1 00:00:02,240 --> 00:00:02,899 At athenahealth, 2 00:00:03,279 --> 00:00:06,480 we know your ambulatory practice wants healthier, a 3 00:00:06,480 --> 00:00:09,779 healthier business, healthier care teams, and healthier patients. 4 00:00:10,160 --> 00:00:12,480 But the complexities of modern health care tech 5 00:00:12,480 --> 00:00:14,240 make it hard for you and your care 6 00:00:14,240 --> 00:00:15,855 teams to focus on what matters 7 00:00:16,414 --> 00:00:19,295 most? That's where athenahealth can help. Our AI 8 00:00:19,295 --> 00:00:22,594 native all in one solutions reduce administrative burdens, 9 00:00:22,974 --> 00:00:25,875 streamline billing and payments, and deliver critical insights 10 00:00:25,934 --> 00:00:28,734 when clinicians need it most. That means fewer 11 00:00:28,734 --> 00:00:31,614 clicks, more time for patients, and stronger bottom 12 00:00:31,614 --> 00:00:31,829 lines. 13 00:00:32,710 --> 00:00:35,989 Practicing medicine is complex, but running a practice 14 00:00:35,989 --> 00:00:37,850 can be that much simpler with athenahealth. 15 00:00:38,549 --> 00:00:42,170 See how simpler is healthier@athenahealth.com. 16 00:00:44,085 --> 00:00:46,565 Hello. This is Franchesca Matthews with the Becker's 17 00:00:46,565 --> 00:00:47,865 ASC review podcast. 18 00:00:48,325 --> 00:00:50,164 I'm thrilled to be joined today by Vijay 19 00:00:50,164 --> 00:00:50,664 Bachchani, 20 00:00:51,125 --> 00:00:53,445 president and chief chief growth officer of New 21 00:00:53,445 --> 00:00:55,685 York Bariatric Group. Thank you so much for 22 00:00:55,685 --> 00:00:58,024 being here today. Thank you for having me. 23 00:00:58,299 --> 00:00:59,979 Yeah. To start us off, could you just 24 00:00:59,979 --> 00:01:01,979 introduce yourself and tell us a little bit 25 00:01:01,979 --> 00:01:02,799 about your background? 26 00:01:03,739 --> 00:01:04,239 Sure. 27 00:01:05,579 --> 00:01:09,599 So, I'm, currently president and chief growth officer 28 00:01:09,659 --> 00:01:11,359 at New York Bariatric Group. 29 00:01:11,974 --> 00:01:14,795 We're the largest bariatric platform in the country. 30 00:01:15,094 --> 00:01:17,174 We're in five states, New York, New Jersey, 31 00:01:17,174 --> 00:01:19,355 and Connecticut, as well as Arkansas and Oklahoma. 32 00:01:20,375 --> 00:01:23,015 And we also have four surgery centers. So 33 00:01:23,015 --> 00:01:24,215 we have a surgery center, 34 00:01:24,534 --> 00:01:25,034 in 35 00:01:25,719 --> 00:01:26,219 Arkansas, 36 00:01:26,680 --> 00:01:27,979 one in Long Island, 37 00:01:28,359 --> 00:01:30,359 one in Paramus, New Jersey, and one in 38 00:01:30,359 --> 00:01:31,260 Stanford, Connecticut. 39 00:01:32,120 --> 00:01:34,599 And my background, I've been here about nine 40 00:01:34,599 --> 00:01:35,099 years, 41 00:01:35,719 --> 00:01:36,540 kind of really 42 00:01:36,920 --> 00:01:39,159 led the growth, of the company for the 43 00:01:39,159 --> 00:01:40,140 last nine years, 44 00:01:41,165 --> 00:01:43,004 and very different today than than when I 45 00:01:43,004 --> 00:01:43,744 first started. 46 00:01:44,444 --> 00:01:47,104 And, you know, really responsible for strategy, 47 00:01:48,125 --> 00:01:49,504 growth, business development. 48 00:01:50,604 --> 00:01:51,744 I lead the hospital 49 00:01:52,364 --> 00:01:52,864 negotiations. 