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Hello, everyone. This is Franchesca Matthews with the

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Becker's ASC review podcast.

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I'm thrilled to be joined today by Andrew

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Lovewell,

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CEO at Columbia Orthopedic Group.

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Thank you so much for being here today.

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Yeah. Thank you so much. I'm, looking forward

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to our discussion today.

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Yeah. Excellent.

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Just to start off, could you please introduce

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yourself and tell us a little bit about

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your background?

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Yeah. My name's, Andrew Lovewell. I am the

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chief executive officer

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for Columbia Orthopedic Group.

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We're a large MSK

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ortho practice in, Columbia, Missouri.

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We own a surgery center,

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DME, pharmacy,

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imaging center. Just about anything you could imagine

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that touches one of our patients,

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we we have a full comprehensive offering,

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for all of our patients.

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Prior to this role, I actually, worked for

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our group currently,

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running our surgery center before.

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And then I was with an academic,

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medical center before that and then with an

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academic hospital before that. Been in health care

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for

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about sixteen years in various different roles, and

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it's a complicated,

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puzzle that we all get to try to

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solve every day. So looking forward to, talking

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about some of that stuff.

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Absolutely.

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Complicated puzzle for sure.

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Just to to dive right in here, what

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are the top three trends that you're following

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in health care and ASCs today?

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Yeah. I think, you know, if anybody

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comes on the podcast and and doesn't talk

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about AI

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as a a top three trend,

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they might not be reading any of your

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guys'

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publications.

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But AI is a huge one for us.

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You know, we're trying to figure out

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where does it land,

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where is the utility,

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How far do we go? You know, do

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you start small? Do you go all in?

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What elements do you kind of,

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kinda start with in your practice? You know,

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is it scheduling or pre cert or faxing

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or

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all those kind of tasks,

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oriented things that an AI bot or something

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can help with.

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You know, past that, I would say the

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the payer landscape for me is a a

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big one,

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dealing with,

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commercial contracts and payers and

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looking at how

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they structure deals and payer policies change the

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landscape completely. You know, UnitedHealthcare just came out

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and said they're they're cutting their CRNA reimbursement

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by 15%

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coming up.

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Obviously, that's not a shocker for us, but,

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you know, it is a now we have

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to, you know,

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react

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to that type of news.

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And then I would say outside of that,

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past the payer issues, it it's just the

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mergers, acquisitions, private equity, all of those things,

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trying to keep up with all the transactions

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that are occurring out in the marketplace and

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being aware of

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what,

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the trajectory of the health care landscape looks

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like. So

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there's a lot on our plates, you know,

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obviously, as health care leaders today, but,

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you guys at Becker's do a great job

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with providing information and insight, and that's an

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easy way to kick start your day with

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some of the articles that are there. They're

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quick. They're easy to read, and I think

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that

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staying informed is is nice,

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with your guys' platform.

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But, really,

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I'd say one of the biggest resources we

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all have too is our network of colleagues

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and talking to them about all these emerging

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things and getting a take on, hey, what

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are you trying for AI? What are you

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doing? You know, just crowdsourcing some of that

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stuff is extremely valuable.

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Mhmm. Absolutely. And, you know, always appreciate the

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the love for Becker's and all of our

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insights and

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content come directly from providers like yourself. So

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I think definitely what you said there about

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that network is, you know, one of the

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most valuable tools that folks have and

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figuring out the the complicated puzzle of of

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health care.

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And just to kind of follow-up a little

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bit on the AI component, I'm curious. I've

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had this conversation with a few folks recently,

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but what how do you at your your

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practice, how are y'all thinking about AI and

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kind of how are you distinguishing

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between a meaningful,

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implementation and something that is maybe just a

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little bit of hype and not something that's

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actually gonna be effective?

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Well, I think that that's a good question.

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You know, like, where we're at with AI

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is not where we're going to be, you

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know, in six months, a year.

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I think that our perspectives today on AI

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are very different than than the future perspective

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we're going to have.

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You know, I think that AI is a

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novelty at this point in time.

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Maybe I'm a complete idiot for thinking that,

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but

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we quite really understand

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what is AI and what isn't AI. I

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think it's become this, like, thrown around buzzword

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that we're all very excited to talk about.

