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forward slash beckers podcast.
This is Gracelyn Keller with the Becker's Healthcare
Podcast, and we are recording live at the
twenty second annual Spine Orthopedic and Pain Management
Conference.
I'm currently joined by Mahur Rai, who is
the CEO and medical director at Kansas Surgery
Center. Thank you for being here. And let's
start off by having you share a little
bit more about yourself, your role, and your
organization.
Good afternoon, everybody. Beautiful day in Chicago here.
We are at the Riverside,
at the Suze Hotel in Chicago.
So my name is Mahua Ray. I am
a anesthesiologist
and a pain physician that was initially,
out working in the VA and with academia
and then returned to private practice in about
2015.
I've been,
instrumental in,
getting set up as a surgery center just
ground up. We built a building ground up,
set up our own pain ASC
about four or five years ago. I'm currently
the medical director.
I'm involved in all aspects from staffing
to being on top of the service lines,
such
as credentialing, anesthesiology
services, inventory,
nursing, and staffing.
And I have learned a lot from Becker's,
and I hope that I can contribute through
this podcast.
Wonderful. Well, thank you for being here.
And let's start the conversation
with what trends and shifts you're seeing right
now in the industry that you think are
most important for leaders to pay attention to.
So there are certain trends that all of
us know about, including
that a lot of the procedures that were
traditionally done in the hospital setting have moved
to the ASC. For example, knee, hip, shoulder
replacements,
minimally invasive spine.
In pain management, that's a big field.
So that is really good news for ASC
owners because they sent very easy negotiate negotiation
point
for getting contracts set up because, you know,
you can save a lot of money for
it to be done in an outpatient setting.
It does come with a lot of, you
know, accreditation
and compliance that you have to follow, especially
with regards to sterilization.
You know, because of our profit margins going
down, we also have to look into the
future to see what procedures
or surgeries
are are lucrative to do in the ASC
because some of them might not feel make
any sense given the reimbursements.
So we just have to make sure that
every procedure, the health care economics has worked
out. The second thing is that the cost
transparency.
I think the patients
have to be well informed ahead of time
about the cost transparency as more and more
patients
move towards high deductible plans,
and we don't want any surprises at the
end. When patients were used to going to
the hospitals,
that was something that physicians and ASC owners
were not used to dealing with.
But I see there are a lot of
bad patient reviews
based on billing, you know, and not having
transparency.
So that is something we are focusing on
in the future.
The third thing in the shift is that
the population the baby boomers have become a
lot older. The population has gotten sicker and
older. So there's a critical role of having
MD anesthesiologists
who can review charts in order to prevent
cancellation of anesthesia cases.
So that's the third one.
Absolutely.
And let's also touch on staffing and workforce
challenges as these continue to be concerns across
health care.
So how is your organization navigating these pressures,
and what strategies have you seen work well?
So there are two main parts of ASC
staffing that is a problem all through the
country. One is the anesthesiology
or anesthesia staffing, and the second is RN
staffing.
RN staffing
was really difficult during ASC. It has gotten
better.
A whole lot of, small business has have
opened for RN staffing. So we use, like,
a few companies out there that are able
to supply us RN on last minute. You
have to make sure you have relationship with
them with the understanding that
you might be in need of an RN
at last minute notice.
For the for the anesthesiology
shortage, there's not much you can do. Most
CRNAs are now doing locum work. So what
we do is since we have pain and
anesthesia both, we have some of our anesthesiologists
help out in the Operating Room.
The other thing that we have done for
for RN shorting is we have tried to
hire more LPNs and medical assistants that can
at least help
expedite what an RN does. We have also
tried to be good with our preoperative process
so that the RN time is reduced in
the pre op. Everything is printed out for
her. She has all the med list and
everything available. So just utilizing the staff that
we have, giving them a lot of help
so we can get by with fewer staff.
And as outpatient care continues to grow, how
do you see the role of orthopedics,
spine, and ASCs evolving with the broader health
care ecosystem?
So I think the future looks bright here
because of more and more procedures that are
moving from the hospital to the ASC.
I think if I was speaking in a
hospital space, I wouldn't be happy at this
time.
It is coming with growing pains.
I don't think ASCs were ready to handle
all this orthopedic spine and pain volume.
And,
you know, places like Becker helped for us
to network and find new technologies and AI
to help. So I think the future looks
bright.
Absolutely.
And as we wrap our conversation,
I'd love to touch on how you train
your teams. So whether that's clinical or front
office,
how do you train your teams to have
conversations around healthcare costs, insurance coverage, and financial
responsibility in a way that feels clear and
supported for patients? And why do you see
this as important?
So that's a really good question and something
that has we struggled as a surgery center
in the last few years. You know, you
bill the patient and then after a few
statements, you send them to collections and the
patients are upset.
So we actually had to hire an up
patient account manager.
We also had to hire an additional billing
person in house that, first of all, understands
the the difference between co pays and deductibles
and out of pocket expenses.
We are using,
a software that has helped us. It's also
a billing software
that will help us, do a good faith
estimate.
I think that's very, very important.
It's not ideal. Sometimes the estimate is a
little bit off and patients might be surprised,
but it's within 10% of what is we
are going to ask the patient to pay.
Every once a month, all the front office
are trained,
retrained on how to collect
a head, how to collect an estimate, how
to collect a balance,
what softwares we can use to help the
patients do payment plans.
Very difficult topic, actually, because as more and
more patients are moving to high deductible plans,
a surgery center that's dependent on in network,
has to make sure that proper information is
given.
The lastly, also, what we're doing in the
training sessions is that we are recording some
of these training sessions, and we are allotting
free time to our employees
to retrain on these, things,
because it's become extremely hard to find front
office with billing backgrounds.
We are also looking into AI software, which
we have not yet purchased,
if that could help and maybe automatically calculate
the estimates. Until then, we are doing it
through the help of a software.
Yes. Wonderful. Well, thank you so much for
joining me today on the Becker's Healthcare Podcast.
Again, we are recording live at the twenty
second annual Spine Orthopedic and Pain Management Conference.
Thank you.