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Imagine this. You're at the Hyatt Regency Chicago

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surrounded by the top minds in the ambulatory

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surgery center industry.

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Welcome to the Becker's 30th annual meeting, the

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business and operations of ASCs from October 30th

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to November second,

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2024. Picture the excitement as you collect business

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cards from over a 1000 executive level attendees

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forging priceless connections.

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Feel the buzz of conversations

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as you participate in more than 60 sessions

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led by over

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225 elite ASC speakers.

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Envision yourself gaining actionable insights on topics like

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private equity strategies,

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ASC business growth, and innovations in spine, orthopedics,

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GI, ophthalmology, and cardiology.

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Now imagine yourself listening to inspiring keynotes from

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Hall of Fame boxing world champion, Lila Ali,

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and professional basketball player, Caitlin Clark. Their stories

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will motivate you to take your business to

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new heights. You'll leave with a wealth of

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knowledge and a network of connections to help

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lead your ASC into the next year. Don't

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miss out. Get registered today. Visit beckershospitalreviewdot

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com and click on the events page to

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find the conference website. That's the beckershospitalreview.com

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events page. See you in Chicago.

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This is Alan Condon back on the Becker's

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podcast, and I am delighted to be joined

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today by Taylor Sarah, who is the chief

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operating officer at the Orthopedic

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Surgery Center. Taylor,

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fantastic to have you back on the podcast

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with us again.

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For those who might not be familiar with

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you or your organization,

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you take a moment to just talk a

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little bit about your role and your background

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at the Orthopedic Surgery Center?

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Sure, Alan. Well, first, you know, thanks for

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having me back. Always enjoy,

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doing these with Becker.

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So to start, I'm Taylor Serra, Chief Operating

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Officer at the Orthopedic Surgery Center, which is

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our ASC

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and also Youngstown Orthopedic Associates,

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where I focus on optimizing revenue,

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implementing new technologies, streamlining processes,

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and optimizing

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resource management.

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I've had the privilege of leading

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this team of of,

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that were recognized for our, you know, intelligence,

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highly adapted structure,

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and and always trying to to to foster

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a culture of of growth

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and innovation.

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I'm I'm very passionate about creating,

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systems not only to improve profitability, but also

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elevate,

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our quality of care that we provide to

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patients. And I think,

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you know, moving forward, my goal is to

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continue to stay ahead of industry trends and

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ensure our centers deliver the highest quality of

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patient care while maintaining cost effective operations.

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Absolutely. That's the the biggest challenge we're all

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chasing. Right?

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Taylor, I'm really excited to have you back

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on today. I'm always excited talking about folks

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who are at the forefront of business and

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the operational

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side of ASCs,

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particularly in the orthopedic space.

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You talked a little bit there about

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creating systems to improve profitability,

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but also systems that elevate quality of care.

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And just to hear more about those, but

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before we do, can you give me 2

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or 3 trends that you're really following in

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healthcare and the ASC space today and why?

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Yeah. Well, healthcare and and ASCs as we

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know it, that landscape is is continuing to

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evolve quite rapidly.

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For me, the top three trends I'm closely

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monitoring are the continued shift to outpatient care,

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outpatient care,

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value based care models,

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and, of course, technology

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and the use of data

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analytics and, you know, decision making.

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If the outpatient care, data analytics, value based

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care as well. I'd love to dive a

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little bit deeper into

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what we hear a lot from

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recent conferences, from executives, the surgeons, physicians, the

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evolution

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of AI, data analytics, penetrating all walks of

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life, specifically health care. Could you give me

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a specific initiative or something that you're working

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on within that realm?

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What are you most excited about or kind

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of a project in that area?

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Yeah. You know, as as we talk about

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this continued shift,

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very excited about

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how we can deliver

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innovation in an outpatient setting.

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As health care continues to move away from

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traditional hospital based care,

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we're finding more efficient and effective cost models

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in ambulatory surgery settings

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centers.

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And,

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you know, this ability

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to bring more complex

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procedures

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into the outpatient environment

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is is changing this land landscape,

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offering patients convenience

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at lower cost, quicker recovery times,

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and, of course, at a higher quality of

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care.

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More specifically,

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innovations in surgical technologies such as robotic assisted

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surgery

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are really making this possible in the outpatient

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space.

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You know, I think the combination of growth

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in the outpatient

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setting and continued,

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cutting edge innovation is truly what excites me,

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and it's about to continue,

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you know, improvement,

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for patient patient outcomes and the overall efficiency

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in the ASC operations.

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Yeah. The the the evolution of robotics, particularly

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in the orthopedic space, the spine space for

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hips and knees, has been fascinating over the

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years. I know that will become an even

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greater component of orthopedic practices and ASCs in

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the future.

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Do you do you see is this we

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hear often about how robots are being used

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as being being used to recruit

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the the latest,

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top talent of orthopedic surgeons coming out of

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fellowships, coming out of residencies because they're now

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searching for practices, searching for ASEs that have

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these technologies, which come with a pretty pretty

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expensive price tag as well. Right?

