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To learn 13 00:00:30,649 --> 00:00:32,929 more, visit carecredit.com 14 00:00:32,929 --> 00:00:34,789 forward slash beckerspodcast. 15 00:00:35,649 --> 00:00:37,729 This is Gracelyn Keller with the Becker's Healthcare 16 00:00:37,729 --> 00:00:39,729 Podcast, and we are recording live at the 17 00:00:39,729 --> 00:00:42,710 thirty first annual business and operations of ASCs. 18 00:00:43,075 --> 00:00:45,635 I'm currently joined by Eliza August, who is 19 00:00:45,635 --> 00:00:49,075 the administrator of Precision Care Surgery Center. So 20 00:00:49,075 --> 00:00:51,155 Eliza, thanks for being here. And to kick 21 00:00:51,155 --> 00:00:52,594 us off, let's have you share a little 22 00:00:52,594 --> 00:00:54,115 bit more about yourself and your work in 23 00:00:54,115 --> 00:00:55,174 the ASC space. 24 00:00:55,590 --> 00:00:57,289 Sure. As she said, I'm Eliza. 25 00:00:57,909 --> 00:00:59,750 I have been in the industry for about 26 00:00:59,750 --> 00:01:02,329 fifteen years, if not more at this time. 27 00:01:02,469 --> 00:01:04,549 I do run a orthopedic center out in 28 00:01:04,549 --> 00:01:07,189 East Setauket, Long Island. I'm also the vice 29 00:01:07,189 --> 00:01:09,769 president of my state association as well. 30 00:01:10,194 --> 00:01:12,114 A little fun fact, I have done almost 31 00:01:12,114 --> 00:01:14,295 every nonclinical function in an ASC 32 00:01:14,915 --> 00:01:17,155 from the time I was probably in high 33 00:01:17,155 --> 00:01:19,075 school, starting out working at front desk and 34 00:01:19,075 --> 00:01:20,354 working my way all the way up to 35 00:01:20,354 --> 00:01:20,854 administrator. 36 00:01:21,795 --> 00:01:22,295 Wonderful. 37 00:01:22,754 --> 00:01:23,814 And let's have our 38 00:01:25,409 --> 00:01:27,810 market because in The US, it's projected to 39 00:01:27,810 --> 00:01:29,969 reach $60,800,000,000 40 00:01:29,969 --> 00:01:30,950 by 2030 41 00:01:31,090 --> 00:01:33,569 and continues to experience strong year over year 42 00:01:33,569 --> 00:01:35,810 growth. So from your perspective, what are the 43 00:01:35,810 --> 00:01:38,209 most significant trends in Market Forces driving this 44 00:01:38,209 --> 00:01:40,825 expansion, and how should ASC leaders be preparing 45 00:01:40,825 --> 00:01:41,325 today? 46 00:01:42,025 --> 00:01:43,644 Sure. So I'll start with the trends. 47 00:01:43,944 --> 00:01:45,385 I believe, like, one of the first trends 48 00:01:45,385 --> 00:01:47,704 is the migration or appropriate cases to the 49 00:01:47,704 --> 00:01:48,604 ASC space. 50 00:01:48,905 --> 00:01:51,385 As technology basically is improving, we're doing more 51 00:01:51,385 --> 00:01:52,844 and more cases in the ASC. 52 00:01:53,260 --> 00:01:55,420 Years ago, total joints in the ASC was 53 00:01:55,420 --> 00:01:57,259 not even a thing. And now here we 54 00:01:57,259 --> 00:01:59,900 are doing total joints, total shoulders. We're doing 55 00:01:59,900 --> 00:02:02,619 ACDF cases. Now there's cardiac in the AC 56 00:02:02,780 --> 00:02:03,840 ASC space. 57 00:02:04,219 --> 00:02:06,379 Second also is really, I would say, payer 58 00:02:06,379 --> 00:02:06,879 pressure 59 00:02:07,225 --> 00:02:10,344 and really employer steerage. So payer pressures, multiple 60 00:02:10,344 --> 00:02:11,405 payers are realizing 61 00:02:11,865 --> 00:02:12,365 the, 62 00:02:12,824 --> 00:02:14,205 I guess, cost savings 63 00:02:14,504 --> 00:02:17,145 of migrating all of their surgeries from the 64 00:02:17,145 --> 00:02:20,025 hospital space to the ASC space. So the 65 00:02:20,025 --> 00:02:22,310 point that payers are now creating programs 66 00:02:22,689 --> 00:02:25,090 targeting ASCs to say, hey. Listen. We will 67 00:02:25,090 --> 00:02:27,009 help drive volume to your facility if you 68 00:02:27,009 --> 00:02:28,849 can get these cases done for us, you 69 00:02:28,849 --> 00:02:31,009 know, at a lower rate. You also have 70 00:02:31,009 --> 00:02:33,250 employer groups that are doing direct employer with 71 00:02:33,250 --> 00:02:34,710 health care facility negotiations, 72 00:02:35,344 --> 00:02:37,044 cutting out the middleman of the insurance, 73 00:02:37,344 --> 00:02:39,584 looking for cost savings, especially for these self 74 00:02:39,584 --> 00:02:40,405 funded plans. 