This is Alan Conlon with the Becker's ASC
podcast,
and I'm thrilled to be joined today by
Melissa Rice, administrator of Loyola Ambulatory Surgery Center
in Illinois.
The surgery center is part of Trinity Health
as well, I believe.
Melissa, pleasure to have you back on what
I believe is your second podcast with us.
I know you'll be here at our event
next month as well. Really looking forward to
having you speaking on a panel.
Before we dive into our discussion today, I
love to turn the floor over to you
just to hear a little bit more about
your role and your background at Loyola Ambulatory
Surgery Center.
Yes. Thank you so much, Ellen. I am
very excited, that I'm on the Becker's AC
podcast again. As you mentioned, Melissa Rice. I
am currently the administrator of a multi specialty
ambulatory surgery center that is with Loyola Health
Medicine, and you are correct. We are part
of the Trinity Health System. Very exciting.
I've spent the last fifteen plus years in
the ambulatory surgery space,
leading centers, navigating compliance,
managing finances,
and most importantly, like, finding ways to make
care more efficient and more patient focused.
I'm passionate about blending clinical excellence with operational
strategy to drive growth, improve outcomes, and support
the teams that make it happen.
Over the years, I've overseen process improvements that
cut costs without sacrificing quality, help implement digital
systems to streamline workflows,
and led successful accreditation surveys.
I also serve on the board of the
ambulatory
surgery center association for Illinois where I advocate
for policy innovation, collaborative,
collaboration in the outpatient care. I'm excited to
be here today and share some of what
I've learned,
talk about the future of ACs, and maybe
shed some light on how we can continue
to evolve,
health care delivery in meaningful and sustainable ways.
Yeah. Fantastic. No. Thank you so much for
the the brief kinda insight there as well.
So fifteen plus years, I believe you said,
in the ASC space.
Quite a lot's happened,
over the years, I imagine,
potentially,
arguably more challenging now than maybe before. But
I'd love to kind of get your perspective.
But talking to ASC leaders over the last
few months,
a lot going on when we think about
kind of trends in Capitol Hill, potential reimbursement
issues. What are the top two or three
trends that you're paying closest attention to today,
Melissa, in health care and the ASC space?
Love to get your perspective.
That's a great question because like you said,
it's so hard to narrow down, like, what
just down to three because there's
it's it been evolving since day one.
But here are the top three trends that
I'm excited that I'm keeping a close eye
on right now, you know, especially since I
am on the ISCA board.
The continued shift of higher acuity cases to
the ASC setting, that's a really big one,
that I've been watching because we're seeing more
and more complex procedures like total joints,
spine cases, and advanced pain management safely and
successfully
being done in outpatient settings. It's being driven
by pain pressure,
patient preference, and the advances, like, in with
our fellow colleagues in the anesthesia group and,
you know, and technology.
Freyja sees this shift presents
both like a big opportunity, but also a
challenge. So we have to make sure that
we're scaling it the right way with the
proper infrastructure,
staffing, and protocols in place to maintain safety
and quality outcomes. You don't just kinda wanna
throw all the patients, you know, in the
same silo.
Another one that I've been really thinking about,
especially coming from such a wonderful large health
care that we really work on maintaining
staffing and burnout is, like, workforce resilience and
staffing innovation.
Like many in the industry, we're still feeling
the ripple effects of workforce shortages,
but it's also leading to innovation, whether it's
cross training staff, investing in leadership development, or
leveraging tech to reduce administrative burdens.
At the end of the day, our people
are our most valuable asset, so finding new
ways to support them is a top priority,
not only for myself, but also for our
entire ministry.
And I would say a third one that's
pretty exciting for me is, like, data driven
decision making and operational transparency.
I had the opportunity,
to speak at ASCA at their national conference
last month, and data driven was one of
the, topics that I spoke on, so it's
very near and dear to my heart. But
we've moved past tracking just basic metrics.
We're now looking at integrated dashboards,
real time benchmarking,
and predictive analytics
to guide decisions.
So whether it's improving case costing, understanding the
patient flow, or negotiating managed care contracts,
access to actual data is no longer a
nice to have. It's absolutely essential for staying
competitive and efficient.
Each of these trends ties back to delivering
high quality patient centered care, but doing it
smarter, more efficiently, and in a way that
positions ASC for long term success.
Got it. Also, data driven, like you said,
not no longer a nice to have it.
It's essential to really have a data driven
analytics. It's a must have. The workforce resiliency
aspect that you touched on as well. I'd
love to just ask one quick follow-up on
the first trend that you mentioned in terms
of, obviously, a a trend that's been going
on for quite some time in terms of
the higher acuity cases,
moving into the ASD and outpatient settings.
You know, it's not that long ago, maybe
four or five years, a little bit longer
that complex spine surgeries, total joints, like you
said, were done in hospitals with two or
three nights stays in the hospitals. Now they're
routinely being done with open ambulated in a
couple of hours.
You you mentioned that you saw it was
a big opportunity, but maybe a challenge as
well in terms of more of these complex
cases moving to the ASC setting. Do you
mind just elaborating on that a little bit
in terms of the opportunity versus challenge?
Yeah. I think the big opportunity is that
we're also,
allowing patient preference and, opening the doors and
then bringing them into a surgery center versus
bringing them into a hospital setting.
It's lower cost for the patients as we
all know in the ASC space than to
go to the hospital.
I think the challenges that people really need
to think about is making sure that these
patients are ASC appropriate.
You know, you're really vetting and going through
their history and physical and that's where
anesthesia comes into play where they're they're it's
really a partnership whether they're, you know, actual
employees,
you're partnered up with a health care system,
or it is a third party contractor.
That is where you can take the challenge
and turn it into an opportunity when you
work together to make sure that these patients
are ASC specific
and appropriate.
