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Hello and welcome to the Becker's Healthcare Podcast.

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My name is Chanel Banger. I'm recording live

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at the twenty second annual Spine Orthopedic and

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Pain Management Driven ASC

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plus the Future of Spine Conference. And I'm

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sitting down with John Russell,

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executive operations at Sutter Health.

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Thank you so much for joining me today.

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Thanks for having me. Perfect. Well, to get

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us started out, can you please introduce yourself

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and tell us a bit about your background

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and organization?

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Sure. I'm Doctor. John Russell. I work for

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Sutter Health out in the great state of

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California,

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and I've been there for about eighteen years.

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I oversee seven surgery centers in our surgery

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center division of about 36 total between,

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surgical hospitals and ASCs.

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So, happy to be here and happy to

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talk about things that we're looking forward to

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over the next couple of years and current

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practice and future practices.

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Well, perfect. Let's just jump right in. Can

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you, talk about maybe the top three trends

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that you're watching in healthcare in your role

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today? So one of the things that we're

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looking at is patients want to come to

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our centers, right, no matter what part of

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the nation you're in.

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Hospitals are incredibly

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expensive for patients. So the ASCs are in

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a situation to partner with hospitals if you're

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affiliated with a big organization like we are.

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We have hospitals,

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HOPDs and ambulatory surgery centers, so you really

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wanna see patients

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getting care at the right facility.

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Now that means that if you take from

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the hospitals, then you need to back fill.

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Right? Because the hospitals are are incredibly

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busy, but also a intricate part of our

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organization. So

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partnering with the CEOs or their executives to

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make sure that patients are being seen in

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the right facility

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is a lot of work. There's a lot

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of things that go behind that, you know,

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contracts,

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payer mixes, all these things are factors.

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One of the things that we're noticing is

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patients want to come in, have their procedures,

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and go home.

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So we're in a situation where we can

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provide that service. However, ASC struggles sometimes because

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we typically don't work twenty four seven like

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the hospitals do. Right? So we're trying to

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look at how we can best utilize our

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our space.

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One of the things that we are looking

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at, based on some data that we have

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been recently given by our president and CEO

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is that we had several thousand patients that

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couldn't get seen last year because we are

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just that impacted.

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So having more physicians come on board, making

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sure we utilize our space,

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looking at

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block utilization,

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block time, and making sure that white space

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is not,

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unused because that's an opportunity missed to take

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care of a patient.

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So what we're doing is we are revamping

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our policies to reflect,

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real

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block time schedules and partnering with those physicians

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in their offices to make sure that they

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have a month or sometimes up to three

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months of time to schedule and and then

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release block time if it's not being used.

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And

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with pain and ortho and and all these

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other service lines that come to the ASCs,

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we are in a situation right now where

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we have to do something. We can't sit

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back and wait because we're already behind the

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eight ball. Right? If we've got thousands of

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patients that can't be seen, we need to

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figure this out. So utilization

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and access are two very strong key factors

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that we're looking at, now and over the

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next few months, just to make sure that

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we are

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going in the right direction. Because, again, we've

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extended hours, we open up on Saturdays, whatever

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the whatever it takes to take care of

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the patients, what we're willing to do. Absolutely.

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And kind of going off script here, what

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does reimbursement look like? Are you fee for

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service or how does that work? Yeah. So

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fee for service. So, you know, we get

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paid,

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not as much as the hospitals because our

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our pay structure is completely different, where we

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usually have a bundled

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package.

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The hospitals can charge you for every single

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item, you know, that piece of paper, that

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one Tylenol, things like that.

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So we do go by ChargeMasters,

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and that's updated annually. We have a a

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great finance team that looks at that and,

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thank god because, you know, we need them

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to do that, not me.

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I'm there to execute.

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But having

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said that,

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you know, we

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not for profit, we still need to make

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money. Right? Because what we do when we

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make money is we reinvest it back into

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the community.

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So while we may be not for profit,

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we we can't just sit back and not

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have some revenue coming in. You know, we

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need equipment. We need supplies. We need to

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make sure the lights are on, all these

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things. So we gotta pay employees. Yeah. We

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gotta pay our employees.

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But one of the good things is that

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we also teach our employees on how to,

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take care of the patients at a lower

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cost and not compromise care. Right? So you're

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still going to get the same level of

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care that you expect as a patient.

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And and I don't wanna say better than

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the hospitals because the hospitals are really great

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at delivering care. But sometimes you go into

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the hospital, and we all know this. This

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is not unique. You end up getting sicker

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sometimes in the hospital with nosocomial

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infections or whatever.