75 00:02:40,944 --> 00:02:42,625 You also have to look from perspective of 76 00:02:42,625 --> 00:02:44,245 cost inflation for patients. 77 00:02:44,784 --> 00:02:47,185 In this industry now, you know, health care 78 00:02:47,185 --> 00:02:48,724 is the costs are rising. 79 00:02:49,139 --> 00:02:52,019 Patients are having rising costs everywhere across the 80 00:02:52,019 --> 00:02:55,139 board from food, housing, health care, and they're 81 00:02:55,139 --> 00:02:56,900 looking for ways to still get appropriate care 82 00:02:56,900 --> 00:02:59,379 at a cost effective way, and ASCs are 83 00:02:59,379 --> 00:03:00,039 the answer. 84 00:03:00,819 --> 00:03:01,319 And 85 00:03:01,699 --> 00:03:01,844 I 86 00:03:02,564 --> 00:03:03,525 I would say in regards to preparing, to 87 00:03:03,525 --> 00:03:05,044 be honest with you, if you're a surgery 88 00:03:05,044 --> 00:03:07,125 center and you're considering doing, let's say, a 89 00:03:07,125 --> 00:03:09,525 new service line, really assess and plan for 90 00:03:09,525 --> 00:03:10,985 new service lines and have 91 00:03:11,284 --> 00:03:13,205 a really solid plan of how to implement 92 00:03:13,205 --> 00:03:16,539 them. Also, really invest in your team, whether 93 00:03:16,539 --> 00:03:18,300 it's hiring new people that are experts in 94 00:03:18,300 --> 00:03:21,020 certain fields, whether it's billing or, let's say, 95 00:03:21,020 --> 00:03:22,959 it's a nurse that does a particular specialty, 96 00:03:23,099 --> 00:03:24,539 or really just training the people that you 97 00:03:24,539 --> 00:03:26,719 have in house to really prepare to handle 98 00:03:27,020 --> 00:03:29,039 influx of volume in different specialty. 99 00:03:29,534 --> 00:03:31,294 Also, making sure that you're really assessing your 100 00:03:31,294 --> 00:03:34,275 revenue cycle process. There are different billing nuances 101 00:03:34,574 --> 00:03:35,955 with all types of specialties. 102 00:03:36,254 --> 00:03:37,935 If you're not prepared to really handle it, 103 00:03:37,935 --> 00:03:39,715 then you're gonna be doing all these cases 104 00:03:39,775 --> 00:03:42,014 and not maximizing the revenue you need to 105 00:03:42,014 --> 00:03:43,694 be able to actually handle the cost of 106 00:03:43,694 --> 00:03:44,675 providing services. 107 00:03:45,810 --> 00:03:48,709 And from AI and robotic surgeries to advanced 108 00:03:48,769 --> 00:03:51,569 EHR systems, technology remains both a make or 109 00:03:51,569 --> 00:03:54,449 break factor and a critical driver of ASC 110 00:03:54,449 --> 00:03:55,830 operations at scale. 111 00:03:56,209 --> 00:03:58,069 So how do you see deeper tech integration 112 00:03:58,129 --> 00:04:00,694 shaping the way ASCs deliver care and manage 113 00:04:00,694 --> 00:04:02,395 their business over the next few years? 114 00:04:03,175 --> 00:04:04,935 So I will say with the rise in 115 00:04:04,935 --> 00:04:07,574 tech, first and foremost, basically integrated pre op 116 00:04:07,574 --> 00:04:11,014 journeys. We're really able to live track patient 117 00:04:11,014 --> 00:04:13,495 journeys from registration all the way to the 118 00:04:13,495 --> 00:04:15,330 end of their journey when they're discharged from 119 00:04:15,330 --> 00:04:17,410 their ASC. As well as being able to 120 00:04:17,410 --> 00:04:19,350 share information with other physicians, 121 00:04:19,810 --> 00:04:22,230 other hospitals, whether that's through centralized 122 00:04:22,769 --> 00:04:24,769 health exchanges depending on the state that you're 123 00:04:24,769 --> 00:04:27,169 in, I believe that that's really impacting health 124 00:04:27,169 --> 00:04:28,769 care and being able to make proper health 125 00:04:28,769 --> 00:04:30,149 care decisions for your patients. 