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I'm curious just to kind of hear your

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your prediction for robotics that are evolving in

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the ASC space,

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and kind of how they kind of trend

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into

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marketing on the patient side, but also recruitment

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on the surgeon side?

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Yeah. And and and, Alan, you're correct.

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As we continue to train

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the the latest and and and, let's say,

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experts in orthopedic surgery and and specifically,

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total total joints,

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you know, these individuals

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are

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picking up and believing in the robotic assisted

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surgery. And so,

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you know, as as private practice,

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you know, physicians and administrators,

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you know, we're being,

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forced

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in a positive aspect. We're being forced into

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how

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do

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we acquire robotics into our orthopedic,

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methoskeletal

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care campuses,

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because that's what

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the physicians,

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are requiring.

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And so, you know, working with vendors,

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there are very strategic and and specific ways,

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to negotiate

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these deals to to bring robotics into,

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into your center.

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From a from a patient standpoint,

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you know, I think

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the orthopedic vendors have done a great job

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in providing patient facing

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marketing,

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and storytelling,

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and successes

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of robotics and orthopedics,

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because, you know, patients are aware of it

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and they're asking for it. And so

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regardless

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of the belief

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or not in robotics,

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patients are asking for it. So

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the the feel is that if you don't

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have some type of robotics as part of

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your orthopedic or musculoskeletal

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program, you're you're you're probably pulling behind

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in in some ways.

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So, you know, our thought

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here in Youngstown, Ohio is there is a

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tremendous value,

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to robotic

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surgery.

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You know, we've found a way to bring

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robotics into our practice.

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It has been very successful for us both

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from

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a physician recruitment retention standpoint,

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from a from a growth in the total

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joint service line standpoint,

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And from a patient care quality standpoint,

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we're having very high success rates.

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Yeah. Such an interest in technology. And just

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in the last few years, how far we've

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seen it grow, it's really exciting to see

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how far the technology will be 2, 3,

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4 years from now, particularly when we think

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about how technologies like AI may be integrated

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into the decision making protocols and whatnot of

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these robots in the future as well.

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Taylor, one quick follow-up, one last follow-up on

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this before we turn to our next question.

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There there are many, many of our listeners

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out there, might be executives,

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administrators, physician owners of ASCs,

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considering,

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to look look to acquire

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a knee, hip, spine robot of their own.

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You talked a little bit about,

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vendors under different tactics to negotiate,

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payment for these high capital purchases.

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Could you, could you expand a little bit

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on that and kind of how how maybe

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your centers, have navigated the purchase for these

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robots?

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Yeah.

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Yes. There are different

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strategies and ways to acquire

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these pieces of technology.

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And

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I think the backbone of it

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is establishing and continuing to build

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relationships between

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vendors and facilities and of course surgeons.

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If you can grow

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those relationships

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and look beyond

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maybe total joints and look into

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capital equipment,

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you know, other subspecialties

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in sports medicine

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and fracture care,

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and and and better align,

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you know, with vendors of

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robotics,

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there are

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attainable

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and and more cost effective

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ways for for maybe smaller

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ASCs

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that have, you know, financial capital constraints and

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can't outlay

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1,000,000 of dollars to obtain equipment,

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like I said, in better alignment with,

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the vendors,

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there are ways to to bring in these

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technologies,

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to your center.

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Yeah. Yeah. Absolutely. And you said that's obviously

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one area that is, helped your center grow

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in the recruitment or retention of surgeons, also

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in terms of patients as well who are

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more increasingly seeking out these products.

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I'd love to get a perspective, when you're

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looking,

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12, 24 months ahead, how are you thinking

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about growth, Taylor?

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Yeah. Well,

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to summarize what we

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have discussed today, in 2025,

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we believe growth in ambulatory surgery centers will

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be driven by a few factors.

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First, it's a continued

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shift towards outpatient care that is expected to

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accelerate,

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with more complex total joint spine procedures being

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approved for ASCs,

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and then the particular

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payer and health systems push for more cost

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effective care and more cost effective settings.

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This is a significant opportunity,

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I believe, for growth in ASCs.

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And again, investing in technology is gonna play

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a huge part in driving this growth.

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As we

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continue

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to discuss

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ways to grow revenue,

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my focus

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is going to be not only to

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look at different service lines to be able

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to do this, but also

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not get away from focusing on,

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the operating margin.

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I think

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it's great to grow revenue,

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but increasing

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operating margin is better.

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As costs continue to rise,

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more pressures are being put on

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ASCs,

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physician practices.

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I think

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it's crucial to not lose sight of that

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operating margin.

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Focus on what you're currently doing. Focus on

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what you're currently doing good

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and find ways, whether it's through AI

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or

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innovation,

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data analytics,

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to either

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maintain

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or improve

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that operational margin. And I think

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it's,

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again, for executives,

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it's to not just look for

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the next big thing to add into your,

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call it, portfolio

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at the ASC,

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but to really focus on

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micromanaging

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the margins that currently exist,

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because I think that's going to be the

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focus as we go forward

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is continuing to maintain

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or improve those margins as payers,

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look to continue

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to cut rates.

