Hi, everyone. This is Brian Zimmerman with Becker's
Healthcare.
Thank you so much for tuning in to
the Becker's Healthcare podcast.
Today, we're going to talk about AI and
automation strategies to strengthen ASC margins in 2026.
Joining me for today's discussion is doctor Farzad
Masudi and and Sridhar Yermere. Doctor Masudi, Sridhar,
thank you both for being here today. Let
let's let's get going here. Would love each
of you to share just a bit about
yourselves,
your your professional background journey, and then also
maybe some some high level thoughts about what
you believe is driving the increased urgency around
margin management as ASCs head into 2026.
Sreedhar, maybe you can you can get us
started.
Thanks, Brian, and thanks for having me. My
name is Shridhar Eramreddy, the CEO of Stear
Health. At Stear, our AI
driven growth and automation platform specifically is designed
to help healthcare organizations
and including ASCs
to operate at top of their license.
And, you know, as we look towards 2026,
right, and several ASC leaders have indicated there's
a significant margin squeeze
where operational costs, specifically labor and supplies, are
raising much faster than reimbursements.
While we know,
you know, they're projected to be relatively flat
or even the reimbursement rates are only seeing
modest increases. Right? Around 1.5%
while expenses are going triple or, you know,
quadruple of that. So
for AAC leaders, right, the days of relying
solely upon volume growth to mask inefficiencies
are over.
And what we do at Steel Health is
we bring this amped up mentality where, you
know, we try
to drive yield per operating room minute. If
you your old wars have gaps, right, or
if staff is bogged down and administrated, you
rework.
You aren't just losing time. Right? You're actually
leaking margin,
in an environment that no longer forgives it
or can afford it. Right? That's how we
look at the margins question in, 2025.
Yeah. I I think you said it really
really well when you when you you think
about ASC leaders can no longer just rely
on volume to mask inefficiencies.
I think that that says a lot right
there. Farzad, doctor Masudi,
can you introduce yourself a bit? And, also,
I is there anything you'd add to that
list that that Shritar said?
Absolutely.
Yes. I'm Farzad Nasudi. Thank you for having
me,
participate in this podcast.
Delighted to be here. I'm a full time
practicing neurosurgeon. I've been in practice for twenty
seven years in Orange County, Southern California.
And, I've,
had firsthand experience with operating out of variety
of outpatient surgery centers as well as hospitals.
And,
I have a unique perspective on Steer Health
because I'm not,
just the end user of all their products
and offerings in my own practice, but, I've
had
a helping hand in design and progression and
advances in the Steer Health platform
as one of the clinical advisors,
and I've had the distinct honor of, serving
on the board at Steer and working very
closely with Sridhar and the leadership team. I
think,
health care,
is,
really at a crossroads.
In my own experience over the last twenty
seven years,
We have really the gathering of a perfect
storm when it comes to health care delivery
in this country,
specifically speaking in outpatient surgery centers and hospitals
in particular.
We have a increasing labor shortage,
that is manifesting itself across the spectrum in
health care,
which is really colliding with inherent and baseline
and, really
embedded inefficiencies
of the system,
from a health care delivery standpoint as well
as administrative,
standpoint.
And, it is really resulting
in erosion
of,
profit margins,
erosion of
operational efficiencies,
and,
really putting a dent into the
maximal and optimal utilization of the capacity of
the surgery centers.
And a lot of that is
really the result
of increasing
administrative burden,
repetitive tasks that, have a tendency to, fatigue
and demoralize
the already short labor
and the staff that we have. And then
some of the,
unexpected things that can happen with patient care
delivery and
cancellations and delays leading up to surgeries and,
the the procedures that have been scheduled. So
we have a perfect storm here that is
really eroding margins and eroding,
labor morale.
And, I think,
we
at Steer have
really a good solution
to these problems
with AI enabled automation of processes,
really stemming out of our experience deep experience
with health care and our experience in the,
trenches of health care delivery and patient care
delivery as I've seen it in the past
several years.
Yeah. And and and Farzad, that that steers
us right to where we wanna go next,
which is really unpacking. I mean, I I
think some folks out there, they they might
realize this themselves already.
But wanna unpack the why behind automation, why
automation
is the logical next lever for improving financial
performance
in this perfect storm. And and how really,
how is it also helping ASCs better manage
capacity and and workflow demands? Farzad, let let's
begin with you.
Well, you know, anytime you speak of automation,
you have to be dealing with inherently a
set of,
highly important but repetitive
tasks that actually need to be done with
great degree of accuracy and precision
in order to have optimal end results.
And, you know, in that statement, we are
characterizing, summarizing at least 90% of what happens
in health care,
from,
to medical and cardiac evaluation of the patients
preoperatively
to optimization of the revenue cycle management and
billing that goes along with the health care
services.
