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This is Alan Condon with the Becker's ASC
podcast. I'm thrilled to be joined today by
Will Reeves who is the vice president of
operations at
Wisconsin
Spine and Pain.
Will, delighted to have you on the podcast
with us today. Before we dive into some
questions, I'd love to hand it over to
you to hear a little bit more about
yourself, your role, and, of course, Wisconsin Spine
and Pain too.
Yeah. Thanks for having me, Alan. I appreciate
it.
I'm with Wisconsin Spine and Pain as the
vice president of operations.
We have, 5 interventional pain clinics,
3 ambulatory surgery centers,
between
Milwaukee and Green Bay area in Wisconsin.
Lucky enough to kind of have a role
that allows me to help the company grow
while finding ways to remove barriers for our
providers. So that way, they can do what
they do best and that's, you know, continue
to provide excellent patient care.
Fantastic. So I I think thanks for staying
to stay. Five clinic locations in Wisconsin, 3
ambulatory surgery centers.
I'd love to start off there. I think,
obviously, quite a substantial presence for for for
the area of Wisconsin in which you operate.
But how are you looking at either expanding
within its con within Wisconsin or potentially across
state lines? I know you also cater to
some patients,
and part of the Northern Michigan Peninsula, Illinois
as well. But how are you looking at
growth in the future?
Yeah. Absolutely. So everybody's always trying to grow.
We're no different. So, you know, we've always
kind of had the mindset that the more
we grow, the more patients we can help.
So that's what we certainly wanna continue to
try to do.
Looking at other areas that are a little
further south,
we have a few different options there as
well as kind of partnering with other physicians
potentially that,
are looking to join the practice as well.
So not only location wise, but also possibly
grow it from a provider standpoint as well.
Gotcha. And when you think about it, you've
obviously got those 3 ambulatory service centers. Certainly
an exciting time to be in the ASC
space when we think about the rapid growth
that we're seeing there. I think is there
anything when you look at the outpatient environment
or ASC sector more specifically,
are there any 2 or 3 trends that
you're particularly paying attention to,
or most excited by?
Yeah. Absolutely. So,
technology is always a big one that's on
the top of the list. Right? And I
think, I always keep my eyes on it,
and I'm sure everybody else does too to
see how they can kinda best leverage,
technology to help. But for us, we're always
looking at it to see how we can
help improve patient experience as well as everything
from that to, you know, how our team
works on a day to day basis from
their experience as well as improving workflows across
the board.
The most discussed topic, I'd say, certainly, even
at the Becker's conference was how do we
utilize AI within health care.
We've actually started doing that by implementing,
AI scribes into our documentation process, which has
gone really well. We've actually seen quite a
bit of time savings from some of our
providers that have started to utilize it. We're
looking to kinda open that up to the
whole group now as a whole.
I'd say another trend that we probably
discuss all the time too is reimbursement
rates. Right? That's always at the forefront of
the health care discussion.
With Medicare Advantage Plans kinda covering a majority
of the Medicare population now as well as
governmental health care payers,
covering sometimes in some areas even more than
the commercial payers do. It creates certainly a
concern about decrease in reimbursement rates and what
are we going to do about it. That
kinda goes back to the technology. How do
we utilize
that? Kinda leverage that. That way we can
help ensure that even if reimbursement rates do
decrease, we can find ways to
still increase possibly the volume or increase efficiencies.
So that way we ensure we don't have,
you know, a large number of denials or
we have to have prior authorization issues or
anything like that.
I'd say probably the the third trend too
that has kinda fallen off the radar a
little bit for everybody else, but we certainly
still keep our eye on it,
is the job market.
So although the wage rates,
have, you know, leveled off and gotten a
little bit more stagnant, which is a little
bit easier to deal with. We also
have seen turnover rates have slowed down a
bit, which is excellent. But even with that,
as well as our group, as well as
any other health care groups that I've spoken
with, everybody still seems to struggle with finding
those great candidates.
So you can find somebody to fill the
position. It's just now, which is great, but
that's improvement from before, but it's still trying
to find a way to find that great
candidate because,
hiring right is certainly important. I think, you
know, if the past has taught us anything,
it's the importance of hiring the right person
for the job rather than just trying to
fill that position.
Right. Yeah. Exactly. I think so. 3 three
really important really growing trends at the moment,
obviously, in relation to the job market, which
you had mentioned there. On the technology side,
interesting to see here about what you're doing
with AI Scribes and the documentation
process and some of the some of the
efficiencies there. But I'd love to kind of
follow-up with with what you mentioned just in
terms of the reimbursement rates and challenges within
the Medicare Advantage space. I think to your
point, you said it now,
caters to about 51%
of the nation's seniors.
