1
00:00:00,080 --> 00:00:02,659
This is Alan Condon with the Becker's Podcast.

2
00:00:02,879 --> 00:00:05,279
I'm thrilled to be joined today by doctor

3
00:00:05,279 --> 00:00:06,819
Pedro Martinez Clark,

4
00:00:07,120 --> 00:00:08,820
medical director at AmoVida

5
00:00:09,119 --> 00:00:10,900
Heart and Vascular Health.

6
00:00:11,279 --> 00:00:13,519
Doctor Martinez Clark, a pleasure to have you

7
00:00:13,519 --> 00:00:15,139
on the podcast with us today.

8
00:00:15,594 --> 00:00:17,835
Before we dive into some questions and get

9
00:00:17,835 --> 00:00:20,154
the ball rolling here, I'd love to turn

10
00:00:20,154 --> 00:00:22,074
the floor over to you just to help

11
00:00:22,074 --> 00:00:23,434
to fill us in a little bit more

12
00:00:23,434 --> 00:00:25,454
about your role and your practice.

13
00:00:26,794 --> 00:00:28,890
Yes. It's a pleasure for me to be

14
00:00:28,890 --> 00:00:31,149
here. Thank you so much for the invitation.

15
00:00:31,769 --> 00:00:34,429
And, again, my name is doctor Pedro Martinez

16
00:00:34,570 --> 00:00:36,829
Clark, and I'm an interventional cardiologist

17
00:00:37,770 --> 00:00:38,750
here in Miami.

18
00:00:39,450 --> 00:00:39,770
In,

19
00:00:40,329 --> 00:00:41,549
a few years ago,

20
00:00:42,255 --> 00:00:43,774
we started what is called,

21
00:00:44,335 --> 00:00:48,094
Amavita Heart and Vascular Health, which has become

22
00:00:48,094 --> 00:00:51,155
a very busy cardiovascular practice in Miami

23
00:00:51,535 --> 00:00:52,355
Dade County

24
00:00:52,815 --> 00:00:54,835
with several office locations,

25
00:00:56,015 --> 00:00:57,234
and one OBL

26
00:00:57,990 --> 00:01:01,429
and 2 outpatient surgical centers that are quite,

27
00:01:02,229 --> 00:01:05,030
quite new and, are kind of the center

28
00:01:05,030 --> 00:01:05,769
of our

29
00:01:06,390 --> 00:01:06,890
strategy,

30
00:01:07,510 --> 00:01:08,409
moving forward.

31
00:01:09,670 --> 00:01:12,284
Gotcha. So we focus on our interventional cardi

32
00:01:12,445 --> 00:01:16,045
interventional cardiology, excuse me, with 2 ASCs in

33
00:01:16,045 --> 00:01:17,585
the Miami Dade area.

34
00:01:18,045 --> 00:01:20,365
I imagine a very, very busy practice, and

35
00:01:20,365 --> 00:01:22,045
they're excited to kinda pick your brains and

36
00:01:22,045 --> 00:01:24,064
learn a little bit more in their conversation

37
00:01:24,445 --> 00:01:25,505
today. So

38
00:01:25,950 --> 00:01:28,510
I guess before we do, doctor Martinez Clark,

39
00:01:28,510 --> 00:01:30,750
can you give me, are there 2 or

40
00:01:30,750 --> 00:01:31,729
3 trends

41
00:01:32,349 --> 00:01:34,849
that you're paying close attention to

42
00:01:35,150 --> 00:01:36,909
in health care or in the a s

43
00:01:37,069 --> 00:01:38,530
ASC space today?

44
00:01:38,829 --> 00:01:40,049
What might they be?

45
00:01:40,784 --> 00:01:44,385
Yes. That's an excellent question. In, obviously, there

46
00:01:44,385 --> 00:01:47,584
are national trends, but they're also very local

47
00:01:47,584 --> 00:01:48,805
trends. Right? So,

48
00:01:49,344 --> 00:01:52,064
a couple trends that are intrinsic to Florida

49
00:01:52,064 --> 00:01:55,045
and to more specifically to Miami Dade County.

50
00:01:55,420 --> 00:01:58,079
Miami Dade County has a very high Medicare

51
00:01:58,140 --> 00:01:59,200
Advantage population,

52
00:01:59,900 --> 00:02:00,400
rate

53
00:02:00,939 --> 00:02:01,680
in penetration.