50 00:01:53,325 --> 00:01:55,344 I also assist in the payer negotiations. 51 00:01:57,049 --> 00:01:59,689 We've done several acquisitions of the last, few 52 00:01:59,689 --> 00:02:02,269 years. I've I've led those acquisitions as well. 53 00:02:02,969 --> 00:02:05,390 And, prior to this, I spent, 54 00:02:05,769 --> 00:02:06,510 two years, 55 00:02:06,969 --> 00:02:08,269 at a hedge fund. 56 00:02:09,335 --> 00:02:11,594 And prior to that, I spent six years 57 00:02:11,655 --> 00:02:13,814 at a health IT incubator where we took 58 00:02:13,814 --> 00:02:14,395 a product 59 00:02:14,935 --> 00:02:17,094 from inception to exit, and we sold to 60 00:02:17,094 --> 00:02:19,034 a fortune 500 company. So, 61 00:02:19,574 --> 00:02:21,495 I think I have a decent mix of 62 00:02:21,495 --> 00:02:23,335 health care and finance, and I guess that's 63 00:02:23,335 --> 00:02:23,789 why, 64 00:02:24,349 --> 00:02:25,949 I'm here. But but out of all my 65 00:02:25,949 --> 00:02:27,870 jobs, I've I've loved this the best, and 66 00:02:27,870 --> 00:02:29,569 I find this has the most opportunity. 67 00:02:30,349 --> 00:02:33,069 Yeah. Awesome. Great great rundown there. It's always 68 00:02:33,069 --> 00:02:34,909 always great. I spent amount of time talking 69 00:02:34,909 --> 00:02:35,409 to 70 00:02:35,709 --> 00:02:37,389 to people on more of the physician side 71 00:02:37,389 --> 00:02:39,485 of things, so I'm always really interested to 72 00:02:39,485 --> 00:02:40,125 hear more, 73 00:02:40,685 --> 00:02:41,825 more from your perspective. 74 00:02:43,405 --> 00:02:45,325 What are the top three trends that you're 75 00:02:45,325 --> 00:02:47,504 following in health care and ASCs today? 76 00:02:48,125 --> 00:02:48,605 Yeah. 77 00:02:49,165 --> 00:02:51,245 So I'll I'll give you more than three, 78 00:02:51,245 --> 00:02:53,325 but just general trends I'm following. You know, 79 00:02:53,325 --> 00:02:53,789 obviously, 80 00:02:54,189 --> 00:02:56,689 procedures coming off the inpatient only list. 81 00:02:57,229 --> 00:02:58,849 We always have an eye on that. 82 00:02:59,549 --> 00:03:01,729 The increase or the rise in, 83 00:03:02,509 --> 00:03:03,650 self funded employers. 84 00:03:03,949 --> 00:03:05,789 Right? So the rise of the ASO model, 85 00:03:05,789 --> 00:03:07,090 we're seeing more and more 86 00:03:07,469 --> 00:03:07,969 employers 87 00:03:08,715 --> 00:03:11,675 being, you know, self funded. And and with 88 00:03:11,675 --> 00:03:14,155 that, there's opportunity. Right? There's opportunity to go 89 00:03:14,155 --> 00:03:15,215 direct as well. 90 00:03:15,675 --> 00:03:17,754 And we do have bundle agreements with several 91 00:03:17,754 --> 00:03:18,254 employers, 92 00:03:19,034 --> 00:03:21,514 increased price transparency. I think that's good for 93 00:03:21,514 --> 00:03:22,014 everybody. 94 00:03:23,400 --> 00:03:24,199 And we definitely, 95 00:03:25,319 --> 00:03:27,159 use that to our advantage in terms of 96 00:03:27,159 --> 00:03:29,340 negotiating with payers because we know exactly 97 00:03:29,879 --> 00:03:31,580 what the hospitals are getting paid, 98 00:03:32,040 --> 00:03:33,819 and the services that we're providing. 99 00:03:34,439 --> 00:03:36,219 And then just general consolidation. 