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This is Gracelyn Keller with the Becker's Healthcare
Podcast, and we are live at the business
and operations of ASCs.
I'm currently joined by Jacob Corbell, who serves
as the CEO of Midwest Cardiovascular
Institute.
Jacob, thanks so much for taking the time
to be here today. We'd love to have
you introduce yourself and tell us a little
bit more about your work in the industry.
Thanks. I'm I'm happy to be here. So
I have worked, on the private practice side
in cardiology my whole career,
most recently the last 4 years, in the
western suburbs of Chicago, Midwest Cardiovascular Institute,
29,
cardiologist, private practice.
And so I I think,
most of my career has been spent,
working for physicians in cardiology
and how those physicians,
obviously run their practice and also how they
integrate and interact with local health systems.
Wonderful. Well, thanks for being here. Let's start
our conversation today talking about ASC volume. So
this is expected to increase by 16%
across the country
by the year 2032.
With this growth, what is the most pressing
challenge to maintaining a positive patient experience?
Well, I think it starts with access, and
I think it's it also starts with cost.
I think right now, we have an unaffordable,
unaccessible health care system. And especially in cardiology,
where
right now we're expecting,
by 2050,
61% of adults in America to have heart
disease. That is a staggering statistic,
that more than half of the adult population
in America will have cardiovascular disease.
So we've got to solve for access. Patients
need to be able to get in to
see a cardiologist
as quickly as possible. The ER,
should never be the front door to cardiology
care. And and we think the ambulatory surgery
center really becomes an extension of that accessible
outpatient experience
where patients can get in to see a
cardiologist. Again, in Chicago, not uncommon
to wait 3, 4 months to see a
cardiologist.
We think it should be the next day.
It should never go past 3 days. So
a patient should be able to get in,
see a cardiologist, and then have an option
if they need a procedure,
an option for a lower cost,
more high experience setting like an outpatient surgery
center. You know, other specialists in medicine have
been, you know, doing these surgery centers for
a long time. Cardiology is new to the
game. In 2020, Medicare approved the the the
coronary stent, and that really has now brought
cardiology
into the ambulatory surgery center fold. So the
patients,
it would be very unlikely for a patient
to spend more than 4 to 5 hours
in the center.
The cost of the patients anywhere between 60
to 80% less as it would in a
hospital setting where they would probably spend between
12 and 24 hours.
And going off of that, what strategies have
worked for your organization to tackle some of
those challenges? And what's a recommendation you have
for health care leaders looking to stay ahead?
That's a great question. I think strategically,
again, if what you're doing as an organization
is not increasing access and access is not
just a buzzword. Access is can patients come
in and see your doctors.
And if they can't,
or the time that it takes for them
to do that
provides a barrier to receive care, you're not
providing access. And so I think strategically,
you start being accessible by having doctors more
efficient.
Doctors need to be just doing physician work.
Physicians can't be sitting in front of a
computer doing
non medical work all day long. You need
to have support staff and a care team
that allow all those in the care team
to operate at the peak of their licensure.
So your strategy should be about making doctors
more efficient, giving them the support to just
being doctors.
Again, physicians,
they wanna take care of patients. They wanna
see patients.
If half their time is becoming a clerical
data entry clerk,
it's not what they signed up for. And
and so allowing doctors to just take care
of patients, making them efficient
will allow you to see the volume needed
to create the access.
So that's really the strategy, access and efficiency.
And then and then specifically to ambulatory surgery
centers. Again, we are a private practice. We're
building a very nice surgery center. We will
open, in January, and we joint ventured with
our local hospital.
We think that but even though Medicare,
most of your industry trends are are going
outpatient,
we still believe our our community hospital should
be very successful.
So we want them to partner with us.
You know, 1, we're sharing in the risk
and to everyone is growing,
whether it be revenue, whether it be procedural
volume, whether it be innovation.
Everyone, the physicians and the health system are
growing together.
And switching gears just a little bit toward
the financial side. How can leaders ensure their
staff are well equipped to help patients navigate
the financial aspects of care? And how does
this benefit patient provider relationships?
Well, I think you've gotta be transparent. I
think you've gotta be open with patients. We
we like to tell our patients what their
out of pocket costs are gonna be before
the procedure, and we think that should be
standard operating procedure.
I think that's another problem with medicine today
and health care today is to it's not
like when you go to Target and you
have 15 items, you know what you're paying
and Target knows what they're getting paid before
you walk out the door. In health care,
you have no idea.
So you you go see a doctor today
and you get an ultrasound and you get
some testing done. You really don't know what
you're paying. You have a copay, but
You really don't know what you're paying. You
have a co pay. But what is the
insurance gonna cover? What are you gonna have
to come out of pocket? What's the practice?
It's hard to run a business that way.
And and so I think price transparency really
works both ways. I think those providing care
need to know,
what they have to pay for something, and
those receiving the care need to know as
well. So I think it starts with,
do you have
a sophisticated technology,
relationships with the insurance companies that can tell
a patient what their cost is gonna be?
And do you have a core philosophy that
that matters? Does that matter to your organization?
And we we believe it does.
Yeah. Very excellent point. As we wrap our
conversation here, is there anything else you'd like
to share for closing remarks on the podcast
today?
Well, I think, it's an exciting time in
health care. Obviously,
health care is a very dynamic industry, and
and you have to be prepared every day
for change. There's talk right now in Capitol
Hill that,
site of service neutrality may be a a
a reality where,
the hospital outpatient fee schedule could be prepared
to take a hit.
The private you know, in 2008, 90% of
cardiologists were were private.
Literally 15 years ago, 9 out of every
10 cardiologists own their own practice. Today,
8 out of 10 work for hospitals and
2 out of 10 own their own practice.
And so like everything in medicine, it there's
a pendulum that swings and and there's,
evolving landscapes. I think what you're gonna see
in the next 10 to 15 years and
what your listeners should be prepared for is
a return to private practice.
And and I think that actually benefits patients,
benefits hospitals, and benefits physicians. And I think
that that if the health systems, in fact,
if there's gonna be some regulatory burdens now
on their revenue infrastructure,
they need to find ways to uniquely partner
with hospitals. And I'll be able to wrap
it up with this. One of the greatest
ways private practice physicians and local hospitals can
partner is a joint venture ambulatory surgery center.
Wonderful. Well, Jacob, thank you so much for
sharing you those insights today and taking the
time to join me on the Becker's Healthcare
Podcast. Again, we're live at the business and
operations of ASCs.
Great. Thank you. Thanks for having me.