54
00:02:01,980 --> 00:02:02,480
Therefore,

55
00:02:03,340 --> 00:02:04,079
the outcomes

56
00:02:04,700 --> 00:02:06,700
first of all, one of the most important

57
00:02:06,700 --> 00:02:09,740
trend was, that we were following was the

58
00:02:09,740 --> 00:02:10,879
outcome of the election.

59
00:02:11,395 --> 00:02:13,414
In, that that being said,

60
00:02:13,794 --> 00:02:15,955
obviously, that may or may not have some

61
00:02:15,955 --> 00:02:16,455
implications

62
00:02:17,155 --> 00:02:19,414
into what we might see in the future

63
00:02:19,555 --> 00:02:22,995
of Medicare Advantage Plans, which is very important

64
00:02:22,995 --> 00:02:25,155
in Miami Dade County because of the high

65
00:02:25,155 --> 00:02:27,989
Medicare population and the high penetration

66
00:02:28,370 --> 00:02:30,709
of Medicare Advantage Plans. So that's

67
00:02:31,009 --> 00:02:33,669
one very important trend that we're following.

68
00:02:33,969 --> 00:02:34,870
Number 2,

69
00:02:36,610 --> 00:02:37,830
why are those procedures,

70
00:02:39,409 --> 00:02:40,050
that are,

71
00:02:40,689 --> 00:02:44,294
allowed to be performed in the outpatient setting

72
00:02:44,514 --> 00:02:48,215
in ambulatory surgical centers from the cardiovascular

73
00:02:48,675 --> 00:02:49,175
perspective.

74
00:02:49,875 --> 00:02:52,215
So that was the second that's the second,

75
00:02:52,995 --> 00:02:53,814
very important,

76
00:02:54,435 --> 00:02:56,215
point that we follow very closely.

77
00:02:56,840 --> 00:02:57,900
And and 3,

78
00:02:58,760 --> 00:03:01,260
is, obviously, the economics of,

79
00:03:02,199 --> 00:03:03,819
running surgical centers

80
00:03:04,280 --> 00:03:05,900
in, health care in general,

81
00:03:06,599 --> 00:03:07,099
contracting,

82
00:03:07,560 --> 00:03:08,060
purchasing,

83
00:03:09,044 --> 00:03:09,544
efficiencies

84
00:03:10,324 --> 00:03:12,025
in in in how to maximize

85
00:03:14,485 --> 00:03:16,824
productivity in the in the surgical centers.

86
00:03:17,925 --> 00:03:19,444
Yeah. Yeah. Absolutely. I think,

87
00:03:20,165 --> 00:03:22,085
really interesting to kinda open up our discussion

88
00:03:22,085 --> 00:03:24,459
there. And like you said, particularly as it

89
00:03:24,459 --> 00:03:25,919
relates to Medicare Advantage,

90
00:03:26,300 --> 00:03:28,060
you know, a national trend, but no. They're

91
00:03:28,060 --> 00:03:30,459
very local trend as well in Florida like

92
00:03:30,459 --> 00:03:31,199
you've mentioned.

93
00:03:32,539 --> 00:03:34,879
I guess when it comes to Medicare Advantage,

94
00:03:35,615 --> 00:03:39,375
in an ideal world, what changes or updates

95
00:03:39,375 --> 00:03:41,635
would you like to see in the program,

96
00:03:41,935 --> 00:03:43,474
especially when we think about

97
00:03:43,855 --> 00:03:46,574
there's, I believe, half the nation's seniors are

98
00:03:46,574 --> 00:03:48,675
enrolled in the Medicare Advantage Program.

99
00:03:48,979 --> 00:03:50,680
And no doubt when we think about Florida

100
00:03:50,739 --> 00:03:53,560
as a high high, population of seniors,

101
00:03:53,939 --> 00:03:55,539
no doubt that has a big impact on

102
00:03:55,539 --> 00:03:56,759
your practice as well.

103
00:03:57,620 --> 00:04:00,019
Absolutely. And one of the biggest one of

104
00:04:00,019 --> 00:04:02,794
the biggest areas of interest to me is

105
00:04:02,794 --> 00:04:04,974
how do how are we going to transition

106
00:04:05,194 --> 00:04:06,094
to a

107
00:04:06,635 --> 00:04:08,175
value based model?