Many tasks are very laborious,
but they are also predictable and repetitive.
So when you are,
faced with a situation like this, which is
resulting in administrative inefficiencies and erosion of, profit
margins,
automation comes,
very handy,
and it's a highly effective tool. So,
at Steer, we have spent a lot of
time trying to perfect a platform
that effectively and reliably and consistently
automates these repetitive tasks with the end results
that we really need to,
be accurate and
produce the optimal outcome for for the particular
entity. So here, it's a situation that is,
ideal
for automation.
And Shreedhar can, speak to how we've really
taken this automation
platform to the next level,
with the introduction of AI and AI enabled
automation
that has really made it a hyper personalized
and a very patient centric
process and experience.
Yeah. Fascinating to hear more there. Shreedhar, go
ahead.
Yeah. And then doctor Masuri articulated really well.
I think all the work that goes into
it, like, you know, obviously, terminology, like, t
twenty one, twenty one days before surgery, fourteen
days before, and seven days before.
There's so many,
little steps that can really impede or impact
the surgeon's schedule or anesthesiologist's
schedule the day before the surgery,
causing issues. And if you look at, you
know, last several decades,
you know, throwing people at this problem is
not the solution. I I truly believe in,
the current time,
automation is the only lever,
that can actually scale and address some of
these, repetitive
tasks. Right? Because talent is not there. You
know, the cost of hiring and, you know,
also,
the attrition is, you know, is very the
costs are very high. The way
we view,
automation, right, is kind of like the difference
between having your staff be drivers versus passengers.
And what I mean by that is really
right now, if you look at it, too
many skilled nurses
and surgical coordinators are passengers to bad workflows.
You know, stuck on the phone, you know,
trying to do the phone tagging or, like,
you know, chasing insurance companies for prior auths
or, you know, manually entering data between various
things. These are the tasks that are very
highly suited
and purposely
kind of, like, you know,
manifested for machines to do really a good
job.
That's that's where we look at when we
deploy
automation. We're offloading these repetitive low value tasks,
like all of them. This allows, like, you
know, obviously, your your highly valued staff to
focus entirely on clinical capacity,
surgical outcomes, and patient care. It's not just
about cutting costs, about increasing the velocity of
your ASC operations.
When you automate the intake,
the risk factors and try to drive, you
know, the prep work that goes before surgery
in a very structured manner,
and you have a virtual,
assistant or agent take AI, we call it,
do a lot of that lift, you now
have, staff that's kind of really freed up,
and you could run more cases per day
with the same headcount.
That's where I call pure margin ex expansion
can happen.
Yeah. And I I wanna get to something
that sort of or unpack a bit more,
something you you stated at the beginning of
of your response there, which is really the
challenges around that scheduling variability
that's sort of a constant in in in
the ASC world.
Can can you get into some details about
how precisely AI and automation
are helping organizations
shift from sort of this reactive response to
potential cancellations or issues with scheduling toward a
more proactive approach for for managing and and
and filling up open AOR time?
Yeah. Brian, great question. And this is one
of the biggest wins or opportunities we see.
Traditionally, if you look at an ASC, a
cancellation at 2PM for the next more next
morning was a kind of a dead slot.
So you receive a cancellation request 2PM today
for tomorrow's
morning search day at 10:10AM.
It it it was lost revenue because no
human could scramble and fast enough to really
get that slot reoccupied. Right? So
what we have moved from reactive to proactive
by using what we call smart backfill
and waitlist auto pull. So our
technology and platform doesn't just see an empty
slot. It it manages the wait list, identifies
patients who are clinically cleared
and insurance ready, and we can automatically reach
out to make sure we can put that
patient on that on that surgeon's schedule without
impacting them. Right? Again, we do that via
omnichannel approach. But, again, a lot of prep
work that goes into it. Right? Again, we
are keeping that ASC that that surgeon spot
valued highly and make sure they're practicing on
top of their license. If your patient, a,
a, that has, you know,
a a a tennis elbow surgery is dropped
off, we can pick the next one that
could fit into the same spectrum
and be able to do that. Right? So,
again, it's,
turning a manual chaotic scramble into seamless automated
work workflow. So that's how kind of, like,
we're essentially playing, you know, what they call
Tetris with the OR schedule in real time,
ensuring the block utilization remains high without burning
out the scheduling team. So we're keeping that
OR utilization optimal,
without the manual headaches and workflows involved.
Yeah. You you're you're playing Tetris, but you're
doing it very well. Correct. It's just like
I I think anybody who's played Tetris, you
you understand what it looks like when the
the the things go awry during that game.
Right, Tritar?