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Right. I mean, I think that's such an

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important point as well, right, in terms of,

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not not so much use growing your revenue

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00:13:29,934 --> 00:13:32,514
if your if your expense growth is outweighing

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your revenue growth. Right?

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I I'm curious,

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if there's 1 or 2 specific,

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00:13:38,335 --> 00:13:40,654
final takeaway you could mention, Taylor, in terms

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of,

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a key initiative maybe that you've worked on,

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something that has resulted in,

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00:13:46,230 --> 00:13:49,049
a particular benefit to to your operating margin.

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When I think about

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ASCs or physician owners out there who may

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be struggling to improve their overall operating margin,

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00:13:56,585 --> 00:13:58,184
what are one or two key pieces of

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00:13:58,184 --> 00:13:59,485
advice you might have for that?

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00:14:00,424 --> 00:14:01,245
It is

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one thing that we believe,

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so we've been quite good at is again

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leveraging

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through data analytics

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our vendor relationships,

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whether that's

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our medication management

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systems,

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our medical surgical supply systems,

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00:14:19,289 --> 00:14:20,829
and of course, implant

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00:14:21,424 --> 00:14:24,324
vendors with regards to our orthopedic business.

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00:14:24,704 --> 00:14:25,524
It's really

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00:14:26,225 --> 00:14:27,524
leveraging those relationships

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00:14:27,985 --> 00:14:29,284
and finding opportunity

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to decrease costs.

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And then second is

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continued,

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conversation and relationships with the payers,

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00:14:41,039 --> 00:14:43,860
letting them understand things that are going on

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in your marketplace,

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and how steerage of

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00:14:48,095 --> 00:14:51,075
volumes, whether it's outpatient total joint replacements,

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00:14:52,014 --> 00:14:53,315
or outpatient spine,

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00:14:53,695 --> 00:14:55,295
can be at a lower cost and a

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00:14:55,295 --> 00:14:57,555
higher quality in an outpatient ASC,

391
00:14:58,014 --> 00:14:59,235
continuing to leverage,

392
00:15:00,029 --> 00:15:02,509
the opportunity that's in front of us from

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00:15:02,509 --> 00:15:05,009
an ASC outpatient facility standpoint

394
00:15:06,110 --> 00:15:06,929
and show

395
00:15:07,709 --> 00:15:10,269
the wins per se by steering volumes and

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00:15:10,269 --> 00:15:12,769
patients to the outpatient center. So

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00:15:13,549 --> 00:15:14,049
continuing

398
00:15:14,509 --> 00:15:15,250
to leverage

399
00:15:16,245 --> 00:15:18,105
what's going on in the ASC market

400
00:15:18,485 --> 00:15:19,225
with payers

401
00:15:21,125 --> 00:15:23,144
and being able to potentially

402
00:15:23,684 --> 00:15:24,504
bring in

403
00:15:24,884 --> 00:15:25,625
and negotiate

404
00:15:26,804 --> 00:15:29,465
some of those procedures into the ASC setting

405
00:15:30,165 --> 00:15:31,304
with a bit more

406
00:15:31,990 --> 00:15:33,529
you know, higher reimbursements

407
00:15:34,629 --> 00:15:36,170
bringing those into the ASC.

408
00:15:37,190 --> 00:15:39,129
Yeah. I think, Taylor, it was fascinating,

409
00:15:39,910 --> 00:15:41,990
discussion so far. Great to be able to

410
00:15:41,990 --> 00:15:43,670
pick your brains a little bit on your

411
00:15:43,670 --> 00:15:45,990
your 3rd appearance on the Becker's podcast and

412
00:15:45,990 --> 00:15:48,725
some some great, really great piece of advice

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00:15:48,725 --> 00:15:50,804
and takeaways there to round out our discussion

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00:15:50,804 --> 00:15:51,304
today.

415
00:15:51,764 --> 00:15:53,924
Fascinating conversation, and look forward to connect with

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00:15:53,924 --> 00:15:54,985
you again down the line.

417
00:15:55,365 --> 00:15:56,964
No. I appreciate it. It's always nice to

418
00:15:56,964 --> 00:15:58,664
talk with you and the folks from Becker's.

419
00:15:59,684 --> 00:16:01,625
All great stuff. Always paying

420
00:16:01,940 --> 00:16:03,700
close attention to it. And,

421
00:16:04,980 --> 00:16:07,240
thanks for raising the awareness of ASCs

422
00:16:08,419 --> 00:16:09,860
and all the things that we're good at

423
00:16:09,860 --> 00:16:10,360
producing

424
00:16:11,139 --> 00:16:13,079
to patients and communities and

425
00:16:13,379 --> 00:16:14,440
appreciate the opportunity.

426
00:16:15,539 --> 00:16:17,159
Absolutely. Thank you so much.