1. Provide benefits via the ASC directly as the employer of the employees. This option provide the ASC the opportunity to create a benefits package that is specific to the ASC and manage costs based on what the ASC can afford. The challenge is these benefits can be costly because to the size of the group (few employees to spread the risk across).  For start-up centers, the first three employees do not have access to benefits due to the requirement that most insurance companies will not provide group benefits to employers with fewer than three benefit eligible employees. Typically, they will not even provide a benefit quote if you have fewer than three employees — unless it is for an individual policy. 

In order to receive a quote, insurers require a census of three employees.  In this scenario, benefit costs are based on employee census and claims experience. 

2. Use a management company to employ the staff. If the ASC is part of a management company, some management companies employ the staff on behalf of the facility. This is a great option because you have the benefit of a larger number of employees, thus you are able to provide a competitive benefit package at a lower cost than doing it as a stand-alone ASC. You are able to leverage economies of scale by utilizing this option.  Benefits costs are not predicated on the individual’s medical history and benefits are available immediately because group policies are already in existence.

3. Employ the staff via a Professional Employer Organization. [This option involves] outsourcing all other aspects human resource management to include benefits while maintaining the daily control and management of the staff. This model allows the ASC to focus on its core business, caring for patients and outsources all of the HR functions to a third party employer.Depending on the model, the ASC may be able to leverage economies of scale for some benefits, thus providing a more robust benefit package that is competitive and lower in cost than a free-standing ASC.