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This is Gracelyn Keller with the Becker's Healthcare

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podcast, and we are live at the business

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and operations of ASCs.

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I'm currently joined by Ali Masiwala,

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who is a neurosurgeon

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at DISC Sports and Spine Center. So doctor

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Masiwala, thanks so much for joining me today,

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and would love to have you start off

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by introducing yourself and telling us a little

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bit more about your work in the industry.

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Great to be here. Ali Masiwala. I'm a

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neurosurgeon

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in Southern California at DISC Sports and Spine.

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I've been doing ASC work since 2006.

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And our ASCs are more of a tertiary

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care type of setting where we perform

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every type of spine procedure you can imagine

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from

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simple things like microdiscectomies

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to more complicated things like spinal cord tumors.

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We do our fair share of fusions and

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dis replacements. We've now

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expanded our service lines. We perform joint surgery

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too, so hips and knees.

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And so for us, we've gone from one

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center to, you know, 5 in Southern in

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California,

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and then expanding across the US under the

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same umbrella.

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Wonderful. Well, thank you for taking the time

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to be here. And let's start our conversation

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today with ASC volume. So countrywide, this is

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expected to increase by 16%

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by the year 2032.

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With this growth, what is the most pressing

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challenge to maintaining a positive patient experience?

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So as you increase volume, you don't want

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to sacrifice

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quality of care or the patient experience. So

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for most patients,

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especially

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those that chose to come to the AC

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setting many years ago,

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they always had the hospital as their default

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choice. But we had to convince them that

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the reason to come to the AC setting

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was for better patient experience, more efficient care,

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safer environment, quality control, things like that. And

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certainly during COVID, you know, ASCs were still

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open, so a lot of cases could still

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be done there when the hospitals are shutting

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down for obvious reasons.

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As growth expands

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and you see it not only within the

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specialty, but other specialties, and as more and

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more cases are migrating from

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the

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ASC setting, you have to really be prepared

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to maintain that quality of care and patient

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experience. So it's not just a question of

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can you handle the volume,

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but can you deliver the same attention to

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detail?

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Can you provide cutting edge services and technology?

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And this thing is more comfortable, more caring,

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and ultimately,

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provides a better overall experience and value for

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the patient's daughter.

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And kind of going along with that, what

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strategies have worked for your organization

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in tackling these challenges, and what is one

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recommendation you have for health care leaders to

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stay ahead?

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So I think 2 things that are competitive.

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1,

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technology and the desire to bring the latest

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and greatest stuff to the ASC setting. Many

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of those things nowadays have to do with

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the robotics and AI, and those are expensive

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purchases and really not developed and designed for

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the ASC setting, but we have them in

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hospitals. And so

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patients, even, you know, newer doctors who've just

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finished their training,

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really rely on that technology to provide cutting

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edge, billing based care,

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and that can be in direct conflict with

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the contracts

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and payers

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that you already have set up. And what

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I mean by that is oftentimes new technology

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is not covered

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within these contracts. So whether they're implants or

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whether they're robots,

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these are things that you have to build

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into your

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negotiating and building your contracts so that you

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can actually keep up with and anticipate the

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changes that are coming

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because there's always so much money, you know,

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in the health care pot. And it's being

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divided in differential ways every year.

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And we have the election upcoming next week,

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and that may further change

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the way that we approach health care. So

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it's anticipating

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all these things and making sure that no

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matter what happens,

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you're positioned to take advantage of the situation,

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or you can react to changes that are

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really out of your control.

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And how can leaders ensure their staff are

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well equipped to help patients navigate the financial

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aspects of care? And how does this benefit

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patient provider relationships?

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So I think transparency is key. So, you

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know, historically,

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the finances of health care have been a

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black box for most patients.

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Now more and more patients are are

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getting their EOBs or explanation of benefits from

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the hospital, from their insurer, and they can

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really go through in in a line item

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fashion what money was spent on what part

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of their care. And when it comes to

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the ASC setting,

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for certain insurers, certain policies, patients may have

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a substantial out of pocket fee, which they

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may not have in a traditional hospital setting.

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And so it's understanding,

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you know, where their dollar is going and

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what they can essentially buy

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for their particular,

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spend. And so for a lot of our

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patients who,

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you know, need surgery, they will use up

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their deductible earlier in the year, and they

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will shift their surgery towards the end of

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the year when their deductible has been used

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so they don't need to come with out

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of pocket expense

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to cover their case. The other thing is

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that in some cases, they're actually less expensive

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to pay cash for certain things than they

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have to use your insurance.

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And one of those,

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examples would be imaging. So particular imaging centers

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that you work with

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can offer an MRI for a few $100.

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If they went through their insurance, it might

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be $800. So the system doesn't always make

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sense, but I think if you're transparent with

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the patient in terms of the true cost

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of things and where their money is going,

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oftentimes,

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it only encourages

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them to wanna come to you because it's

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a more trusting relationship.

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And as we wrap up here, is there

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anything else you'd like to share or any

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parting words you have for the podcast?

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I think that ASC growth is never gonna

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cease.

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The reality is that patients who are sick

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need hospitals. Patients who are otherwise well and

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have a specific problem

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can easily be treated in that patient setting.

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And the challenge is really being able to

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provide that care in a way that benefits

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the patient, but at the same time, it

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doesn't take away

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from what the physician is getting out of

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it. And, unfortunately, this is still a business,

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and so we have to pay our bills.

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And so if we can do it in

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such a way where the patient is always

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getting the best quality of care, but the

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physicians are benefiting as well, it's a win

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win for both, and that will continue to

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encourage patients to leave the hospital setting, come

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to the ASCs, and drive that all the

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payers as well.

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Wonderful. Well, Ali, thanks so much for joining

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me today on the Becker's Health Care podcast.

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Again, we are live at the operations and

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business of ASC's event. Thank you. Thank you.