126 00:04:30,555 --> 00:04:32,235 Next, a lot of it really is AI. 127 00:04:32,235 --> 00:04:34,074 When it comes to AI for coding and 128 00:04:34,074 --> 00:04:34,574 documentation 129 00:04:35,035 --> 00:04:37,694 and taking some of those nuanced little workflows, 130 00:04:37,754 --> 00:04:38,735 basically, that 131 00:04:39,115 --> 00:04:40,955 really could be done by a computer and 132 00:04:40,955 --> 00:04:43,375 basically targeting your people to do other things 133 00:04:43,514 --> 00:04:45,935 so that you're still being efficient as possible. 134 00:04:46,660 --> 00:04:48,279 Also, really denial management. 135 00:04:48,580 --> 00:04:51,220 We're an industry where dealing with physicians, they'll 136 00:04:51,220 --> 00:04:53,779 code basically certain procedures, let's say, and there's 137 00:04:53,779 --> 00:04:56,259 mistakes. And being able to predict the mistakes 138 00:04:56,259 --> 00:04:57,540 ahead of time to be able to correct 139 00:04:57,540 --> 00:04:59,960 your coding so that you're maximizing your revenue. 140 00:05:00,235 --> 00:05:02,074 Because as we know as an ASC, we 141 00:05:02,074 --> 00:05:04,574 rely heavily on our revenue to continue operations. 142 00:05:04,955 --> 00:05:06,555 If you're not making any money, you can't 143 00:05:06,555 --> 00:05:08,634 continue operations, and then you end up closing, 144 00:05:08,634 --> 00:05:10,095 which patients end up suffering. 145 00:05:10,715 --> 00:05:12,955 And then I would say, lastly, supply chain 146 00:05:12,955 --> 00:05:13,455 management. 147 00:05:13,835 --> 00:05:15,535 That probably is one of the, 148 00:05:16,209 --> 00:05:17,029 I would say, 149 00:05:17,569 --> 00:05:18,629 probably first places 150 00:05:19,089 --> 00:05:21,409 that people don't realize that they're losing money 151 00:05:21,409 --> 00:05:24,209 because you're spending, spending, spending, not tracking what 152 00:05:24,209 --> 00:05:27,089 you're spending, not properly case costing, not basically, 153 00:05:27,089 --> 00:05:28,529 you're taking on case maybe that you can't 154 00:05:28,529 --> 00:05:30,370 afford to do and not realizing it because 155 00:05:30,370 --> 00:05:31,829 you're not actively using 156 00:05:32,264 --> 00:05:33,805 technology to really track it. 157 00:05:34,504 --> 00:05:36,904 And follow-up to that, is there a single 158 00:05:36,904 --> 00:05:38,985 technology or innovation that stands out to you 159 00:05:38,985 --> 00:05:40,285 as especially transformative? 160 00:05:41,464 --> 00:05:43,245 I can speak for myself personally. 161 00:05:43,944 --> 00:05:46,345 My center has had some challenges in regards 162 00:05:46,345 --> 00:05:47,644 to coding alignment 163 00:05:48,270 --> 00:05:50,990 between facility and physician coding. You know? And 164 00:05:50,990 --> 00:05:53,389 we're looking into technologies that are really based 165 00:05:53,389 --> 00:05:55,790 on AI coding where it can read a 166 00:05:55,790 --> 00:05:57,889 claim essentially or read a report 167 00:05:58,350 --> 00:06:00,830 and read the patient's implant log and this 168 00:06:00,830 --> 00:06:01,810 is last consult 169 00:06:02,194 --> 00:06:03,875 and determine basically if the codes that we're 170 00:06:03,875 --> 00:06:06,134 looking to bill actually align with the documentation. 171 00:06:06,595 --> 00:06:08,675 It'll tell you if there's opportunities for improvement 172 00:06:08,675 --> 00:06:10,514 in your actual documentation, if there was a 173 00:06:10,514 --> 00:06:12,514 missed code, or if something that you're billing 174 00:06:12,514 --> 00:06:14,194 just doesn't make sense to help kind of 175 00:06:14,194 --> 00:06:16,720 prevent your denial management. So that's less work 176 00:06:16,720 --> 00:06:18,480 on the back end for my revenue cycle 177 00:06:18,480 --> 00:06:18,980 team. 178 00:06:19,600 --> 00:06:22,899 And with 60% of health systems considering ASC 179 00:06:22,959 --> 00:06:25,920 joint ventures and many ASCs already partnering with 180 00:06:25,920 --> 00:06:28,560 systems in their communities, what opportunities do you 181 00:06:28,560 --> 00:06:31,514 see for collaboration, whether with other providers or 182 00:06:31,514 --> 00:06:32,014 vendors, 183 00:06:32,475 --> 00:06:35,134 to strengthen patient care and operational efficiency? 