1 00:00:00,080 --> 00:00:02,500 This is Laura Dierda with the Becker's Ambulatory 2 00:00:02,560 --> 00:00:03,699 Surgery Center's podcast. 3 00:00:04,000 --> 00:00:05,679 I'm thrilled today to be joined by Jennifer 4 00:00:05,679 --> 00:00:08,160 Friend, chief executive officer and owner at Friend 5 00:00:08,160 --> 00:00:09,139 Surgical Solutions. 6 00:00:09,439 --> 00:00:10,719 Jennifer, it's a pleasure to have you on 7 00:00:10,719 --> 00:00:12,639 the podcast today. It's great to be here. 8 00:00:12,639 --> 00:00:15,035 Thank you for having me. Now I'm really 9 00:00:15,035 --> 00:00:17,274 excited for our conversation because I know just 10 00:00:17,274 --> 00:00:19,434 the ASC space is so fascinating today and 11 00:00:19,434 --> 00:00:20,954 really a lot happening in health care. It's 12 00:00:20,954 --> 00:00:23,195 very dynamic. So, I know we've got a 13 00:00:23,195 --> 00:00:25,035 couple questions here. But before we dive in, 14 00:00:25,035 --> 00:00:26,714 can you introduce yourself and tell us a 15 00:00:26,714 --> 00:00:27,934 little bit about your background? 16 00:00:28,699 --> 00:00:30,859 As you said, I'm Jennifer Friend. I own 17 00:00:30,859 --> 00:00:32,799 and operate Sun Surgical Solutions. 18 00:00:34,219 --> 00:00:37,820 Sun Surgical Solutions is a consultant and medical 19 00:00:37,820 --> 00:00:39,739 billing group. Although, I try to focus more 20 00:00:39,739 --> 00:00:42,239 on the consultant side where I help providers 21 00:00:42,615 --> 00:00:45,195 with any licensure needs, any concerns, 22 00:00:46,454 --> 00:00:47,914 compliance, all of those 23 00:00:48,375 --> 00:00:51,094 tedious tasks on the business end of health 24 00:00:51,094 --> 00:00:51,594 care. 25 00:00:52,295 --> 00:00:53,815 So that way they can focus on the 26 00:00:53,815 --> 00:00:56,609 operations and keeping things going. Although I do 27 00:00:56,609 --> 00:00:59,170 love the operation side too, I'm I find 28 00:00:59,170 --> 00:01:01,009 myself most happiest when I'm in a procedure 29 00:01:01,009 --> 00:01:02,869 room helping, you know, helping 30 00:01:03,329 --> 00:01:05,409 a provider, you know, get cases done and 31 00:01:05,409 --> 00:01:07,569 get patients the care they need. I I 32 00:01:07,569 --> 00:01:10,629 have a master's degree from George Washington University. 33 00:01:11,265 --> 00:01:13,185 I also have a my bachelor's degree is 34 00:01:13,185 --> 00:01:15,265 in political science, which you wouldn't think ties 35 00:01:15,265 --> 00:01:17,665 to health care. But actually knowing how the 36 00:01:17,665 --> 00:01:19,364 government works, how the government operates 37 00:01:20,224 --> 00:01:23,745 is very helpful in understanding Medicare and Medicare, 38 00:01:23,745 --> 00:01:25,685 Medicaid, CMS, HHS, 39 00:01:26,305 --> 00:01:27,939 you know, all the terms that we've heard 40 00:01:27,939 --> 00:01:29,159 being thrown around in 41 00:01:29,540 --> 00:01:31,140 in in the news lately and how it 42 00:01:31,140 --> 00:01:33,459 operates and how it ties into our practice 43 00:01:33,459 --> 00:01:34,280 in health care. 44 00:01:35,060 --> 00:01:37,219 That's amazing to hear, in in, you know, 45 00:01:37,219 --> 00:01:38,739 what a great service to be able to 46 00:01:38,739 --> 00:01:41,159 provide surgery centers and those physician owners. 