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To learn 13 00:00:30,649 --> 00:00:33,009 more, visit carecredit.com 14 00:00:33,009 --> 00:00:34,229 forward slash beckerspodcast. 15 00:00:35,649 --> 00:00:37,890 This is Gracelyn Keller with the Becker's Healthcare 16 00:00:37,890 --> 00:00:40,229 Podcast, and we are live at the Orthopedic 17 00:00:40,609 --> 00:00:42,710 Spine and Pain Management Conference. 18 00:00:43,125 --> 00:00:45,064 Today, we're going to talk about how financial 19 00:00:45,125 --> 00:00:48,344 transparency helps transform the patient and practice experience. 20 00:00:48,804 --> 00:00:51,284 Joining me for today's discussion is doctor Pamela 21 00:00:51,284 --> 00:00:54,405 Mehta, a board certified orthopedic surgeon, chief medical 22 00:00:54,405 --> 00:00:56,405 officer at the Good Feet Store. So doctor 23 00:00:56,405 --> 00:00:58,329 Mehta, thanks for being here today, and let's 24 00:00:58,329 --> 00:01:00,090 start off by having you introduce yourself a 25 00:01:00,090 --> 00:01:01,770 little bit further and share more about your 26 00:01:01,770 --> 00:01:02,590 role and organization. 27 00:01:03,050 --> 00:01:04,969 Thank you so much for having me today. 28 00:01:04,969 --> 00:01:07,290 It's been a great conference so far. I 29 00:01:07,290 --> 00:01:10,109 just did a really fun session with CareCredit. 30 00:01:11,545 --> 00:01:14,265 I am a board certified orthopedic surgeon. I 31 00:01:14,265 --> 00:01:16,745 have been in practice for fifteen years, and 32 00:01:16,745 --> 00:01:19,484 I started my own practice called Resilience Orthopedics 33 00:01:19,704 --> 00:01:20,765 ten years ago. 34 00:01:21,704 --> 00:01:23,625 I was in a position that I just 35 00:01:23,625 --> 00:01:26,284 employed. Medicine wasn't working for me anymore. 36 00:01:26,640 --> 00:01:28,880 I had two children that were fifteen months 37 00:01:28,880 --> 00:01:30,640 apart, so I had a two year old 38 00:01:30,640 --> 00:01:32,079 and a one year old when I decided 39 00:01:32,079 --> 00:01:34,099 to go out into practice on my own 40 00:01:34,560 --> 00:01:36,319 and decided to do that for a lot 41 00:01:36,319 --> 00:01:38,000 of reasons. But one of them was that 42 00:01:38,000 --> 00:01:39,939 I wanted to have an out of network 43 00:01:40,165 --> 00:01:42,004 cash practice so that I would have more 44 00:01:42,004 --> 00:01:43,144 time with my patients, 45 00:01:43,604 --> 00:01:45,064 really give them that personalized 46 00:01:45,364 --> 00:01:45,864 experience, 47 00:01:46,405 --> 00:01:48,584 and not worry so much about the middleman 48 00:01:49,125 --> 00:01:51,364 insurance companies when it comes to my practice. 49 00:01:51,364 --> 00:01:52,024 I also 50 00:01:52,400 --> 00:01:54,319 was trying to figure out a way to 51 00:01:54,319 --> 00:01:56,579 prevent my own burnout, my staff's burnout, 52 00:01:56,959 --> 00:01:59,040 really to promote that we should give good 53 00:01:59,040 --> 00:02:01,760 patient care without those other things. And for 54 00:02:01,760 --> 00:02:03,519 me, that meant an out of network cash 55 00:02:03,519 --> 00:02:05,599 practice that keeps my overhead lower. I don't 56 00:02:05,599 --> 00:02:07,299 have a lot of staff running around 57 00:02:07,805 --> 00:02:08,705 getting authorizations 58 00:02:09,164 --> 00:02:11,405 and fighting appeals, and so it really has 59 00:02:11,405 --> 00:02:12,625 been a really good 60 00:02:12,925 --> 00:02:14,865 model for me and for my patients. 