Hello and welcome to the Becker's Healthcare Podcast.
My name is Chanel Banger. I'm recording live
at the twenty second annual Spine Orthopedic and
Pain Management Driven ASC
plus the Future of Spine Conference. And I'm
sitting down with John Russell,
executive operations at Sutter Health.
Thank you so much for joining me today.
Thanks for having me. Perfect. Well, to get
us started out, can you please introduce yourself
and tell us a bit about your background
and organization?
Sure. I'm Doctor. John Russell. I work for
Sutter Health out in the great state of
California,
and I've been there for about eighteen years.
I oversee seven surgery centers in our surgery
center division of about 36 total between,
surgical hospitals and ASCs.
So, happy to be here and happy to
talk about things that we're looking forward to
over the next couple of years and current
practice and future practices.
Well, perfect. Let's just jump right in. Can
you, talk about maybe the top three trends
that you're watching in healthcare in your role
today? So one of the things that we're
looking at is patients want to come to
our centers, right, no matter what part of
the nation you're in.
Hospitals are incredibly
expensive for patients. So the ASCs are in
a situation to partner with hospitals if you're
affiliated with a big organization like we are.
We have hospitals,
HOPDs and ambulatory surgery centers, so you really
wanna see patients
getting care at the right facility.
Now that means that if you take from
the hospitals, then you need to back fill.
Right? Because the hospitals are are incredibly
busy, but also a intricate part of our
organization. So
partnering with the CEOs or their executives to
make sure that patients are being seen in
the right facility
is a lot of work. There's a lot
of things that go behind that, you know,
contracts,
payer mixes, all these things are factors.
One of the things that we're noticing is
patients want to come in, have their procedures,
and go home.
So we're in a situation where we can
provide that service. However, ASC struggles sometimes because
we typically don't work twenty four seven like
the hospitals do. Right? So we're trying to
look at how we can best utilize our
our space.
One of the things that we are looking
at, based on some data that we have
been recently given by our president and CEO
is that we had several thousand patients that
couldn't get seen last year because we are
just that impacted.
So having more physicians come on board, making
sure we utilize our space,
looking at
block utilization,
block time, and making sure that white space
is not,
unused because that's an opportunity missed to take
care of a patient.
So what we're doing is we are revamping
our policies to reflect,
real
block time schedules and partnering with those physicians
in their offices to make sure that they
have a month or sometimes up to three
months of time to schedule and and then
release block time if it's not being used.
And
with pain and ortho and and all these
other service lines that come to the ASCs,
we are in a situation right now where
we have to do something. We can't sit
back and wait because we're already behind the
eight ball. Right? If we've got thousands of
patients that can't be seen, we need to
figure this out. So utilization
and access are two very strong key factors
that we're looking at, now and over the
next few months, just to make sure that
we are
going in the right direction. Because, again, we've
extended hours, we open up on Saturdays, whatever
the whatever it takes to take care of
the patients, what we're willing to do. Absolutely.
And kind of going off script here, what
does reimbursement look like? Are you fee for
service or how does that work? Yeah. So
fee for service. So, you know, we get
paid,
not as much as the hospitals because our
our pay structure is completely different, where we
usually have a bundled
package.
The hospitals can charge you for every single
item, you know, that piece of paper, that
one Tylenol, things like that.
So we do go by ChargeMasters,
and that's updated annually. We have a a
great finance team that looks at that and,
thank god because, you know, we need them
to do that, not me.
I'm there to execute.
But having
said that,
you know, we
not for profit, we still need to make
money. Right? Because what we do when we
make money is we reinvest it back into
the community.
So while we may be not for profit,
we we can't just sit back and not
have some revenue coming in. You know, we
need equipment. We need supplies. We need to
make sure the lights are on, all these
things. So we gotta pay employees. Yeah. We
gotta pay our employees.
But one of the good things is that
we also teach our employees on how to,
take care of the patients at a lower
cost and not compromise care. Right? So you're
still going to get the same level of
care that you expect as a patient.