108
00:04:08,555 --> 00:04:10,715
And and now that our practice has a

109
00:04:10,715 --> 00:04:11,215
significant,

110
00:04:11,915 --> 00:04:15,020
footprint in in Miami Dade and that we

111
00:04:15,020 --> 00:04:18,319
have offices located throughout the the county,

112
00:04:18,939 --> 00:04:21,360
which is very densely populated, obviously.

113
00:04:21,980 --> 00:04:23,100
But we have access

114
00:04:23,819 --> 00:04:25,660
or or pretty much every patient has,

115
00:04:26,379 --> 00:04:28,480
easy access to one of our offices,

116
00:04:28,824 --> 00:04:31,245
and we have surgical centers that are strategically

117
00:04:31,625 --> 00:04:33,464
located, 1 in the north and one in

118
00:04:33,464 --> 00:04:34,045
the south.

119
00:04:34,425 --> 00:04:37,705
We would love to figure out models that

120
00:04:37,705 --> 00:04:38,185
we can,

121
00:04:38,824 --> 00:04:40,205
pilot with different,

122
00:04:41,800 --> 00:04:44,620
Medicare Advantage Plans where we can experiment

123
00:04:45,399 --> 00:04:47,979
a little bit more on on on transitioning

124
00:04:48,360 --> 00:04:50,860
to value based medicine because, obviously,

125
00:04:51,319 --> 00:04:52,379
that is a

126
00:04:52,839 --> 00:04:54,699
a strong and significant trend,

127
00:04:55,225 --> 00:04:56,525
that is going to,

128
00:04:57,384 --> 00:04:58,605
decrease the number

129
00:04:58,985 --> 00:05:00,045
of people service,

130
00:05:01,305 --> 00:05:03,545
patients that we're going to see. So I

131
00:05:03,545 --> 00:05:06,585
think as as, physicians, we have to recognize

132
00:05:06,585 --> 00:05:09,269
that. We have to adapt. We have to

133
00:05:09,410 --> 00:05:11,569
figure out how we become comfortable in that

134
00:05:11,569 --> 00:05:13,729
environment, and we have to and from a

135
00:05:13,729 --> 00:05:16,449
procedural perspective, we have to figure out how

136
00:05:16,449 --> 00:05:17,829
we're going to transition

137
00:05:18,449 --> 00:05:19,910
and change our mindset,

138
00:05:20,449 --> 00:05:21,189
our mindset

139
00:05:21,569 --> 00:05:22,069
from,

140
00:05:22,834 --> 00:05:26,834
being compensated for events and just procedures that

141
00:05:26,834 --> 00:05:29,875
we do rather to rather more holistic or

142
00:05:29,875 --> 00:05:32,854
more comprehensive for more focal, care,

143
00:05:33,555 --> 00:05:33,794
with,

144
00:05:34,435 --> 00:05:35,654
a risk sharing.

145
00:05:36,595 --> 00:05:37,095
Mhmm.

146
00:05:37,459 --> 00:05:40,339
Yeah. It's certainly interesting, especially like you said,

147
00:05:40,420 --> 00:05:43,399
with the the results of the election, how

148
00:05:43,620 --> 00:05:46,180
how how potential changes we could see in

149
00:05:46,180 --> 00:05:48,899
the Medicare Advantage Plan or CMS more broadly

150
00:05:48,899 --> 00:05:50,435
over the next 4 years or so, but

151
00:05:50,435 --> 00:05:52,595
certainly an interesting trend like you've like you've

152
00:05:52,595 --> 00:05:54,115
said to keep an eye on both at

153
00:05:54,115 --> 00:05:55,814
the national and the local level.

154
00:05:56,834 --> 00:05:59,954
Doctor Martinez Clark, can you no doubt there's

155
00:05:59,954 --> 00:06:02,834
some challenges there, but potentially some opportunities as

156
00:06:02,834 --> 00:06:03,334
well.

157
00:06:03,660 --> 00:06:06,139
When you think about the future of health

158
00:06:06,139 --> 00:06:09,259
care, whether it relates to interventional cardiology or

159
00:06:09,259 --> 00:06:11,340
health care more broadly, what are you what

160
00:06:11,340 --> 00:06:12,800
are you most excited about?