100 00:03:36,520 --> 00:03:38,205 Right? It it's very difficult, 101 00:03:38,745 --> 00:03:41,564 I think, for the independent physician practice. 102 00:03:42,664 --> 00:03:44,185 And, you know, they're not gonna get rates 103 00:03:44,185 --> 00:03:45,004 from the payers. 104 00:03:45,864 --> 00:03:49,305 Hospitals are acquiring primary care folks, and physicians 105 00:03:49,305 --> 00:03:51,245 and tell them to refer internally. 106 00:03:51,790 --> 00:03:53,950 So in that kind of environment, you know, 107 00:03:53,950 --> 00:03:56,430 how does how do you succeed? Right? So 108 00:03:56,430 --> 00:03:57,090 for us, 109 00:03:57,629 --> 00:03:59,310 we we are, you know, we are back. 110 00:03:59,310 --> 00:04:01,650 We do have outside investors, but, nevertheless, 111 00:04:02,430 --> 00:04:04,129 you know, it's all about understanding, 112 00:04:05,165 --> 00:04:07,504 like, who has leverage and how to negotiate. 113 00:04:08,444 --> 00:04:11,004 And that's something that, you know, we've kind 114 00:04:11,004 --> 00:04:13,504 of learned and improved upon over the years, 115 00:04:13,805 --> 00:04:15,965 but it's it's tough out there for for 116 00:04:15,965 --> 00:04:18,285 for, you know, the independent practice to survive 117 00:04:18,285 --> 00:04:19,264 this kind of environment. 118 00:04:20,279 --> 00:04:23,720 Mhmm. Yeah. Absolutely. That question of kind of 119 00:04:23,720 --> 00:04:26,039 leverage and negotiation is definitely something we get 120 00:04:26,039 --> 00:04:27,339 into a lot here and, 121 00:04:27,879 --> 00:04:28,699 something our 122 00:04:29,000 --> 00:04:31,720 audience really, you know, is talking about a 123 00:04:31,720 --> 00:04:32,199 lot. 124 00:04:32,599 --> 00:04:34,860 What are you most excited about right now? 125 00:04:36,444 --> 00:04:38,605 So, you know, new so our headquarters is 126 00:04:38,605 --> 00:04:39,985 New York, and, 127 00:04:40,685 --> 00:04:42,444 we have a lot of offices in New 128 00:04:42,444 --> 00:04:44,205 York. We also have offices in New Jersey 129 00:04:44,205 --> 00:04:45,185 and and Connecticut. 130 00:04:45,485 --> 00:04:45,985 And, 131 00:04:47,085 --> 00:04:48,925 you know, one thing we are excited about 132 00:04:48,925 --> 00:04:49,425 is, 133 00:04:50,045 --> 00:04:51,600 you know, next month, the state of New 134 00:04:51,600 --> 00:04:53,459 York is going to vote 135 00:04:54,000 --> 00:04:56,500 on whether or not they're gonna allow cardiology, 136 00:04:57,279 --> 00:04:59,459 to be done outpatient here in New York. 137 00:04:59,919 --> 00:05:02,419 And cardiology is one of the fastest growing, 138 00:05:03,519 --> 00:05:05,459 AAC specialties in in AACs, 139 00:05:06,295 --> 00:05:08,455 this past year. I think there was something 140 00:05:08,455 --> 00:05:11,335 like 25 or 26 cardiology AACs that came 141 00:05:11,335 --> 00:05:11,835 online. 142 00:05:12,375 --> 00:05:15,095 And the thing that that we find, exciting 143 00:05:15,095 --> 00:05:17,975 about that opportunity is, you know, New York 144 00:05:17,975 --> 00:05:19,275 is a CON state, 145 00:05:19,949 --> 00:05:21,729 and it's very hard to get an ASC. 146 00:05:22,430 --> 00:05:24,589 And we've already been in discussions with several 147 00:05:24,589 --> 00:05:25,729 cardiology groups, 148 00:05:26,509 --> 00:05:28,750 in such that, you know, up until now, 149 00:05:28,750 --> 00:05:30,829 it's never made sense for them to own 150 00:05:30,829 --> 00:05:31,329 ASCs, 151 00:05:31,995 --> 00:05:33,595 and it's very hard if they wanted to 152 00:05:33,595 --> 00:05:35,035 to build one. It would take it would 153 00:05:35,035 --> 00:05:37,274 take several years and and negotiating you know, 154 00:05:37,274 --> 00:05:40,095 building it out, getting approval, getting contracts. 