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We all think there's, like, you know, something

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out there. I don't think it's going to

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ever replace the human to human interaction that

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we have with, you know, patients,

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and physicians in in the room. It's just

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not gonna happen. So

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where we have to get is we have

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to supplement or augment,

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you know, some of the remedial

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task work involved with medicine today so we

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can get back to actually treating patients. And

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if we can use AI to do that,

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you know, that's a game changer. I I

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think that

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what

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we as a medical society or health care,

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society have kind of

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recognized

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is that

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there's a lot of work that happens that

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is very

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it just gets in the way of providing

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care. You know, like peer to peers are

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one of those things that are just a

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significant frustration for clinicians and providers all over

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the country.

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Dealing with denials and prior auths are a

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huge problem. Just sorting through faxes alone is

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like just a nightmare. You know, our organization

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Mhmm. About 50,000

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faxes a month. I can't even believe that

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that's a technology we still leverage today.

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It's,

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it has its utility for sure, AI does.

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You know, we just have to figure out

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which avenue

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you you plug that into.

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And then we also have to figure out

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how we define what is AI versus what's,

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you know, machine learning or large language models

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or stuff like that because

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not everything is truly AI. And

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I think that that's a challenge that,

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you know and and it's not a knock

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on the vendors, but

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if any vendor out there, they pivoted to

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AI inside the last two years, they all

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got it in their branding and messaging and,

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you know, I I don't know that I

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saw very many booths up there this year

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that didn't have an AI type flare to

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them.

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Mhmm. Yeah. Definitely. I'm hearing what you're saying

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is just echoed with, other

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ASC leaders I've talked to. There's kind of

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a cautious optimism

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for sure there.

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And, you know, you mentioned kind of what's

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what's exciting. I'm curious, what what are you

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most excited about right now in the ASC

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space?

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Yeah. I think in the ASC space, you

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know,

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obviously,

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I've been on the podcast a few times,

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been up there and and talked to Beckers.

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You know, the ASC space is it's still

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prime for growth. You're gonna continue to see

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more

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stuff shift to the ASC. You know, I've

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CMS put out something where they're talking about

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getting rid of the inpatient only list altogether.

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Now, I don't know that that's

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I have cautious optimism on that as well.

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There's some stuff that honestly we shouldn't do

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in the ASC.

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There's a lot of stuff we can, you

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know, because it's safe. You know, I think

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years ago, people never thought we'd be doing

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anterior lumbar fusions in the ASC.

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Well, we do those today in our ASC.

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Total joints, another one. You know, Medicare approved

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us doing those, and now that,

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kind of the barn's out of the horse

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there, like, everyone's off to the races doing

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that. So

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I think for us, it's the continuing evolution

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of,

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you know, medicine and how technology and innovation

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can continue to see us

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move more stuff, more cases

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into a lower cost, higher value environment.

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And what that does for patients, what that

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does for, you know, Medicare, what that does

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for

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self funded employers across The US, that's a

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big deal.

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I also think you're gonna see extremely

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more

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effort from health systems and also

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private equity firms to get into this ASC

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space even more than what we're seeing now.

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You know, you're you're seeing

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Bain Capital and Surgery Partners, their deal broke

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up, but

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I don't think that anything there is is

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conclusively done until, you know,

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something else happens. It's just a matter of

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time before we see more

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activity in our in the market with ASCs.

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It's

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they're ripe, you know. We are

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by far the

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the biggest,

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opportunity, I would say, to kind of bend

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the cost curve of medicine at this point.

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Yeah. Absolutely.

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And zooming out a little bit, is there

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anything you mentioned, you know, there's some excitement

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around AI, but what in health care broadly

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speaking are you excited about right now?

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You know, I think

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I'm kind of a naturally pessimistic person by

278
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nature.

279
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But,

280
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I think the things I get excited about

281
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are,

282
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you know, working with other

283
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people

284
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around how we develop

285
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interdisciplinary

286
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plans to grow. You know, is that through

287
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mergers? Is that through collaborations?

288
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You know, what can we do together instead

289
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of separately?