Got it. Yeah. And it ties into the
next question I wanted to ask you about.
I heard your voice, the uplift in your
voice when you were talking specifically about data
driven analytics and everything going on in that
space. Can I assume that that that's an
area that you're particularly excited about, or is
there anything else that you'd like to flag
when you think about the future of ASC?
Yeah. You know what? I find it quite
interesting when you start speaking to other colleagues
in the ASC industry and just start talking
about, you know, the challenges that you have,
whether it be the ever, you know, issue
that we have of, you know, costs going
up and reimbursements going down. In trying to
collaborate with your colleagues or people on your
team as well is how do we make
better decisions that we can actually start, you
know, skimming and bringing down those those charges
so that, you know,
as we're all here, you know, for the
the bottom line to be a little bit,
you know, higher than lower. And it kind
of blew my mind the first couple of
conversations that I had, whether it be at
Becker's conferences or other health care specific conferences,
that a lot of people in executive
positions really don't know their data.
Mhmm. They rely on their amazing teammates and
colleagues to be able to give them information
when they're when they're asking, but they don't
know
the actual operational transparency of of those numbers.
So, yes, data driven decision making is definitely
a huge, passion of mine because
collaborate collaborating with my, you know, my
work here or with other colleagues and being
able to show them how you could take
the numbers that you already have and it
tells a story. And it helps them have
really great conversations whether it be,
you know, managed care contracting or be, you
know, some type of construct pricing for implants.
But you have the numbers there to act
to actually help you make those decisions. So
it's
it's, it's like you said, it's not a
nice to have anymore. It is an absolute
essential in order for you to stay, you
know, ahead of the game.
Yeah. I'm wondering I'm curious. Is there maybe
a recent conversation that you kinda used? You
were equipped and armed yourself with this data
to have a great conversation with either physician,
a surgeon over a procedure, or maybe a
vendor, even a payer. Is there a specific
example that you you found
having this data driven decisions that are are
tools at your disposal really helps kinda put
you in a driver's seat, I guess, at
the negotiation table or any of these conversations?
Yeah. I wouldn't say it was a negotiating
table. I felt mine was more from a
educational standpoint, but it was, like, so meaningful
for both parties.
Like I said, I work for Loyola Health,
and it's, you know, an academic center. So
a lot of our providers have a lot
of residents or fellows that, you know, follow
them around and get amazing, you know, educational
stuff from them. So being able to walk
into a room and have the conversation with
the primary surgeon to say, hey, you know,
I don't think that this particular implant or
this particular procedure with this payer, specifically for
our center, is gonna be conducive towards our
contract and what our, you know, our potential
profitability is. And for these residents and fellows
to then ask a follow-up question, it gives
me the opportunity to be the teacher where
I'm typically not.
And it's been very beneficial because years later,
I've had the opportunity for them to reach
out and ask follow-up questions when they're in
their own, practices now.
So I feel that being able to show
them ahead of the game versus before and,
you know, after they're in practice has been
definitely beneficial.
Got it. So, like, almost like an ongoing
education. So if somebody follows coming later on
down the line from some of these residents
like you've mentioned as well. Mhmm.
Melissa, last question before before I let you
go. I'd love to hear, how are you
thinking about growth over the next twelve months
or so? Is it adding more physicians,
expanding specialties, or or something completely different?
Yeah. I mean, over the next twelve months,
we're approaching growth in a very intentional and
strategic way. You know, there's multiple to the
reason for that, like we spoke about bringing,
different
procedures into the center. So it's not just
about the volume. It's about smart growth that's
sustainable,
patient centered, and aligned with, like, our clinical
strengths as well.
First, we're exploring opportunities to expand our case
mix, you know, particularly areas like total joint
and spine. You know, there are as we
said before, a couple years ago, these cases
were not something that you'd see in the
ASC space. Medicare has recognized
that ASC appropriate patients
should be able to come here and be
able to get the best care that they
can. So we
we're we've seen strong outcomes in increasing that
demand. That means working closely with our physician
partners to ensure we have the right protocols,
equipment,
and staffing in place to take on some
of these more complex procedures.
Secondly, as a ministry, we're focusing heavily on
payer strategy. You know, we brought that up
about contracts.
As reimbursement dynamics continue to shift,
and we're all feeling that, we're being proactive
with our managed care contracts and working to
demonstrate the value of ASCs bring.
Like I said before, I am very,
happy that I'm on the ASC board for
Illinois,
and we've brought some of our
congressional,
representatives and stuff into this mix for them
to champion for ASCs and that type of
stuff. So the more we can collaborate with
payers to align incentives, the better position we
are to grow responsibly.
And I'd say a third,
that we're investing is infrastructure,
digital and physical.
So whether it's improving like our scheduling systems,
enhancing our EMR capabilities, or optimizing our supply
chain,
we're really focused on building a strong foundation
that supports growth without sacrificing efficiency or patient
experience.
It's been great to be able to partner
with a lot of our ASC
specific vendors
since I come from such a hospital based,
system.
You know, to me, growth isn't just about
doing more. It's about doing better and doing
it in a way that's scalable,
strategic, and supportive, you know, for our team
and for our patients as well.
Got it. So no no growth for the
sake of growth. Like you said, smart and
strategic growth really like nailing down the things
that make the most sense for your ASC.
Yes.
Got it. Melissa,
fifteen minutes absolutely flies by. Absolutely. Really enjoyed
having you on the podcast. Your second time
on the podcast.
Really, really looking forward to connect with you
at our event next month here in Chicago,
our spine, orthopedic, and pain management driven ASC
event. Melissa, it's been an absolute pleasure. Thank
you so much. Thank you, Ellen. I appreciate
it.