61 00:02:15,405 --> 00:02:17,645 I also am chief medical officer at the 62 00:02:17,645 --> 00:02:18,705 Good Feet Store, 63 00:02:19,084 --> 00:02:21,884 and I started Pinnacle Conference with two of 64 00:02:21,884 --> 00:02:24,379 my other cofounders six years ago. It's a 65 00:02:24,379 --> 00:02:26,400 national conference that we hold annually, 66 00:02:26,939 --> 00:02:27,599 a multispecialty, 67 00:02:28,219 --> 00:02:30,460 and we really teach women about the things 68 00:02:30,460 --> 00:02:32,639 in medicine we do not learn in school. 69 00:02:33,420 --> 00:02:34,800 A lot of business negotiation, 70 00:02:35,099 --> 00:02:37,615 leadership, how to communicate as a woman. We 71 00:02:37,615 --> 00:02:39,134 are now in our sixth year. We just 72 00:02:39,134 --> 00:02:40,034 had our conference, 73 00:02:40,495 --> 00:02:41,155 in May, 74 00:02:41,455 --> 00:02:44,254 and we are now a jointly accredited program. 75 00:02:44,254 --> 00:02:45,555 So we offer CME 76 00:02:46,014 --> 00:02:46,514 for 77 00:02:46,814 --> 00:02:47,715 many platforms 78 00:02:48,094 --> 00:02:51,134 of education, digital, and live conferences. So that's 79 00:02:51,134 --> 00:02:53,290 a little bit about me. Wonderful. Well, thank 80 00:02:53,290 --> 00:02:55,689 you for being here. And let's start broad 81 00:02:55,689 --> 00:02:57,689 strokes. What trends or shifts are you seeing 82 00:02:57,689 --> 00:02:59,849 right now in the orthopedic space that you 83 00:02:59,849 --> 00:03:01,689 think are most important for industry leaders to 84 00:03:01,689 --> 00:03:04,010 pay attention to? I think that's a great 85 00:03:04,010 --> 00:03:05,310 question. In orthopedics, 86 00:03:06,185 --> 00:03:08,444 we have always prided ourselves on innovation 87 00:03:09,224 --> 00:03:12,104 and always learning the best and newest techniques 88 00:03:12,104 --> 00:03:12,844 for things. 89 00:03:13,625 --> 00:03:15,485 I think when it comes to 90 00:03:15,784 --> 00:03:16,925 old school technology 91 00:03:17,384 --> 00:03:19,639 and joint replacement surgery, 92 00:03:19,939 --> 00:03:22,419 we have really improved the pain management behind 93 00:03:22,419 --> 00:03:24,439 it, and we are now seeing that patients 94 00:03:25,460 --> 00:03:27,240 are not being admitted to the hospital 95 00:03:27,540 --> 00:03:30,180 for three days or longer and going home 96 00:03:30,180 --> 00:03:31,699 a week later with a lot of pain 97 00:03:31,699 --> 00:03:32,199 medications. 98 00:03:32,585 --> 00:03:34,585 We're seeing that patients are having these surgeries 99 00:03:34,585 --> 00:03:36,125 done in an ASC setting. 100 00:03:36,425 --> 00:03:38,985 They are being admitted for just a few 101 00:03:38,985 --> 00:03:40,585 hours, and they're going home and they're getting 102 00:03:40,585 --> 00:03:44,044 started on PT, which is really improving their 103 00:03:44,264 --> 00:03:46,764 post op course and their quality of care 104 00:03:47,020 --> 00:03:48,780 and just getting them moving and back to 105 00:03:48,780 --> 00:03:50,800 the life that they enjoy living much faster. 106 00:03:51,180 --> 00:03:53,020 What we're also seeing a lot of is 107 00:03:53,020 --> 00:03:55,740 wellness. People wanna come in before they have 108 00:03:55,740 --> 00:03:58,219 an injury, before they have arthritis hit their 109 00:03:58,219 --> 00:04:01,259 joints. So they're really looking for regenerative medicine 110 00:04:01,259 --> 00:04:03,094 and ways to preserve their joint. 111 00:04:03,634 --> 00:04:05,634 We're seeing patients that are younger and younger 112 00:04:05,634 --> 00:04:06,694 that are staying more, 113 00:04:07,555 --> 00:04:08,055 active 114 00:04:08,675 --> 00:04:09,155 and, 115 00:04:09,794 --> 00:04:11,634 want to make sure that they can continue 116 00:04:11,634 --> 00:04:14,675 that sport that they enjoy well into their 117 00:04:14,675 --> 00:04:16,294 fifties, sixties, and seventies. 