161
00:06:13,819 --> 00:06:16,845
Well, I'm I'm a big technology person, so

162
00:06:16,925 --> 00:06:20,605
I think enabling or integrating technologies to into

163
00:06:20,605 --> 00:06:23,185
our practice that allow us to manage,

164
00:06:23,805 --> 00:06:24,704
chronic conditions

165
00:06:25,245 --> 00:06:27,004
in a in a in a way that

166
00:06:27,004 --> 00:06:30,384
is more effective and efficient and less episodic,

167
00:06:31,629 --> 00:06:34,350
definitely, it's gonna help us transition to that

168
00:06:34,350 --> 00:06:36,850
model of care that I was discussing before.

169
00:06:37,230 --> 00:06:38,370
So in integrating

170
00:06:38,750 --> 00:06:41,569
those sample technologies, remote monitoring, etcetera,

171
00:06:42,589 --> 00:06:45,230
into our our practice is going to help

172
00:06:45,230 --> 00:06:47,524
us tremendously in making that transition.

173
00:06:47,904 --> 00:06:50,464
I'm also very interested in implementing all the

174
00:06:50,464 --> 00:06:53,044
technologies and platforms that allow us to

175
00:06:53,345 --> 00:06:54,964
provide a more seamless,

176
00:06:55,584 --> 00:06:58,224
experience that the patient may have during the

177
00:06:58,704 --> 00:07:00,964
with the interaction with health care system.

178
00:07:01,300 --> 00:07:03,400
You know, I I I think the opportunity

179
00:07:03,540 --> 00:07:04,420
is to make this,

180
00:07:05,060 --> 00:07:06,680
experience a little more pleasant,

181
00:07:07,060 --> 00:07:09,060
and and and I think there are,

182
00:07:10,500 --> 00:07:13,240
technologies and and operational efficiencies

183
00:07:13,834 --> 00:07:16,475
that could be explored to make this this

184
00:07:16,475 --> 00:07:17,455
sort of interaction

185
00:07:17,995 --> 00:07:21,295
with the health care system, offices, practices, etcetera,

186
00:07:21,595 --> 00:07:23,595
a lot more pleasant for the patient or

187
00:07:23,595 --> 00:07:24,415
for the consumer.

188
00:07:24,875 --> 00:07:26,955
And the other thing that I'm most most

189
00:07:27,194 --> 00:07:29,375
very excited about is is how

190
00:07:30,770 --> 00:07:33,889
we, increase the number or or how we

191
00:07:33,889 --> 00:07:36,770
do more procedures in the outpatient setting. And

192
00:07:36,770 --> 00:07:38,870
and the complexity of our procedures

193
00:07:39,569 --> 00:07:42,129
is is how we understand the complexity of

194
00:07:42,129 --> 00:07:44,470
the procedures that we perform and what procedures

195
00:07:44,610 --> 00:07:45,704
need to be done in the hospital,

196
00:07:46,264 --> 00:07:48,584
and which procedures we can do in a

197
00:07:48,584 --> 00:07:49,564
in a safe,

198
00:07:50,345 --> 00:07:52,345
manner in the outpatient setting. I think,

199
00:07:53,384 --> 00:07:55,485
if you look at most of the cardiovascular

200
00:07:55,784 --> 00:07:57,724
procedures that we

201
00:07:58,024 --> 00:08:02,389
do in interventional cardiology, either vascular procedures or

202
00:08:02,389 --> 00:08:03,930
or cardiac per se,

203
00:08:04,389 --> 00:08:07,209
our procedures are because a lot safer

204
00:08:07,589 --> 00:08:10,069
and a lot faster to perform because our

205
00:08:10,069 --> 00:08:10,569
ability

206
00:08:10,870 --> 00:08:14,214
to do these procedures and our understanding has

207
00:08:14,214 --> 00:08:14,714
increased,

208
00:08:15,014 --> 00:08:17,275
and also the technology has improved

209
00:08:18,295 --> 00:08:20,615
dramatically. So I think we're gonna see an

210
00:08:20,615 --> 00:08:22,775
expansion of the number of in the number

211
00:08:22,775 --> 00:08:23,435
of procedures,

212
00:08:24,375 --> 00:08:26,214
that we can do in the,

213
00:08:26,775 --> 00:08:28,555
ambulatory surgical center.