47 00:01:41,484 --> 00:01:43,004 Now what are the top three trends that 48 00:01:43,004 --> 00:01:45,265 you're following in health care and ASCs today? 49 00:01:46,364 --> 00:01:47,984 I do see some growth, 50 00:01:48,604 --> 00:01:49,104 although, 51 00:01:49,804 --> 00:01:51,265 you know, obviously, given 52 00:01:51,724 --> 00:01:52,224 Medicare 53 00:01:52,844 --> 00:01:54,384 and Medicare is 54 00:02:03,349 --> 00:02:05,349 acuity of what's going on in in the 55 00:02:05,349 --> 00:02:06,569 AFC setting. However, 56 00:02:07,109 --> 00:02:09,495 you know, with the Medicaid cuts and and 57 00:02:09,495 --> 00:02:10,715 the other cuts coming, 58 00:02:11,495 --> 00:02:13,415 it's making me a little wary of where 59 00:02:13,415 --> 00:02:15,254 we're of where they're going, but I still 60 00:02:15,254 --> 00:02:17,814 do see growth in the different procedures that 61 00:02:17,814 --> 00:02:20,794 we can provide in an ambulatory surgery setting. 62 00:02:21,495 --> 00:02:23,435 I also see more coming into 63 00:02:24,379 --> 00:02:26,939 moving the ambulatory surgery space and coming into 64 00:02:26,939 --> 00:02:29,900 an office based surgery facility surgery setting where 65 00:02:29,900 --> 00:02:33,040 you're able to do more monitored anesthesia care, 66 00:02:33,260 --> 00:02:34,879 some lighter anesthesia coverage, 67 00:02:35,340 --> 00:02:37,500 and doing that safely in an office setting 68 00:02:37,500 --> 00:02:40,164 as well to help offset the surgery centers 69 00:02:40,164 --> 00:02:41,705 that are now taking on more, 70 00:02:43,205 --> 00:02:45,364 replacements and all of those types of things 71 00:02:45,364 --> 00:02:47,844 and the cardiac procedures that they're doing. So 72 00:02:47,844 --> 00:02:50,405 that's that's one. I still don't think private 73 00:02:50,405 --> 00:02:52,229 equity I know they've gotten kind of a 74 00:02:52,310 --> 00:02:54,469 somewhat of a bad rap lately or they've 75 00:02:54,469 --> 00:02:56,870 been on the sidelines a little bit. I 76 00:02:56,870 --> 00:02:58,009 still think there's 77 00:02:58,469 --> 00:03:00,549 they're gonna be players or those that wanna 78 00:03:00,549 --> 00:03:02,489 come back in soon. 79 00:03:02,949 --> 00:03:04,330 I also just see people 80 00:03:04,694 --> 00:03:06,854 trying to just keep their heads above water 81 00:03:06,854 --> 00:03:08,474 right now with some of the changes 82 00:03:09,094 --> 00:03:11,275 that are coming. So I think that's hesitation's 83 00:03:11,415 --> 00:03:13,254 gonna be the other trend that's gonna happen, 84 00:03:13,254 --> 00:03:14,155 I think, soon. 85 00:03:14,935 --> 00:03:16,615 Absolutely. I think that makes a lot of 86 00:03:16,615 --> 00:03:17,754 sense. You know, really 87 00:03:18,170 --> 00:03:18,670 dynamic, 88 00:03:19,450 --> 00:03:21,389 industry, lots of changes, and I appreciate 89 00:03:21,689 --> 00:03:23,530 everything we talked about in terms of, you 90 00:03:23,530 --> 00:03:25,849 know, how what procedures coming from the hospital 91 00:03:25,849 --> 00:03:27,290 to the AFC and from the AFC to 92 00:03:27,290 --> 00:03:30,490 the office based setting, looking at private equity, 93 00:03:30,889 --> 00:03:31,870 and other opportunities 94 00:03:32,585 --> 00:03:32,985 for, 95 00:03:33,385 --> 00:03:34,764 surgery centers to 96 00:03:35,064 --> 00:03:38,264 gain additional financial resources and and see where 97 00:03:38,264 --> 00:03:39,245 where they grow. 98 00:03:39,625 --> 00:03:41,625 And then, you know, as you mentioned, just 99 00:03:41,625 --> 00:03:43,965 kind of continuing to watch the field, 100 00:03:44,659 --> 00:03:46,759 field evolve. It's just been fascinating. 