155 00:05:41,035 --> 00:05:43,035 So one thing we're excited about is is 156 00:05:43,035 --> 00:05:45,280 if New York State approves it, you know, 157 00:05:45,280 --> 00:05:48,259 we are in discussions with several cardiology groups 158 00:05:48,639 --> 00:05:51,620 in terms of potentially partnering with them and, 159 00:05:52,080 --> 00:05:54,319 seeing if we can have that available at 160 00:05:54,319 --> 00:05:55,620 our at our ASC. 161 00:05:56,480 --> 00:05:59,415 Yeah. Absolutely. The momentum surrounding outpatient cardiology is 162 00:05:59,415 --> 00:06:01,895 definitely something to watch and something we're we're 163 00:06:01,895 --> 00:06:03,035 looking into a lot. 164 00:06:03,814 --> 00:06:05,175 You know, we've kind of been talking about 165 00:06:05,175 --> 00:06:06,855 this so far, but how are you thinking 166 00:06:06,855 --> 00:06:08,875 about growth over the next twelve months? 167 00:06:10,229 --> 00:06:11,829 Look. I I think growth can come in 168 00:06:11,829 --> 00:06:12,729 several fashions. 169 00:06:13,990 --> 00:06:16,490 You know, we are we have four ASCs, 170 00:06:16,949 --> 00:06:19,189 New York, New Jersey, Connecticut, Arkansas. All of 171 00:06:19,189 --> 00:06:20,729 our ASCs are very profitable. 172 00:06:21,029 --> 00:06:21,529 And, 173 00:06:23,144 --> 00:06:24,584 but at the same time, we have plenty 174 00:06:24,584 --> 00:06:25,245 of capacity. 175 00:06:25,865 --> 00:06:27,944 And so we're really thinking about, like, how 176 00:06:27,944 --> 00:06:30,444 do we partner with other outside groups. 177 00:06:30,904 --> 00:06:32,345 And and, you know, one of the things 178 00:06:32,345 --> 00:06:33,644 that's unique about us, 179 00:06:34,024 --> 00:06:36,269 because we do bariatric surgery, you 180 00:06:36,569 --> 00:06:39,050 know, most AACs have a a BMI cutoff. 181 00:06:39,050 --> 00:06:40,649 Right? And they may have a BMI cutoff 182 00:06:40,649 --> 00:06:43,449 of 40 versus us. Our BMI cutoff is 183 00:06:43,449 --> 00:06:46,169 a lot higher. It's 55 or 60. Right? 184 00:06:46,169 --> 00:06:46,669 Because 185 00:06:47,050 --> 00:06:49,375 our specialty is bariatrics. So we we also 186 00:06:49,375 --> 00:06:51,294 do general surgery. We also do plastic surgery. 187 00:06:51,294 --> 00:06:52,995 We do EGDs. But because 188 00:06:53,694 --> 00:06:54,754 we can accommodate, 189 00:06:55,055 --> 00:06:57,214 you know, patients with a higher BMI, whether 190 00:06:57,214 --> 00:06:58,675 that's, you know, anesthesiologists 191 00:06:59,055 --> 00:06:59,875 that are comfortable, 192 00:07:00,414 --> 00:07:03,154 providing anesthesia services on higher BMI patients, 193 00:07:04,199 --> 00:07:06,439 it's the reinforced toilets. It's the waiting room 194 00:07:06,439 --> 00:07:08,060 furniture, the OR tables. 