This is Alan Congdon with the Becker's ASC
Podcast, and I am thrilled to be joined
today by Tina Piotrowski,
CEO at Copper Ridge Surgery Center in Traverse
City, Michigan. Tina,
pleasure to have you back on the podcast
with us again.
For our listeners who mightn't be as acquainted
with you or your surgery center, can you
take a moment to just tell us a
little bit more about your role and your
background?
Sure. Thank you, Alan.
This is my 20th year in the ASC
industry. I am the past president of the
Michigan Ambulatory Surgery Association.
I have held the cast credential as a
certified administrator since 2016, and I am on
the board of ambulatory surgery certification.
Fantastic. Thank you so much, Tina. So we
offer to do, I think there's so much
going on at any one time in the
health care space, in the ASC space in
particular.
Can you take a moment to tell us
what are 2 or 3 trends that you're
paying close attention to in this space and
why?
Sure.
Well, as we know, the CMS 2025 final
payment rule is out, and we are internally
analyzing the impact to our organization based on
our top volume procedures.
The overall less than 3% increase
is not enough as we know to offset
increased wages and benefit costs,
unfortunately,
and to support the anticipated continued shift of
cases from the inpatient to the ASC setting.
So we will see what that looks like,
particular to our
center and, the industry as a whole.
Additionally,
and of significant importance is the change in
administration that will be taking office in January.
I know there's been some recent news out
with some
positions being appointed in the federal agencies.
Don't know exactly if everything is gonna
line up the way that
we've heard about in the last 24 hours
but
we will be following closely the changes in
leadership
of the federal agencies,
particularly
CMS and the Department of Health and Human
Services and, you know, what kind of impact
this is gonna have on our ASC industry.
Also,
at the recent Becker's meeting, there were several
discussions on using AI in our setting which
I find very interesting
Yeah.
Yeah. Yeah. Absolutely.
I think no doubt, obviously the CMS outpatient
final rule, like you said, not enough to
offset the wages of benefit costs and we've
seen the spiraling labor costs across the last
couple of years. No doubt the changes in
the federal administration
are big one as well.
I guess quick follow-up on that. I guess,
specifically as it relates to you, your ASC,
what are you most concerned about? And what
kind of impact are you preparing for
potentially in in the coming years?
Sure.
Great question. And I feel like there is
still a lot to be unknown out there,
as to what specifically to expect.
You know, really it comes down to what
changes will we see coming from CMS
regarding
procedures that can be performed in the ASC.
Also regarding quality measures,
I know we've worked hard as an ASC
industry and ASCA certainly
has been working very hard
representing
ASCs across the country on some of the
quality reporting measures that we feel are
administrative burdensome to us.
So, we'll be watching closely to see if
some of those quality reporting measures will be
reduced
and also if there's the possibility of further
shifting of some procedures that we've been wanting
to move into the ASC space that CMS
has been hesitant to do so.
Mhmm. Is is there a particular
procedure or specialty that you
really advocating for that would benefit your surgery
center the most to be shifted over to
the outpatient side?
Well, we are a very large multi specialty
surgery center. We perform 11 different surgical specialties
here.
So we,
you know, I know cardiac is a big
one in,
ASCs that,
is is working well for some centers to
consider adding that service line. That isn't one
that we're looking to add here in our,
in our region,
but,
who knows? It could be something, you know,
in years down the road. But
I think that right now, we're pretty well
rounded with all of the offerings that we
can provide.
We're very invested
in,
you know, different technology
for
different service lines that maybe we'll be talking
about, in a little bit little bit later.
But I think, really, we just want to
see how is it benefiting
the ASC industry as a whole. And,
some of the,
you know, some of the spine codes that,
we'd like to see that might be an
area for us to be looking at in
the future. But I think, you know, whatever
benefits,
you know, surgery centers as a whole is
just good for our industry overall, whether it's
a service line that you intend to provide
in your facility or not. It's still
good for patients,
good for health care
and, hoping to see some shifts, continued shifts
that way.