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We are really striving hard to make sure

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that and we track and trend,

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infection control quality, things like that.

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But we work really, really hard to make

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sure the the patient experience is something that

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they'll never forget. And we hope it's always

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gonna be good. Right? But we have room

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for improvement too.

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But it's important to make sure that your

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ChargeMaster is up to date and that your

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contracts are up to date so you can

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be paid,

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a fair FMV

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when you're using supplies or you're using,

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implants, whatever. You know? So it's it takes

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a village to make this happen. So the

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finance team works with the administrators. They work

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with us.

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All these things play, a key role in

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making sure that the patient gets that outcome

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at a reasonable

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price.

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Got it. Got it. And now that we're

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in the 2025,

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can you talk about what you're most excited

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about right now?

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Growth.

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Our president and CEO is,

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high high execute. I thought I was high

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execute. He's got me beat.

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We have a lot of patients that want

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to come to our organization, and we have

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no room for them. So we are in

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full throttle

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to make sure that we either acquire or

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or build facilities based on geography and based

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on needs

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to make sure that these patients can be

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seen. Even me as a patient, it takes

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me two months to see my primary care

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doctor. So if I feel like I need

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to see him, I should get on the

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books today because it's gonna take two months.

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So one of the things that we're looking

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at is, again, utilization and access and making

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sure that we are doing what we can.

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And so one of the things that I

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challenged some of my centers is when we

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have,

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total joints,

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they like to flip rooms because they can

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go faster.

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But when you're flipping rooms, you're also having

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space that's not being utilized. Right? So that

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block time, that two hours or three hours

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in the day total

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accumulation of time is wasted time. So we're

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looking at how can we

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be as effective and efficient staying in one

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room and doing six or seven total joints

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in one room versus two rooms

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so we can open up another room and

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have all that space for other patients that

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need to be seen at the center.

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Absolutely. And you've already touched on this a

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little bit, but how are you thinking about

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growth in the next twelve months?

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One of the things that we're looking at

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is,

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potentially expanding into more Saturdays.

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So not everybody wants to do a Saturday,

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physicians included. They have families. Right?

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But we are looking at ways that we

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can optimize our space. So,

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you know, we don't know what we don't

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know. In ten years, we could be sitting

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here having this conversation and ASCs may be

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twenty four seven operations. Who knows? You know,

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it seems crazy to think about that, but

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let's be realistic.

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So one of the things that we're really

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looking at is how we best can come

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together and partner with our physicians and staff,

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and maybe staff just wanna work Saturdays and

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and have that work life balance where they

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can have a couple of days off during

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the week with their kids or whatever the

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case may be.

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So expanding our hours throughout the week, but

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also

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more Saturdays. Right now, we typically do one

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or two Saturdays a quarter, and it's usually

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for GI, but we're trying to expand that

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into pain and also surgical cases. Because if

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we're gonna be there, we might as well

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do everything, right, that we can.

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All of our patients, I shouldn't say all,

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but most of our patients go home the

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same day. So when we have a twenty

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three hour stay, it's a planned procedure. So

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we know that they're gonna stay overnight.

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That's the beauty of the ASC world is

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that, you know, we have certain criteria that

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has to be met,

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and and we do a really good job

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with our medical directors,

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their input, and also the nursing staff and

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and our policies that we keep updated.

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So

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allowing patients who are super busy,

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whether that's with personal life or professional life,

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have an opportunity to maybe have surgery at

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05:00 in the afternoon,

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recover the next day, and be back at

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work, say, on Monday,

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or have their procedure on Saturday so they

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don't miss work on Friday or Monday

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is something that we really must think about.

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Absolutely.

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Well, John, I've enjoyed our time together. But

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before I let you go, is there anything

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else that listeners should know?

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You know, I think it's imperative that we

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as patients be very active in our care.

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I love when patients ask me questions.

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I you know, by trade, I was a

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nurse for a long time, and

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sometimes, you know, you think, well, why are

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they asking me this? I'm telling them what

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I know. You're right. You're telling them what

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you know, but they don't know. So I

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just really empower patients to ask questions. And

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when they apologize for asking questions, I'm like,

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don't apologize.

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This is your life, your body. You have

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every right to know. An advocate.

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Absolutely. You know, we're we're advocates for the

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patients, but no one can be a better

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advocate for you than yourself.

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Absolutely. Well, John, I wanna thank you once

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again for your time today and for sharing

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your insights on the Becker's Healthcare podcast. Thank

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you so much.