118 00:04:17,279 --> 00:04:20,399 Absolutely. And as outpatient care continues to grow, 119 00:04:20,399 --> 00:04:22,800 that's actually such a great segue. How do 120 00:04:22,800 --> 00:04:25,040 you see the role of orthopedics evolving within 121 00:04:25,040 --> 00:04:26,420 the broader healthcare ecosystem? 122 00:04:27,439 --> 00:04:28,980 I think, as I mentioned before, 123 00:04:29,520 --> 00:04:31,279 a lot more is being done at an 124 00:04:31,279 --> 00:04:34,675 ASC. It's it's really now become rare to 125 00:04:34,675 --> 00:04:35,175 do 126 00:04:35,634 --> 00:04:39,095 orthopedic cases in a hospital setting where 127 00:04:39,474 --> 00:04:42,595 patients are staying for multiple days. This has 128 00:04:42,595 --> 00:04:43,414 really helped, 129 00:04:44,035 --> 00:04:46,310 get our patients moving faster and be able 130 00:04:46,310 --> 00:04:48,069 to also keep the volume so that people 131 00:04:48,069 --> 00:04:50,790 aren't waiting many, many months and years for 132 00:04:50,790 --> 00:04:52,250 their procedures to be done. 133 00:04:52,629 --> 00:04:54,629 As I mentioned before, we're doing total knee 134 00:04:54,629 --> 00:04:57,589 replacements, total hip replacements in an ASC. They're 135 00:04:57,589 --> 00:04:59,355 getting out of there by if their first 136 00:04:59,355 --> 00:05:01,915 start, they're getting out by noon, 1PM sometimes. 137 00:05:01,915 --> 00:05:03,694 They've already worked with physical therapy. 138 00:05:03,995 --> 00:05:05,375 They have their pain regimen. 139 00:05:05,675 --> 00:05:07,355 They're going home with a block, so they're 140 00:05:07,355 --> 00:05:07,855 comfortable. 141 00:05:08,875 --> 00:05:10,314 We're just seeing more and more done in 142 00:05:10,314 --> 00:05:13,170 the ASC, which is awesome for the patients, 143 00:05:13,170 --> 00:05:15,589 and it's really great for the physicians too. 144 00:05:15,649 --> 00:05:17,250 We don't have to worry about our patients 145 00:05:17,250 --> 00:05:17,750 getting 146 00:05:18,209 --> 00:05:21,170 infections in the hospital or taking a fall 147 00:05:21,170 --> 00:05:22,930 or being up late at night because there's 148 00:05:22,930 --> 00:05:25,110 a lot of beeping and IVs and nurses 149 00:05:25,170 --> 00:05:27,089 coming in. So I think it's really improved 150 00:05:27,089 --> 00:05:28,665 the quality of life for the patient. 151 00:05:29,225 --> 00:05:29,725 Absolutely. 152 00:05:30,185 --> 00:05:32,824 And financial transparency has become more of a 153 00:05:32,824 --> 00:05:34,925 prominent part of the patient experience 154 00:05:35,464 --> 00:05:39,004 with growing expectations from consumers and healthcare stakeholders 155 00:05:39,145 --> 00:05:40,764 alike. So from your perspective, 156 00:05:41,305 --> 00:05:43,944 what does true financial transparency look like in 157 00:05:43,944 --> 00:05:44,444 practice? 158 00:05:44,919 --> 00:05:47,000 And for leaders thinking about the business side 159 00:05:47,000 --> 00:05:49,800 of care, especially in an increasing consumer driven 160 00:05:49,800 --> 00:05:53,240 health care environment, how can financial transparency become 161 00:05:53,240 --> 00:05:55,500 not just a patient win, but a competitive 162 00:05:55,560 --> 00:05:56,060 advantage? 163 00:05:57,345 --> 00:05:59,504 These are great questions. And for me, I 164 00:05:59,504 --> 00:06:00,805 think financially financial 165 00:06:01,264 --> 00:06:01,764 transparency 166 00:06:02,865 --> 00:06:04,084 starts at the beginning. 