290
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Because there's a lot of

291
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it's a lot of marketplaces

292
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that are out there where

293
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they're very fragmented and people don't work together.

294
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And I think that that's very detrimental for

295
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not only

296
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patients, but also for your contracts.

297
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I see,

298
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you know, you could look in your guys'

299
00:10:37,334 --> 00:10:39,654
publications or just Google on the Internet the

300
00:10:39,654 --> 00:10:42,110
amount of orthopedic groups in The US that

301
00:10:42,110 --> 00:10:44,049
have merged inside the last ten years.

302
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Like, people are recognizing

303
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that there's strength in numbers and value

304
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in

305
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collaboration. So I see that being,

306
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a continued effort,

307
00:10:54,669 --> 00:10:55,970
from like specialties.

308
00:10:56,674 --> 00:10:58,934
You know, dermatology has done this, opto,

309
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ortho.

310
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It's gonna continue to happen.

311
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That's the thing. One of the most exciting

312
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things we can do is

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work with the employers, the people actually paying

314
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the bills

315
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to set

316
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up steerage programs and networks to get

317
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patients to the right place at the right

318
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time at the right dollar.

319
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You know, a lot of self funded employers

320
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that are out there today, they're not gonna

321
00:11:23,379 --> 00:11:25,379
be able to continue to afford health insurance

322
00:11:25,379 --> 00:11:26,945
in the near future. So,

323
00:11:27,404 --> 00:11:29,485
you know, there's this whole concept of these

324
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smaller community health plans that are popping up

325
00:11:32,764 --> 00:11:36,625
and creating these narrow high value networks where

326
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patients can access care at

327
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a very low in like, a a very

328
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low entry point for cost, but a high

329
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value for an outcome. So

330
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I see those continuing to pop up. There's

331
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an one out there now that the OrthoForum

332
00:11:52,660 --> 00:11:56,514
has founded, called the OrthoValue Network that's extremely,

333
00:11:57,774 --> 00:11:59,855
productive. There's a lot of referrals that come

334
00:11:59,855 --> 00:12:02,174
through that that employers are kinda latching on

335
00:12:02,174 --> 00:12:04,335
to because they're seeing, you know, wow. Look

336
00:12:04,335 --> 00:12:06,414
at these private 100 orthopedic groups that are

337
00:12:06,414 --> 00:12:07,875
out here that have formed this,

338
00:12:08,769 --> 00:12:10,950
network to where we can get patients in

339
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at low cost, high value

340
00:12:13,410 --> 00:12:16,049
settings, and it's gonna work. It's absolutely gonna

341
00:12:16,049 --> 00:12:16,549
work.

342
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So I I see those as being the

343
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big ones out there. Just continued collaboration and

344
00:12:21,730 --> 00:12:22,710
effort to

345
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kinda marry business and health care and all

346
00:12:25,884 --> 00:12:27,725
those things together to result in a better

347
00:12:27,725 --> 00:12:28,785
outcome for everyone.

348
00:12:29,884 --> 00:12:32,465
Yeah. Absolutely. You're speaking to a number of,

349
00:12:32,764 --> 00:12:35,485
pertinent issues in health care there. And you

350
00:12:35,485 --> 00:12:37,965
also mentioned growth and thinking about growth. I'm

351
00:12:37,965 --> 00:12:40,659
I'm curious how you and your organization are

352
00:12:40,659 --> 00:12:42,840
thinking about growth over the next twelve months.

353
00:12:43,700 --> 00:12:46,039
Yeah. I think for us, you know, we

354
00:12:46,820 --> 00:12:48,580
we've grown a lot just really in the

355
00:12:48,580 --> 00:12:50,360
last two to three years. You know, our

356
00:12:50,659 --> 00:12:53,539
our energy is mainly spent on a couple

357
00:12:53,539 --> 00:12:54,360
things. One

358
00:12:54,975 --> 00:12:57,375
is continuing to shore up and develop our

359
00:12:57,375 --> 00:13:01,075
ancillaries because that's a significant opportunity for revenue

360
00:13:01,134 --> 00:13:02,355
with inside of our practice.

