Ambulatory Surgery Center Contracts and Operating Agreements: A Surgeon-Focused Framework for Orthopaedic Practice...

Area of Science:

• Orthopaedic Surgery
• Health Services Research
• Healthcare Administration

Background:

• Ambulatory surgery centers (ASCs) are increasingly performing orthopaedic procedures, including total joint arthroplasty.
• Clinical protocols support safe outpatient care, but nonclinical infrastructure significantly impacts ASC performance.

Purpose of the Study:

• To provide surgeons with a framework for evaluating ASC contract domains.
• To emphasize negotiation priorities, implementation strategies, and regulatory safeguards for ASCs.

Main Methods:

• Review of ASC operating agreements, managed care contracts, lease agreements, and other operational contracts.
• Analysis of how contract architecture influences financial performance, compliance, and equity value.

Main Results:

• Operating agreements govern ownership, finances, and dispute resolution.
• Managed care contracts dictate revenue feasibility and reimbursement.
• Lease, equipment, staffing, and IT agreements impact operational capacity, cost control, and collections.

Conclusions:

• A structured approach to ASC contracting is essential for surgeons.
• Disciplined contracting preserves surgeon autonomy, protects profit margins, and sustains enterprise value in the outpatient orthopaedic market.