But we hear time and time again about
a lot of the challenges within that program
in terms of some of which you alluded
to, maybe slow payments,
some denials, prior authorization challenges as well.
I'm curious to hear, how are you navigating
those challenges? And do you see any sort
of a change in that program given the
size and scope of it, ideally in the
future and how hopefully, benefit all stakeholders, providers,
payers, and, of course, the patient too?
Yeah. Definitely. I think,
one of the ways that we're focusing in
on it is we can control we can
only control what we can control. Right? So,
if our notes get done in a timely
fashion, we can get those claims out in
a timely
That certainly always is helpful because then, those
claims are being paid quicker than if we
sit on it for 30, 60, 90 days,
or whatever it may be,
what I've seen with some practices. So we
certainly try to be efficient there. Also from
a documentation standpoint,
we wanna make sure that we have everything
in the note that's needed so that
way we aren't receiving those denials. And then
we also made sure that on a prior
authorization standpoint that,
we are going through the process even though
sometimes it's very painful.
We wanna make sure that we are prior
authorizing
everything that we can. And, again, that goes
back to the documentation. So ensuring that the
documentation is done timely. That way, we can
submit for the prior auth,
and get those approved.
We do have a very high,
approval rate for our claims. Our denial rate
for that is very, very low, which is
excellent. So that certainly helps.
Fantastic. And would you could you expand on,
I guess, what are the 1 or 2
key things that really help to keep those
denial rates, quite low as you've
mentioned? Yeah. I think it's 1, having a
team that's passionate about it. Right? Because sometimes
picking up the phone and calling and having
those conversations
even though, again, that's very painful at times
to talk to some of these payers,
it certainly is helpful when you have somebody
that's passionate on the phone that is trying
to do right by the patient. And when
we put the patient at the forefront,
of those discussions, that always is helpful. And
we've also seen too that sometimes helping
the patients as well get involved,
and then the patient trying to contact the
payer and discuss those if they are receiving
a prior auth denial.
Sometimes they have a better
response. They'll get a better response than we
do if we're calling as a group.
So working with them on how to kind
of handle those and submit
those authorizations and work through that together as
a team.
Gotcha. Yeah. I mean, really,
no doubt some some great insights that other
practices, ASD groups would no doubt find take
a lot away from there in terms of
how you're navigating some of those challenges within
that Medicare Advantage program.
But turning to looking to the future and
kinda wanna get your perspective.
You've obviously talked about some of those trends
you're following, some of the things you're doing
about growth at Wisconsin Spine and Pain. But
when you think about health care more broadly,
is there anything that you're particularly excited about
right now and why?
Yeah. So deep down, I'm a numbers guy
at heart. When I started in health care
in 2,006,
I actually began in medical records.
So it was very old school. Each and
every day, I'd have to go down to
the basement of our hospital at the time,
pull physical patient charts, switch for paper charts,
load them up in a suitcase, and drive
them around town to all the clients.
So now compare that to the world of
health care that we live in today. Right?
It's a night and day difference. Yeah. So
to say I'm I'm excited that that we
can review,
you know, just about any statistical data point
that we want,
with just a few clicks of a mouse.
I'd say that's probably an understatement. Well, more
than excited about it.
But also with that being said, I'd still
say that even with the team, I still
caution everybody that, even though I'm a huge
fan of numbers, especially in operations, numbers and
statistics can only get you so far because
they don't tell the whole story. And I
think sometimes we rely on those numbers a
little too much, rather than dig into them
and let them kind of point us in
the right direction.
A good example of that would be if
we're looking at call rates and how long
time,
a call is for an employee. Right?
Somebody who might get through an additional 20
phone calls, it looks great from a numbers
perspective.
But when you dig into that and you
listen to the recordings or you kind of
hear the quality of those calls
Mhmm. Well, the number, even though it looks
better, it might not be better because we
might have lost a patient or 2 because
somebody's trying to rush through those phone calls.
So, again, I think it points you in
the right direction and allows us to dig
where we need to dig and do it
a lot more efficient than we certainly used
to when we had, you know, paper charts
or doing everything
by hand.
Yeah. Yeah. Fascinating to hear.
Will, real pleasure to get to speak. Your
debut appearance on the Becker's AC podcast today.
Fascinating to hear about everything going on at
Wisconsin Spine and Pain, and, I really look
forward to catching catching up with you on
the line. Awesome. Thank you so much. I
appreciate it. Thanks for having me.