Advised the imaging group's leadership on critical decision points and potential challenges related to developing and operating the ASC.
  • Conducted a mock survey prior to the ASC's AAAHC/Medicare deemed status survey that helped identify areas needing fine tuning.
  • Helped add other specialties to fill available block time.


Thanks to the collaboration between the imaging group and Avanza, in coordination with the other parties involved in the ASC's development, the surgery center opened close to its target date and budget.

Following the ASC's opening, Avanza was retained to provide support to the business office manager in areas of ASC revenue cycle management and the ASC IT system. The surgery center has earned its Medicare certification and a three-year AAAHC accreditation, with no clinical deficiencies identified during the deemed status survey. The ASC is in the midst of negotiating and securing private payer contracts with Avanza's support.