167 00:06:04,384 --> 00:06:07,925 So I think many patients do not understand 168 00:06:07,985 --> 00:06:10,290 their health care insurance. I think many physicians 169 00:06:10,430 --> 00:06:12,589 don't understand health care insurance too, which is 170 00:06:12,589 --> 00:06:14,509 a problem, and I think we have to 171 00:06:14,509 --> 00:06:16,829 attack that as well. But for me, in 172 00:06:16,829 --> 00:06:19,629 my own practice, I'm very upfront about what 173 00:06:19,629 --> 00:06:21,470 the costs are. I'm no different than a 174 00:06:21,470 --> 00:06:23,490 hair salon. I have a menu of services. 175 00:06:24,110 --> 00:06:26,794 We publish them. We tell the patient. They 176 00:06:26,794 --> 00:06:29,274 pay at time of service. We do all 177 00:06:29,274 --> 00:06:32,254 the billing for the patients so that they 178 00:06:32,314 --> 00:06:34,314 don't need to worry about what is gonna 179 00:06:34,314 --> 00:06:35,214 happen afterwards. 180 00:06:35,675 --> 00:06:37,115 We take care of that for them. They 181 00:06:37,115 --> 00:06:39,675 often recoup most, if not all, of the 182 00:06:39,675 --> 00:06:40,050 cost. 183 00:06:40,529 --> 00:06:43,169 It's just dependent upon their insurance that they 184 00:06:43,169 --> 00:06:45,569 have. And to be honest, many people do 185 00:06:45,569 --> 00:06:47,250 not understand that their in network and out 186 00:06:47,250 --> 00:06:49,889 of network benefits are exactly the same and 187 00:06:49,889 --> 00:06:51,729 that they may have a high deductible plan, 188 00:06:51,729 --> 00:06:53,029 so they're paying anyway 189 00:06:53,354 --> 00:06:55,914 regardless. They just don't have the transparency of 190 00:06:55,914 --> 00:06:58,235 how much they're paying. But at my office, 191 00:06:58,235 --> 00:07:00,314 they're no they know that right at the 192 00:07:00,314 --> 00:07:01,055 get go. 193 00:07:01,435 --> 00:07:03,055 I do work with in network 194 00:07:03,435 --> 00:07:06,235 surgery centers and in network referrals like physical 195 00:07:06,235 --> 00:07:08,095 therapy and MRI and other imaging 196 00:07:08,639 --> 00:07:11,519 centers. And so that makes it easier for 197 00:07:11,519 --> 00:07:13,600 the patient as well because they do know 198 00:07:13,600 --> 00:07:15,919 that those costs are being dealt with through 199 00:07:15,919 --> 00:07:17,860 their insurance. But their physician, 200 00:07:18,160 --> 00:07:20,160 that relationship between me and them is not 201 00:07:20,160 --> 00:07:21,860 hindered by any third party, 202 00:07:22,225 --> 00:07:24,785 which has really helped that patient experience and 203 00:07:24,785 --> 00:07:26,805 make it more personalized as well. 204 00:07:27,264 --> 00:07:29,345 For leaders thinking about the business side of 205 00:07:29,345 --> 00:07:30,964 care, we should all 206 00:07:31,345 --> 00:07:32,644 every single physician, 207 00:07:33,345 --> 00:07:35,125 any kind of medicine you're practicing, 208 00:07:35,745 --> 00:07:37,605 should care about the business of medicine. 209 00:07:38,120 --> 00:07:40,120 The reason we're all burning out and we're 210 00:07:40,120 --> 00:07:41,800 being asked to do more and more for 211 00:07:41,800 --> 00:07:44,360 less reimbursement is because we have not advocated 212 00:07:44,360 --> 00:07:46,520 for ourselves, and we do not understand the 213 00:07:46,520 --> 00:07:47,500 business of medicine. 214 00:07:47,800 --> 00:07:49,720 It needs to start when we're in medical 215 00:07:49,720 --> 00:07:51,639 school and when we're in training and when 216 00:07:51,639 --> 00:07:52,779 we're out in practice. 