184 00:06:35,675 --> 00:06:37,754 I would say from the standpoint of hospital 185 00:06:37,754 --> 00:06:38,254 JVs, 186 00:06:39,035 --> 00:06:41,675 really working with the ASCs and not viewing 187 00:06:41,675 --> 00:06:44,095 ASCs as competition, but more so as partnership. 188 00:06:44,600 --> 00:06:47,959 Maybe offloading, let's say, the lower acuity cases 189 00:06:47,959 --> 00:06:49,720 to the ASC space so that the hospital 190 00:06:49,720 --> 00:06:51,879 could take on the higher acuity cases. We're 191 00:06:51,879 --> 00:06:53,879 in an industry right now where ASCs and 192 00:06:53,879 --> 00:06:56,360 hospitals, even though they are partnered together on 193 00:06:56,360 --> 00:06:58,845 paper, a lot of times from operational perspective 194 00:06:58,845 --> 00:07:00,604 do not partner together very well, and they 195 00:07:00,604 --> 00:07:02,224 view each other almost as competition 196 00:07:02,524 --> 00:07:05,084 for the same surgeries, the same physicians, when 197 00:07:05,084 --> 00:07:06,444 realistically, we should just be you to be 198 00:07:06,444 --> 00:07:08,685 an extension of each other. Then I do 199 00:07:08,685 --> 00:07:10,925 say that there is opportunity with the hospitals 200 00:07:10,925 --> 00:07:12,384 when it comes to payer partnerships. 201 00:07:12,879 --> 00:07:15,300 Once the annulant ASC has a struggle negotiating 202 00:07:15,360 --> 00:07:17,620 rates for itself, but partnering with a hospital, 203 00:07:17,839 --> 00:07:20,019 that gives you more negotiating power to negotiate 204 00:07:20,079 --> 00:07:22,879 better rates, basically having that partnership with your 205 00:07:22,879 --> 00:07:23,379 hospital. 206 00:07:24,319 --> 00:07:26,084 Well, Eliza, thanks so so much for joining 207 00:07:26,084 --> 00:07:28,004 me today. Is there anything else that we 208 00:07:28,004 --> 00:07:30,004 didn't touch on or final thoughts you'd like 209 00:07:30,004 --> 00:07:30,664 to share? 210 00:07:31,444 --> 00:07:33,224 So I would just like to say that 211 00:07:33,604 --> 00:07:34,104 ASCs 212 00:07:34,564 --> 00:07:37,544 are we're here to stay. We are expanding. 213 00:07:37,604 --> 00:07:39,305 We're growing. We're relentlessly 214 00:07:39,845 --> 00:07:40,345 consistent, 215 00:07:40,979 --> 00:07:42,919 patient safe, you know, data driven, 216 00:07:43,220 --> 00:07:44,439 financially disciplined. 217 00:07:44,979 --> 00:07:46,819 I would say, though, as an ASC leader, 218 00:07:46,819 --> 00:07:49,300 do not chase every single shiny object, basically, 219 00:07:49,300 --> 00:07:51,779 that's out there. Really do your homework. Pick 220 00:07:51,779 --> 00:07:53,399 technologies and partnerships. 221 00:07:54,064 --> 00:07:56,384 Basically, that will compress your timelines and your 222 00:07:56,384 --> 00:07:56,884 workflows, 223 00:07:57,345 --> 00:07:58,404 improve your outcomes, 224 00:07:58,785 --> 00:08:01,745 and just overall really be a good fit 225 00:08:01,745 --> 00:08:03,764 for your facility. You don't want to, 226 00:08:04,464 --> 00:08:07,104 I guess, increase your workload and increase your, 227 00:08:07,104 --> 00:08:07,604 basically, 228 00:08:08,350 --> 00:08:10,990 hardship of trying to run your facility. You 229 00:08:10,990 --> 00:08:12,670 wanna make things as easy as possible for 230 00:08:12,670 --> 00:08:14,990 yourself and your staff while still providing a 231 00:08:14,990 --> 00:08:17,069 high quality of care. And the last thing 232 00:08:17,069 --> 00:08:19,330 I would say is invest in your people. 233 00:08:20,029 --> 00:08:21,964 Your people are really what matter because they 234 00:08:21,964 --> 00:08:23,805 are the ones providing care to your patients. 235 00:08:23,805 --> 00:08:25,404 If you do not invest in them, they 236 00:08:25,404 --> 00:08:27,004 will not invest in the quality of care 237 00:08:27,004 --> 00:08:27,824 for your patients. 238 00:08:28,616 --> 00:08:30,936 Wonderful. Well, thanks for being here, and thanks 239 00:08:30,936 --> 00:08:32,776 for joining me on The Doctors Podcast. Again, 240 00:08:32,776 --> 00:08:35,176 we are recording live at the thirty first 241 00:08:35,176 --> 00:08:37,356 annual business and operations of ASCs. 242 00:08:37,736 --> 00:08:38,476 Thank you.