Yes. Absolutely. And that and that's where the
structure comes into play. And, you know, again,
type of depending on type of surgery, what
the process, and that's where our our smart
backfill is and kind of things fit in
with the right spectrum of surgical procedures that
fit into the one that get just got
canceled. And these are the things that we
go in, in detail as we kind of,
onboard clients and stuff and understand those spectrum.
But ultimately, Brian, it's about saving the surgeons
time and and the procedure and making sure
that it's optimized and, you know, the patients
are getting the care and make and and
particularly,
assessing those steps carefully.
That's excellent. Doctor Masudi, can you speak to
this from sort of the end user perspective?
Absolutely. I I think, Shrirhar articulated it very
well, and just to highlight some of the,
great points that he raised. As a surgeon
over the years,
last minute cancellations
because of avoidable issues and problems and challenges
have always been a big issue in my
practice and the practices of my colleagues.
A cardiac clearance that should have been done
three weeks before surgery gets done the way
the day before. And of course, it reveals
something that prohibits
us from proceeding with surgery is one example
of it, which is actually happens with quite
a bit of frequency.
So, really,
the combination,
I would say the brilliant combination of multi
agentic
AI platform,
enabling our automation,
processes,
has been a really an effective billion solution
for these problems. And the way I would
characterize this,
what AI has done for Steer platform, what
it has done for surgeons and,
our clients across the country is it has
provided an anticipatory
and proactive,
platform in which we can deal with issues
and predict them and predict problems
before they really arise to a point where
they interfere with the daily flow of,
surgeries and operations and, for instance, an outpatient
surgery center
and,
anticipating problems or recognizing patterns
of, for instance, delay in medical and cardiac
clearance or abnormal laboratories that, are not discovered
until it's too late and really having generated
a system of and,
a catalog of,
alternatives when it comes to surgeries to be
able to, as Rudhar put it, backfill
a surgical
slot that has been not been been made
vacant,
literally last minute,
are tremendous tools,
that now we have at our disposal
to,
increase and enhance our,
operational efficiencies,
enhance predictability
of a particular day,
days work, worth of workflow
at a surgery center in the hospital.
It really does,
tend to relax
the general temperament
of the staff because they're not worried about
all these unpredictable things that can happen last
minute.
Improves patient care and patient flow processes.
And at the end of the day, you
know, we're living in an environment in a
world where everything is very patient centric.
Everybody is customer service oriented,
and it just really results in better patient
care service,
higher satisfaction rates. And, you know, has
referred this,
to before as,
really intelligent optimization of,
untapped capacity,
of surgery centers and hospitals,
that you really are operating to the maximal,
ceiling of potential you have as opposed to
having,
deficiencies and inefficiencies
undermine your
profitability and clinical outcome.
Yeah.
And beyond sort of even just the the
scheduling component, the the the OR optimization component
that can,
you know, boost revenue and help financial performance,
so much of this front end work that
has implications
for for revenue in other ways too, thinking
through making sure registration is correct, verification or
estimates to prevent denials. Right? Because denials
and administrative rework are a major challenge for
for for ASC. So can can you unpack
that a little bit too about how this
kind of stuff can help get in front
of denials, prevent them before they even get
going? Farzad, maybe we'll begin with you and
then Absolutely. Shreedha, it'll be from you too.
One of, one of the accomplishments we're proud
of and one of our claims to fame
is how we have really through automation and,
multiagentic
AI, enablement
have really optimized your revenue cycle management.
And a big part of, optimization of revenue
cycle management is, again, that sort of an
anticipatory
proactive intervention
in terms of, really checking all the boxes,
making sure that the claims that are generated
are administratively
well founded.
And actually these days, we can,
even
optimize the combination
of CPT codes and claims that are submitted
to the insurance company before they're submitted
and then have a a really an automated
AI enabled,
process that we can,
go back to deny claims
and resubmit the claims with adequate explanation and
clinical support and documentation to maximize,
our turnovers on denial. So revenue cycle management
in its all aspects and forms from the
day, the moment the patient gets registered to
when the CPT claims are generated and how
the denials are met and dealt with,
are a big part of this
picture
where centers,
doctors, and hospitals are struggling,
with a declining revenue stream and how we
can optimize that revenue cycle management through this
very stepwise
proactive anticipatory
intervention.
Excellent. Shreedhar, what would you what would you
add there? And then be curious too if
you you you could you could anchor us
with maybe a specific success story in terms
of what this looks like when you get
capacity management and RCM automation right.
Absolutely, Brian. And doctor Masuri articulated really well.
The point I want to highlight is
the battle for margins as we started this
conversation is really either won or lost days
before the patient enters the facility.
I think this is where we call, like,
you know, automation of the entire financial clearance
phase,
which will basically includes, you know, insurance eligibility.