214
00:08:29,379 --> 00:08:32,199
Yeah. To to your point, really exciting time.

215
00:08:32,659 --> 00:08:34,740
No doubt for our physicians in your specialty

216
00:08:34,740 --> 00:08:37,059
and other high acuity specialties when we think

217
00:08:37,059 --> 00:08:38,039
about orthopedics,

218
00:08:38,500 --> 00:08:39,000
cardiology.

219
00:08:39,459 --> 00:08:40,980
We're starting to see more and more of

220
00:08:40,980 --> 00:08:44,865
these complex, high acuity procedures moved ASCs to

221
00:08:44,865 --> 00:08:46,785
the outpatient setting. Like you said, to the

222
00:08:46,785 --> 00:08:49,524
onset of some of these, minimally invasive technologies

223
00:08:49,664 --> 00:08:51,424
and whatnot. I know you said at the

224
00:08:51,424 --> 00:08:53,585
top of the conversation, you have 2 ASCs,

225
00:08:53,585 --> 00:08:55,205
I believe, if I'm not mistaken.

226
00:08:55,559 --> 00:08:58,279
I'd love to get some insight into how

227
00:08:58,279 --> 00:08:59,240
are you thinking about,

228
00:08:59,720 --> 00:09:01,639
the growth of your practice over the next

229
00:09:01,639 --> 00:09:03,580
12 to 24 months or so.

230
00:09:04,360 --> 00:09:07,500
Yeah. I mean, we have a multi multichannel,

231
00:09:08,544 --> 00:09:11,924
approach. We do a significant amount of, marketing.

232
00:09:11,985 --> 00:09:14,165
We do a lot of community outreach.

233
00:09:15,264 --> 00:09:15,665
We,

234
00:09:16,144 --> 00:09:17,764
we meet with payers,

235
00:09:18,785 --> 00:09:22,065
with big advocates in in in showing our

236
00:09:22,065 --> 00:09:22,565
outcomes.

237
00:09:23,120 --> 00:09:24,399
And, and we do,

238
00:09:25,120 --> 00:09:25,620
obviously,

239
00:09:26,240 --> 00:09:28,419
we're very close to our reporting decisions,

240
00:09:28,799 --> 00:09:32,179
and also we do, direct to consumers. So

241
00:09:32,399 --> 00:09:34,339
I think I think, we have

242
00:09:34,799 --> 00:09:37,699
a a a multi sort of, channel approach,

243
00:09:38,065 --> 00:09:39,764
and, and this has helped

244
00:09:40,144 --> 00:09:41,264
us sustain a,

245
00:09:41,825 --> 00:09:44,384
continuous growth over the last few years. And

246
00:09:44,384 --> 00:09:44,884
and

247
00:09:45,185 --> 00:09:46,725
with the growth in the population,

248
00:09:47,345 --> 00:09:49,985
that required for your vascular services, especially in

249
00:09:49,985 --> 00:09:51,845
an area like Miami Dade County,

250
00:09:52,450 --> 00:09:54,309
where it's a significant number of,

251
00:09:55,089 --> 00:09:55,589
older,

252
00:09:56,049 --> 00:09:56,549
individuals,

253
00:09:57,089 --> 00:10:00,209
the the demand for cardiovascular service is going

254
00:10:00,209 --> 00:10:02,549
to is going to continue to increase.

255
00:10:03,730 --> 00:10:04,230
Absolutely.

256
00:10:04,715 --> 00:10:06,715
Doctor Martinez Clark, it's been a real pleasure,

257
00:10:06,955 --> 00:10:08,634
having you on the podcast for the first

258
00:10:08,634 --> 00:10:10,315
time. It's been great to get to know

259
00:10:10,315 --> 00:10:11,754
you a little bit better and also learn

260
00:10:11,754 --> 00:10:13,835
a little bit more about Amavita Heart and

261
00:10:13,835 --> 00:10:14,894
Vascular Health.

262
00:10:15,355 --> 00:10:16,794
Thank you so much for joining the Becker's

263
00:10:16,794 --> 00:10:18,315
podcast, and we look forward to connecting with

264
00:10:18,315 --> 00:10:20,438
you again down the line. Perfect. Thank you

265
00:10:20,438 --> 00:10:21,188
so much.