101 00:03:47,219 --> 00:03:48,659 Based on a lot of those changes, what 102 00:03:48,659 --> 00:03:50,099 are you excited about right now? What do 103 00:03:50,099 --> 00:03:52,259 you think is really important for surgery center 104 00:03:52,259 --> 00:03:54,500 owners and operators to know and and think 105 00:03:54,500 --> 00:03:56,979 about as they're seeing the the field change 106 00:03:56,979 --> 00:03:57,800 around them? 107 00:03:58,364 --> 00:03:59,564 I think a lot of it, we all 108 00:03:59,564 --> 00:04:02,224 kind of know, but, you know, I'm always 109 00:04:02,525 --> 00:04:03,664 excited to talk 110 00:04:04,444 --> 00:04:06,924 to physician owners and, you know, do they 111 00:04:06,924 --> 00:04:09,724 really know what their operating costs are? Do 112 00:04:09,724 --> 00:04:11,485 they know how much it costs them to 113 00:04:11,485 --> 00:04:14,099 do that, or are there ways to 114 00:04:14,560 --> 00:04:16,339 trim spending so, therefore, 115 00:04:16,720 --> 00:04:18,639 there's not much fat on a there can 116 00:04:18,639 --> 00:04:20,639 be fat on ASC depending on the procedures. 117 00:04:20,639 --> 00:04:22,500 But, you know, with Medicare 118 00:04:23,120 --> 00:04:24,660 potentially cutting some, 119 00:04:25,254 --> 00:04:26,875 excuse me, cutting some rates, 120 00:04:27,334 --> 00:04:29,175 where where can we make sure we're providing 121 00:04:29,175 --> 00:04:30,314 the most cost savings, 122 00:04:31,095 --> 00:04:33,095 to make sure that the ASC is operating 123 00:04:33,095 --> 00:04:33,595 efficiently 124 00:04:34,134 --> 00:04:34,875 and effectively? 125 00:04:35,574 --> 00:04:37,894 But I'm also excited about the different procedures 126 00:04:37,894 --> 00:04:40,540 that are coming in. I primarily focus on 127 00:04:40,540 --> 00:04:41,839 spine pain and ortho. 128 00:04:42,300 --> 00:04:43,740 But with the rise, like I said, of 129 00:04:43,740 --> 00:04:46,220 earlier of cardiac procedures coming in and being 130 00:04:46,220 --> 00:04:48,300 able to do more of those at and 131 00:04:48,300 --> 00:04:49,839 outside of the hospital setting, 132 00:04:50,139 --> 00:04:51,660 I'm excited to see where that goes. I'm 133 00:04:51,660 --> 00:04:55,154 also taking an interest in AI and and 134 00:04:55,154 --> 00:04:57,314 how that can help how that can help 135 00:04:57,314 --> 00:04:59,014 surgery centers. Like, I know 136 00:04:59,395 --> 00:05:01,395 surgeons that use AI to help write their 137 00:05:01,395 --> 00:05:03,495 op reports or their patient notes. 138 00:05:03,875 --> 00:05:05,475 And, yes, of course, they review it because 139 00:05:05,475 --> 00:05:07,314 they're still responsible for what's in the note. 140 00:05:07,314 --> 00:05:09,360 But if it can if AI can help 141 00:05:09,360 --> 00:05:11,459 do some of that or help keep inventory 142 00:05:12,000 --> 00:05:14,480 going back to cost saving measures, if AI 143 00:05:14,480 --> 00:05:16,800 can help with either of those, and that 144 00:05:16,800 --> 00:05:18,639 allows the doctor to focus more time on 145 00:05:18,639 --> 00:05:20,580 the patients and less time on the administrative 146 00:05:20,720 --> 00:05:22,259 side, but then it also lets 147 00:05:22,584 --> 00:05:25,644 the clinic owners know with AI and inventory 148 00:05:26,584 --> 00:05:28,664 better of what their costs are because that 149 00:05:28,664 --> 00:05:30,284 all can be going on in the background. 