But most importantly, prior authorization,
preparation,
along with apply applying agentic AI. You You
know, pay yourself sophisticated mechanisms around things. How
do you really counter, kind of, like, you
know, provide,
equal footing of really being able to approve,
get those approvals on time. And, you know,
along with it, sending good faith estimates to
patients ahead of time. Right? These are things
we do and streamline this and what we
call, like, the financial clearance space. So our
system
can can flag an authorization issue or coverage
gap instantly,
and then identify whether this this is a
case that might get really delayed or someone
needs to get on the phone. And and
this way, I call human in the loop
what flows to make sure that things that
are really streamlined, automated, can still be addressed.
Things like again, when you automate this, you
can reduce the sticker shock for patients and
also send, you know, automated, you know,
notifications. So all parties, including
surgeon's office, the the anesthesiologist,
and everyone is, like, all kept in the
loop and remove that administrative burden for the
financial side. Now to your second part of
your question, right, you know, we work with
several ASCs, but I'll bring, like, you know,
a high performance surgical group in in Chicago,
you know, that really embodies the shift. Like,
they deal with, you know, high acuity, spine,
orthopedic cases, you know, where an empty slot
can be incredibly expensive. Right? So
before working with Steer, they faced a typical
bottleneck staff, but it didn't phone calls,
late cancellations, manual prep,
and engagement gaps. Right? By implementing,
some of the workflows that we have we
have discussed so far, the automated,
kind of, you know, what we call the
surgical patient journey,
from the initial referral all the way, you
know, through
t twenty one fourteen seven.
These things that are really specific to insurance
or financial clearances.
And also, the second part of it is,
like, you know, clinical
clearances, risk assessments. When you do risk assessments,
right, also applying AI to see, you know,
what are other other considerations or factorial,
things that can come into play. I think
these are elements, again, that are extremely
kind of automated, which we have all done
manually before. The result is
significant increase in provider and staff engagement
because the the busy work disappeared. So,
one of their spine surgeons noted that, you
know, patients were showing up better prepared for
surgery
because the education the patient education sequences are
working.
And and that's ultimately, that's where we see
and they saw detection in note in the
late last minute cancellations.
That's what we take pride in. We look
at the current state and really apply those
anchors to figure out what are the next
best steps so we can kind of what
I call crawl, walk, run, identify the pain
points and solve those things and then get
to the next one. Because we provide entire
spectrum
of, you know, patient journey in the surgical
workflow workflow on top of the HR.
Excellent. Appreciate, you getting into those specifics there.
Before I let you gentlemen go, I wanna
tap on each of you to to share
any closing thoughts you might have. Maybe it's
something you wanna reemphasize from our conversation today.
Maybe it's a a a new thought, or
or something you weren't able to get to
in some of our our previous,
questions. Farzad, let's begin with you. What what
what closing thoughts would you like to leave
our listeners with? In closing,
I would like to, just,
remind our listeners
fact that health care is in a very
unique,
crossroads.
We are really realizing
the kinds of inefficiencies and problems that health
care delivery and patient care delivery in this
country has. And ultimately, it's gonna come come
down to
hospitals and surgery centers and medical groups that
utilize
automation processes and AI enabled platforms
to enhance revenue streams, enhance
operational efficiencies, and improve patient satisfaction rates versus
those who don't have these platforms.
And I think the,
organizations
that avail themselves,
of these new technological breakthroughs that, for instance,
Steer Health can offer are at a clear
competitive advantage compared to the ones that choose
not to. And there's gonna be a bifurcation
in the road to success and prosperity,
in the future of these organizations
in a very close imminent future.
Thank you, doctor Masudi. Tredart, what do you
have? Yeah. I think, my closing thought for
the audience, I think, you know, I think
we are what I call, like, an infinite
game in ASCs.
The goal isn't just to survive. You know,
now with the
technologies and agent EKI that we offer,
you know, I think it's it is to
build an operating system that allows you to
adapt faster than the rest of the market.
I would say don't wait for the perfect
time to modernize. You know, velocity matters.
How your staff experience, surgeons experience matters.
I would say start automating the small friction
points today, and you will build a momentum
to tackle the big ones very soon. So
I think in the coming year, I think
I do see, like, lot of ASCs, you
know, kind of leveraging agentic workflows.
Some are doing it today, but, you know,
other again, adoption rates will be much more
imagine an AI that notices a denial for
a case, logs into the patient portal, and
initiates the appeal draft for a human to
review. I think that's where we're heading. I
think we're
automating the pre op, post op communications, I
think, is where really the game is going
to be rewarding for people that, you know,
really act, and do it effectively.
Shreedhar, appreciate you. Farzad, thank you so much.
It's always a a pleasure speaking to both
of you. Thank you so much for coming
on the podcast.
Thank you, Brian.
Thank you, Brian. Appreciate it. Also wanna thank
our podcast sponsors, Stear Health. You can tune
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