Yeah. Yeah. Definitely aligns with what we've heard
at the recent COBRA meeting. A lot of,
surgery centers like yourselves really looking forward to
more of these high acuity
spine codes like you mentioned, higher acuity cardiac
care as well, moving more towards the outpatient
setting as well.
We're coming towards the end of 2024
here. When you look ahead to next year,
what are you most excited about?
Sure. Well, patient centered care has always been
a focus of our organization
as well as the entire ASC industry.
And for us in 2025, I'm excited about
some patient engagement tools that we will be
implementing to support and enhance our current practices.
We're also working through some,
updates and modifications on our website to make
it more patient forward and not only promote
the benefits of an ASC,
but also address some of the key questions
our patients have regarding receiving care at our
facility and making our website,
a better resource for them to get the
information that they need.
Got it. So really honing in, developing your
website, some improvements there, and then honing in
on some patient engagement
tools.
Curious, is there anything specific that you're looking
to implement,
in the patient engagement area?
Sure. We want to be more interactive with
the patient prior to the date of service.
So,
both in their, you know, expected payment
in advance as well as any other communications
that
are important regarding some preoperative instructions.
We're also looking at internally,
how to provide more real time communication
to the patients and
patients' families,
and
how we can,
provide, you know, more real time data as
far as, you know, where the patient is
at, how they're moving through
their perioperative
experience here,
and any updates that are needed
to improve that communication between
what's happening,
in the back with,
keeping the families updated in a more timely
manner.
Gotcha. So really doubling down on
patient experience, honing in on that concierge care
that no doubt your ASC provides.
I'm curious to hear, when you look ahead
the next 12 months or so,
how are you thinking about growth that your
surgeries are? Is it adding new procedures, new
specialties, more physicians, locations?
What's the next step look like for you?
Sure. We are continuously exploring avenues for increased
growth, whether it be, you know, new procedures
as well as adding
We aren't looking to expand,
by locations
at this time. We're large. We have 8
ORs and 4 procedure rooms
and 5 overnight stay rooms that we use
on a regular basis.
So
paying attention to the continued growth of procedures
moving from the inpatient to the outpatient setting,
we've seen continued growth in our surgical robotic
program since we launched it 4 years ago,
particularly in GYN procedures. So these are higher
acuity cases
and demonstrates that ASCs with
well trained staff and investments in technology can
provide safe high quality care for these patients.
We also added an orthopedic robot earlier this
year for total knee replacement.
So the investment in both of those technologies
has fueled the migration of cases from the
inpatient setting to the ASC
and brought along additional providers that normally weren't
performing procedures in our facility. So we're gonna
continue to focus on,
adding providers, adding additional,
service lines as we can, particularly
some expansion possibly in our pain management offerings
and, continue to recruit and retain providers.
Okay. Sounds fascinating to hear. The expansion, excuse
me, right, to the launch of your surgical
robotic program specifically for GYN, but also added
that orthopedic robot last year or this year,
excuse me, for total knee replacement.
I'm curious,
is it kind of we hear we hear
a lot about how patients are now seeking
out these new technologies, seeking
out ASCs, hospitals that have these robots that
perform these procedures. But it's I'm curious, is
it also almost a recruitment tool for some
of these, the next generation of surgeons who
are training in residency and fellowship programs? Or
is it also a recruitment tool for some
of these guys to come into your your
AIC as well?
Absolutely. And you you hit the nail on
the head there, Alan.
You know, younger physicians that are coming out
of their programs, this is a standard of
care for them. They've been using robotic technology
in general surgery
and g y n surgery for some time
and
they like to have that
access to that technology and that equipment,
you know, as they move on to their
private practice.
So we've been happy to be able to
have that. It has definitely been a recruitment
tool here,
as well as, you know, with the orthopedic
side as well. And,
it's, you know, it just shows that you
are,
you know, investing in what really is the
standard of practice
that physicians coming out of their programs are
expecting to have.
Yeah. Fascinating to hear to see where we'll
be in the next couple of years as
more of these technologies advance and the the
next generation come out of these programs.
Tina, it's fascinating to get your perspective, to
touch base a little bit more with you,
and look forward to connecting with you again
down the line.
Very good. Thank you so much for your
time, Alan.