361
00:13:03,054 --> 00:13:06,195
The second thing there is, gaining market share

362
00:13:06,495 --> 00:13:08,975
in not only our market but adjacent markets.

363
00:13:08,975 --> 00:13:09,475
So,

364
00:13:09,850 --> 00:13:11,289
you know, what does that look like? Does

365
00:13:11,289 --> 00:13:13,289
that is that a a partnership with a

366
00:13:13,289 --> 00:13:15,690
hospital to where we become their orthopedic partner

367
00:13:15,690 --> 00:13:17,450
of choice? Is that a, you know, where

368
00:13:17,450 --> 00:13:19,769
you have orthopedics and and we can help

369
00:13:19,769 --> 00:13:21,610
co manage that? You know, how does that

370
00:13:21,610 --> 00:13:23,629
structure kind of fit with us?

371
00:13:24,035 --> 00:13:25,634
And then, you know, we're not immune to

372
00:13:25,634 --> 00:13:26,754
the other things that are out there in

373
00:13:26,754 --> 00:13:28,674
the marketplace. You know, we've bought a few

374
00:13:28,674 --> 00:13:29,174
practices.

375
00:13:29,795 --> 00:13:31,795
We'll continue to look at things in a

376
00:13:31,795 --> 00:13:32,295
very

377
00:13:32,835 --> 00:13:36,195
realistic perspective. You know, the acquisitions that we've

378
00:13:36,195 --> 00:13:37,800
made, I would say

379
00:13:38,180 --> 00:13:40,420
that, everyone won in those deals. You know,

380
00:13:40,420 --> 00:13:42,820
the physicians that were there now make more

381
00:13:42,820 --> 00:13:45,139
money because they are on our contracts. They're

382
00:13:45,139 --> 00:13:47,779
not managing their practice. You know, we had

383
00:13:47,779 --> 00:13:49,320
one practice we bought where

384
00:13:49,764 --> 00:13:51,684
the doc was paying bills at 02:00 in

385
00:13:51,684 --> 00:13:52,964
the morning and trying to make his payroll

386
00:13:52,964 --> 00:13:54,804
for his employees, you know, and it's and

387
00:13:54,804 --> 00:13:56,324
that just wears on you. You know, you

388
00:13:56,324 --> 00:13:58,084
can't be productive when you're doing something like

389
00:13:58,084 --> 00:13:58,824
that. So,

390
00:13:59,125 --> 00:14:00,884
you know, there's a there's a lot of

391
00:14:00,884 --> 00:14:02,490
opportunity out in the market place, but we

392
00:14:02,490 --> 00:14:03,929
all just have to kinda put the ego

393
00:14:03,929 --> 00:14:05,529
aside and say, okay, what can we do

394
00:14:05,529 --> 00:14:07,610
together? But I think that's the fastest way

395
00:14:07,610 --> 00:14:09,690
we're gonna continue to grow is just being

396
00:14:09,690 --> 00:14:10,190
very,

397
00:14:10,649 --> 00:14:13,129
very real about the process and talk through

398
00:14:13,129 --> 00:14:15,210
all of the elements that are involved and

399
00:14:15,210 --> 00:14:16,509
be transparent and,

400
00:14:16,855 --> 00:14:18,955
you know, just go to work. That's

401
00:14:19,654 --> 00:14:20,955
that's that's our strategy.

402
00:14:21,735 --> 00:14:24,215
Yeah. Absolutely. Doing doing more together is something

403
00:14:24,215 --> 00:14:25,654
we say here at Becker's as well, so

404
00:14:25,654 --> 00:14:27,754
definitely definitely hear you on that one.

405
00:14:28,134 --> 00:14:29,815
And that's actually all I have for you

406
00:14:29,815 --> 00:14:30,554
today, Andrew.

407
00:14:31,320 --> 00:14:33,160
Thank you so much for joining us. It

408
00:14:33,160 --> 00:14:35,080
has been a pleasure speaking with you, and

409
00:14:35,080 --> 00:14:36,519
I look forward to connecting with you again

410
00:14:36,519 --> 00:14:38,600
in the future. Sounds great. Thank you so

411
00:14:38,600 --> 00:14:39,820
much for having me.