150 00:05:30,824 --> 00:05:33,224 So there's so there's a couple different things 151 00:05:33,224 --> 00:05:34,769 that I'm excited about right now. 152 00:05:35,410 --> 00:05:37,669 Absolutely. I love that. And, certainly, 153 00:05:38,209 --> 00:05:38,789 you know, 154 00:05:39,169 --> 00:05:41,329 it'd be fascinating to see again how technology 155 00:05:41,329 --> 00:05:44,209 continues to play a role in, what surgery 156 00:05:44,209 --> 00:05:45,649 centers are able to do and how they're 157 00:05:45,649 --> 00:05:48,050 able to continue to operate at a very 158 00:05:48,050 --> 00:05:49,750 high level and become more efficient. 159 00:05:50,354 --> 00:05:52,435 So I'm gonna wrap wrap up here. How 160 00:05:52,435 --> 00:05:54,035 are you thinking about growth over the next 161 00:05:54,035 --> 00:05:55,394 twelve months or so? What does that look 162 00:05:55,394 --> 00:05:56,134 like for you? 163 00:05:56,675 --> 00:05:59,394 Well, I guess, for my ASCs, it's really 164 00:05:59,394 --> 00:06:00,375 gonna depend 165 00:06:01,235 --> 00:06:01,735 on 166 00:06:02,035 --> 00:06:03,095 where they're located. 167 00:06:03,589 --> 00:06:07,210 You know, I operate mostly in municipal areas, 168 00:06:07,270 --> 00:06:08,250 and so, therefore, 169 00:06:09,029 --> 00:06:11,029 some of the Medicaid cuts that are coming 170 00:06:11,110 --> 00:06:13,270 and most of NAICs don't take it, but 171 00:06:13,270 --> 00:06:15,930 it's gonna trickle down through through everything. 172 00:06:16,644 --> 00:06:18,884 They don't take Medicaid because they don't have 173 00:06:18,884 --> 00:06:20,104 to in the state of Florida 174 00:06:20,644 --> 00:06:21,704 to get their licensure, 175 00:06:22,084 --> 00:06:24,084 but rural areas are gonna be hit the 176 00:06:24,084 --> 00:06:28,084 hardest. So that's I'm concerned about, unfortunately, negative 177 00:06:28,084 --> 00:06:30,084 growth in those areas and the widening gap 178 00:06:30,084 --> 00:06:31,464 in care because I lived 179 00:06:32,029 --> 00:06:34,910 in my undergrad area in a in a 180 00:06:34,910 --> 00:06:36,430 rural area, and then I spent several years 181 00:06:36,430 --> 00:06:39,790 there afterwards after after my undergrad. And, you 182 00:06:39,790 --> 00:06:42,270 know, some people are traveling twenty, thirty, 40 183 00:06:42,270 --> 00:06:45,225 miles to get care. Or my family farm, 184 00:06:45,225 --> 00:06:47,545 you know, to get a good cardiologist, you're 185 00:06:47,545 --> 00:06:49,165 traveling over an hour already. 186 00:06:49,865 --> 00:06:51,245 If they lose those 187 00:06:51,785 --> 00:06:54,345 those access points, you're gonna be traveling longer 188 00:06:54,345 --> 00:06:55,964 and longer distances to get 189 00:06:56,504 --> 00:06:58,845 basic care that everyone should have. So 190 00:06:59,410 --> 00:07:01,430 I'm a little bullish right now on growth 191 00:07:01,889 --> 00:07:04,449 because I think just kinda kinda need to 192 00:07:04,449 --> 00:07:05,830 see what's gonna happen. 