195 00:07:08,439 --> 00:07:10,600 You know, because we could accommodate the higher 196 00:07:10,600 --> 00:07:12,540 BMI patient, we think there's opportunity 197 00:07:13,639 --> 00:07:15,660 in, you know, trying to get volume, 198 00:07:16,435 --> 00:07:18,435 of cases that that cannot be done at 199 00:07:18,435 --> 00:07:20,514 other ASCs. So we're in discussions with several 200 00:07:20,514 --> 00:07:21,014 groups. 201 00:07:21,394 --> 00:07:22,694 We're also in discussions 202 00:07:23,235 --> 00:07:25,894 with our, employers, director employers. 203 00:07:26,194 --> 00:07:28,455 You know, we are probably going to launch 204 00:07:29,160 --> 00:07:31,800 orthopedic and spine. There's a lot of synergies 205 00:07:31,800 --> 00:07:33,420 between orthopedics and bariatrics. 206 00:07:34,040 --> 00:07:35,720 So we're in the process of hiring our 207 00:07:35,720 --> 00:07:36,939 own orthopedic surgeons, 208 00:07:37,480 --> 00:07:38,620 own spine surgeons, 209 00:07:39,800 --> 00:07:41,639 and and trying to get those cases done 210 00:07:41,639 --> 00:07:43,740 at our ASC. So we're pretty excited, 211 00:07:44,564 --> 00:07:45,704 about our diversification 212 00:07:46,004 --> 00:07:46,504 efforts. 213 00:07:47,044 --> 00:07:48,964 But, yeah, we we we see, again, you 214 00:07:48,964 --> 00:07:50,824 know, more and more stuff is going outpatient. 215 00:07:51,125 --> 00:07:51,625 Employers, 216 00:07:52,404 --> 00:07:54,884 you know, are faced with rising premiums, the 217 00:07:54,884 --> 00:07:56,504 rise of the ASO model. 218 00:07:56,830 --> 00:07:59,389 And if we have a unique solution in 219 00:07:59,389 --> 00:08:00,610 which we can offer, 220 00:08:01,550 --> 00:08:02,290 great quality 221 00:08:02,590 --> 00:08:05,069 at at a very competitive price, like bundle 222 00:08:05,069 --> 00:08:05,569 pricing, 223 00:08:05,949 --> 00:08:07,069 then I think there's, 224 00:08:07,550 --> 00:08:09,090 volume that that we can get. 225 00:08:09,834 --> 00:08:10,334 Absolutely. 226 00:08:11,355 --> 00:08:13,355 Is there anything that I haven't asked about 227 00:08:13,355 --> 00:08:15,514 so far that you feel like is relevant 228 00:08:15,514 --> 00:08:16,894 or important in this conversation? 229 00:08:19,915 --> 00:08:21,514 Not that I could think of. You know, 230 00:08:21,514 --> 00:08:23,139 we're we're just look. We're very bullish on 231 00:08:23,139 --> 00:08:24,180 the ASC market. And, 232 00:08:26,180 --> 00:08:27,720 you know, and and especially, 233 00:08:28,099 --> 00:08:29,639 it's really hard to get an ASC. 234 00:08:29,939 --> 00:08:32,659 You know, but but there's several opportunities around 235 00:08:32,659 --> 00:08:33,799 the country where 236 00:08:34,500 --> 00:08:36,419 several states are doing away with the CON 237 00:08:36,419 --> 00:08:38,075 laws. And and I think, you know, for 238 00:08:38,075 --> 00:08:39,995 the practices out there in those states, I 239 00:08:39,995 --> 00:08:42,575 I think that's something they should really, really 240 00:08:42,955 --> 00:08:45,754 invest and inquire upon. But at the same 241 00:08:45,754 --> 00:08:47,914 time, you know, my advice to them is 242 00:08:47,914 --> 00:08:50,460 is is to definitely get the right help 243 00:08:50,779 --> 00:08:52,399 and partner with the right folks 244 00:08:52,860 --> 00:08:54,220 because, you know, all of the idea of 245 00:08:54,220 --> 00:08:56,379 an AAC or having the AAC to practice 246 00:08:56,379 --> 00:08:57,679 makes a lot of sense. 