217 00:07:53,175 --> 00:07:55,415 Unfortunately, when I started my practice ten years 218 00:07:55,415 --> 00:07:57,574 ago, there was no handbook for how to 219 00:07:57,574 --> 00:07:59,415 start a practice. I just had to figure 220 00:07:59,415 --> 00:08:01,254 it out on my own. And, unfortunately, ten 221 00:08:01,254 --> 00:08:03,095 years later, it's still the case. There is 222 00:08:03,095 --> 00:08:05,595 not a lot out there to help physicians 223 00:08:05,894 --> 00:08:06,394 recognize 224 00:08:06,699 --> 00:08:08,220 how they can start a practice, how to 225 00:08:08,220 --> 00:08:09,819 run a practice, how to scale a practice, 226 00:08:09,819 --> 00:08:11,819 how to grow your practice. And so I 227 00:08:11,819 --> 00:08:14,699 think we need to, as physicians, be advocates 228 00:08:14,699 --> 00:08:16,939 for that because if we don't have a 229 00:08:16,939 --> 00:08:19,420 stake in that conversation, that conversation is happening 230 00:08:19,420 --> 00:08:21,339 without us, and it has been happening without 231 00:08:21,339 --> 00:08:22,399 us for years. 232 00:08:23,314 --> 00:08:25,555 Absolutely. And then finally, as we wrap our 233 00:08:25,555 --> 00:08:28,775 conversation, from your view, how does strengthening financial 234 00:08:28,835 --> 00:08:31,574 communication help foster long term trust and loyalty 235 00:08:31,634 --> 00:08:33,014 between patients and providers? 236 00:08:33,715 --> 00:08:35,919 Well, I think that's the problem with medicine 237 00:08:35,919 --> 00:08:37,759 is and health care insurance is that there 238 00:08:37,759 --> 00:08:39,860 is not transparency. And so 239 00:08:40,320 --> 00:08:41,539 patients aren't understanding 240 00:08:42,159 --> 00:08:44,399 what they are going to be financially responsible 241 00:08:44,399 --> 00:08:47,279 for until much later. We're the only industry 242 00:08:47,279 --> 00:08:48,879 where you get paid for your service ninety 243 00:08:48,879 --> 00:08:49,700 days later. 244 00:08:50,164 --> 00:08:52,164 And where is that money coming from? How 245 00:08:52,164 --> 00:08:54,644 is it being negotiated? Oftentimes, we don't know 246 00:08:54,644 --> 00:08:56,644 the answers to these questions, which means the 247 00:08:56,644 --> 00:08:59,125 patient doesn't know either. And so I think 248 00:08:59,125 --> 00:09:02,245 the transparency from the beginning establishes trust between 249 00:09:02,245 --> 00:09:04,379 the physician and the patient. And I think 250 00:09:04,379 --> 00:09:06,879 offering tools to a patient like the CareCredit 251 00:09:07,179 --> 00:09:09,259 credit card is a great way for them 252 00:09:09,259 --> 00:09:11,100 to understand that there are ways to pay 253 00:09:11,100 --> 00:09:13,659 for their health care, and there are ways 254 00:09:13,659 --> 00:09:15,980 to get them their treatment faster and sooner 255 00:09:15,980 --> 00:09:18,524 and with the physician that they want. And 256 00:09:18,524 --> 00:09:20,524 so I do think these conversations need to 257 00:09:20,524 --> 00:09:22,924 happen between the physician and the patient and 258 00:09:22,924 --> 00:09:25,164 also between the office staff and the patient, 259 00:09:25,164 --> 00:09:26,784 which requires some education 260 00:09:27,164 --> 00:09:28,845 and for us to have some literacy behind 261 00:09:28,845 --> 00:09:29,985 all of this as well. 262 00:09:30,450 --> 00:09:32,610 Absolutely. Well, thank you, Doctor. Metta for your 263 00:09:32,610 --> 00:09:34,929 time and insights today. We also want to 264 00:09:34,929 --> 00:09:36,710 thank our podcast sponsor CareCredit. 265 00:09:37,090 --> 00:09:38,929 You can tune into more podcasts from Becker's 266 00:09:38,929 --> 00:09:42,870 Healthcare by visiting our podcast page at beckershospitalreview.com.