193 00:07:06,210 --> 00:07:09,250 But but in municipal areas or city areas, 194 00:07:09,250 --> 00:07:10,930 because I I live in the Tampa Bay 195 00:07:10,930 --> 00:07:13,154 region, I, you know, feel like we have 196 00:07:13,154 --> 00:07:16,514 ASCDs on every every other corner similar to 197 00:07:16,514 --> 00:07:18,055 Walgreens and Pasco's, 198 00:07:19,475 --> 00:07:20,615 so they're all around. 199 00:07:21,795 --> 00:07:23,955 Absolutely. That makes a lot of sense. You 200 00:07:23,955 --> 00:07:25,980 know, when you see that expansion of 201 00:07:27,180 --> 00:07:29,740 additional retail office buildings and kind of the 202 00:07:29,740 --> 00:07:32,139 disruption in the health care space, you know, 203 00:07:32,139 --> 00:07:35,259 how do you see the providers, the medical 204 00:07:35,259 --> 00:07:37,580 offices and surgery centers adapting and, 205 00:07:38,139 --> 00:07:39,920 you know, shifting their own strategies? 206 00:07:41,084 --> 00:07:43,564 I think more and more providers are they're 207 00:07:43,564 --> 00:07:45,345 looking at additional sources, 208 00:07:46,125 --> 00:07:48,044 you know, of of revenue. Do they get 209 00:07:48,044 --> 00:07:48,865 out of, 210 00:07:49,324 --> 00:07:50,464 you know, the traditional 211 00:07:50,925 --> 00:07:51,745 health insurance, 212 00:07:52,125 --> 00:07:55,639 Medicare, Medicaid models? Do they accept for Shanbury 213 00:07:55,639 --> 00:07:58,040 patients? Do they accept work comp? Do they 214 00:07:58,040 --> 00:08:00,060 accept other forms of of 215 00:08:00,759 --> 00:08:03,800 of patients in? Or, you know, I know 216 00:08:03,800 --> 00:08:06,040 several a couple classmates of mine from my 217 00:08:06,040 --> 00:08:09,314 master's program, they've gone completely to they'll accept 218 00:08:09,314 --> 00:08:11,475 the health insurance as additional payment, but they've 219 00:08:11,475 --> 00:08:13,814 gone to complete concierge type practice. 220 00:08:14,435 --> 00:08:16,354 I haven't seen that in the ASC setting 221 00:08:16,354 --> 00:08:18,514 yet because I I think it would be 222 00:08:18,514 --> 00:08:20,035 hard to make sure that you have 223 00:08:21,149 --> 00:08:23,069 with the cost of running an ASC to 224 00:08:23,069 --> 00:08:24,750 make sure that you have everything you need 225 00:08:24,750 --> 00:08:26,209 to to have an effective 226 00:08:27,149 --> 00:08:28,910 full line of products to be able to 227 00:08:28,910 --> 00:08:31,170 offer in a surgery setting to go concierge. 228 00:08:31,949 --> 00:08:34,625 That may start playing in, taking more concierge 229 00:08:35,165 --> 00:08:37,725 surgery patients soon too to help offset some 230 00:08:37,725 --> 00:08:39,904 of the lower, you know, the lower reimbursement 231 00:08:39,965 --> 00:08:41,425 or the loss in other revenue. 232 00:08:42,445 --> 00:08:45,004 Got it. That's fascinating to hear. Jennifer, thank 233 00:08:45,004 --> 00:08:46,285 you so much for joining us on the 234 00:08:46,285 --> 00:08:48,790 podcast today. This has been such a formative 235 00:08:49,010 --> 00:08:50,610 conversation, and I look forward to connecting with 236 00:08:50,610 --> 00:08:52,690 you again soon. Sounds good. I look forward 237 00:08:52,690 --> 00:08:53,670 to it. Thank you.