247 00:08:58,300 --> 00:09:00,620 It's really, really hard. So you definitely wanna 248 00:09:00,620 --> 00:09:02,940 partner with folks that have done it before. 249 00:09:02,940 --> 00:09:04,460 And luckily for us, we have a great 250 00:09:04,460 --> 00:09:06,735 AAC team, but, you know, just 251 00:09:07,514 --> 00:09:09,195 building ASC is not enough. You have to 252 00:09:09,195 --> 00:09:11,035 ensure you have the volume, and you have 253 00:09:11,035 --> 00:09:11,695 to know, 254 00:09:12,554 --> 00:09:15,215 you have to ensure that you can negotiate 255 00:09:15,274 --> 00:09:17,035 with the payers. And that you know, just 256 00:09:17,035 --> 00:09:19,215 because it makes sense on paper doesn't mean 257 00:09:19,509 --> 00:09:21,829 it's something that that is easy to do. 258 00:09:21,829 --> 00:09:23,669 So so definitely, you know, I would I 259 00:09:23,669 --> 00:09:26,549 would encourage folks to to research this and 260 00:09:26,549 --> 00:09:28,069 and and partner with folks that have done 261 00:09:28,069 --> 00:09:28,730 it before. 262 00:09:29,429 --> 00:09:30,949 Yeah. Absolutely. I feel like that's kind of 263 00:09:30,949 --> 00:09:32,490 a work smarter, not harder 264 00:09:32,995 --> 00:09:34,915 idea that I am that's also just something 265 00:09:34,915 --> 00:09:36,355 I'm hearing a lot in the ASC space 266 00:09:36,355 --> 00:09:37,875 is the need to partner. So it's, yeah, 267 00:09:37,875 --> 00:09:39,495 interesting to hear you say that. 268 00:09:40,355 --> 00:09:42,115 But, yeah, that's otherwise all I have for 269 00:09:42,115 --> 00:09:43,634 you today, Vijay. Thank you so much for 270 00:09:43,634 --> 00:09:46,054 joining us. Thank you for having me. 271 00:09:46,419 --> 00:09:47,860 Yeah. Of course. It's been a pleasure speaking 272 00:09:47,860 --> 00:09:49,220 with you, and I look forward to connecting 273 00:09:49,220 --> 00:09:51,460 with you again in the future. Likewise. Thank 274 00:09:51,460 --> 00:09:51,960 you. 275 00:09:54,179 --> 00:09:57,059 At athena Health, we know your ambulatory practice 276 00:09:57,059 --> 00:09:57,960 wants healthier, 277 00:09:58,419 --> 00:10:01,220 a healthier business, healthier care teams, and healthier 278 00:10:01,220 --> 00:10:01,720 patients. 279 00:10:02,174 --> 00:10:04,654 But the complexities of modern healthcare tech make 280 00:10:04,654 --> 00:10:06,654 it hard for you and your care teams 281 00:10:06,654 --> 00:10:08,274 to focus on what matters most. 282 00:10:08,654 --> 00:10:11,774 That's where athenahealth can help. Our AI native 283 00:10:11,774 --> 00:10:14,595 all in one solutions reduce administrative burdens, 284 00:10:14,990 --> 00:10:17,949 streamline billing and payments, and deliver critical insights 285 00:10:17,949 --> 00:10:19,569 when clinicians need it most. 286 00:10:19,870 --> 00:10:22,529 That means fewer clicks, more time for patients, 287 00:10:22,589 --> 00:10:24,049 and stronger bottom lines. 288 00:10:24,750 --> 00:10:27,949 Practicing medicine is complex, but running a practice 289 00:10:27,949 --> 00:10:29,809 can be that much simpler with athenahealth. 290 00:10:30,529 --> 00:10:34,229 See how simpler is healthier at athenahealth.com.