And and I don't wanna say better than
the hospitals because the hospitals are really great
at delivering care. But sometimes you go into
the hospital, and we all know this. This
is not unique. You end up getting sicker
sometimes in the hospital with nosocomial
infections or whatever.
We are really striving hard to make sure
that and we track and trend,
infection control quality, things like that.
But we work really, really hard to make
sure the the patient experience is something that
they'll never forget. And we hope it's always
gonna be good. Right? But we have room
for improvement too.
But it's important to make sure that your
ChargeMaster is up to date and that your
contracts are up to date so you can
be paid,
a fair FMV
when you're using supplies or you're using,
implants, whatever. You know? So it's it takes
a village to make this happen. So the
finance team works with the administrators. They work
with us.
All these things play, a key role in
making sure that the patient gets that outcome
at a reasonable
price.
Got it. Got it. And now that we're
in the 2025,
can you talk about what you're most excited
about right now?
Growth.
Our president and CEO is,
high high execute. I thought I was high
execute. He's got me beat.
We have a lot of patients that want
to come to our organization, and we have
no room for them. So we are in
full throttle
to make sure that we either acquire or
or build facilities based on geography and based
on needs
to make sure that these patients can be
seen. Even me as a patient, it takes
me two months to see my primary care
doctor. So if I feel like I need
to see him, I should get on the
books today because it's gonna take two months.
So one of the things that we're looking
at is, again, utilization and access and making
sure that we are doing what we can.
And so one of the things that I
challenged some of my centers is when we
have,
total joints,
they like to flip rooms because they can
go faster.
But when you're flipping rooms, you're also having
space that's not being utilized. Right? So that
block time, that two hours or three hours
in the day total
accumulation of time is wasted time. So we're
looking at how can we
be as effective and efficient staying in one
room and doing six or seven total joints
in one room versus two rooms
so we can open up another room and
have all that space for other patients that
need to be seen at the center.
Absolutely. And you've already touched on this a
little bit, but how are you thinking about
growth in the next twelve months?
One of the things that we're looking at
is,
potentially expanding into more Saturdays.
So not everybody wants to do a Saturday,
physicians included. They have families. Right?
But we are looking at ways that we
can optimize our space. So,
you know, we don't know what we don't
know. In ten years, we could be sitting
here having this conversation and ASCs may be
twenty four seven operations. Who knows? You know,
it seems crazy to think about that, but
let's be realistic.
So one of the things that we're really
looking at is how we best can come
together and partner with our physicians and staff,
and maybe staff just wanna work Saturdays and
and have that work life balance where they
can have a couple of days off during
the week with their kids or whatever the
case may be.
So expanding our hours throughout the week, but
also
more Saturdays. Right now, we typically do one
or two Saturdays a quarter, and it's usually
for GI, but we're trying to expand that
into pain and also surgical cases. Because if
we're gonna be there, we might as well
do everything, right, that we can.
All of our patients, I shouldn't say all,
but most of our patients go home the
same day. So when we have a twenty
three hour stay, it's a planned procedure. So
we know that they're gonna stay overnight.
That's the beauty of the ASC world is
that, you know, we have certain criteria that
has to be met,
and and we do a really good job
with our medical directors,
their input, and also the nursing staff and
and our policies that we keep updated.
So
allowing patients who are super busy,
whether that's with personal life or professional life,
have an opportunity to maybe have surgery at
05:00 in the afternoon,
recover the next day, and be back at
work, say, on Monday,
or have their procedure on Saturday so they
don't miss work on Friday or Monday
is something that we really must think about.
Absolutely.
Well, John, I've enjoyed our time together. But
before I let you go, is there anything
else that listeners should know?
You know, I think it's imperative that we
as patients be very active in our care.
I love when patients ask me questions.
I you know, by trade, I was a
nurse for a long time, and
sometimes, you know, you think, well, why are
they asking me this? I'm telling them what
I know. You're right. You're telling them what
you know, but they don't know. So I
just really empower patients to ask questions. And
when they apologize for asking questions, I'm like,
don't apologize.
This is your life, your body. You have
every right to know. An advocate.
Absolutely. You know, we're we're advocates for the
patients, but no one can be a better
advocate for you than yourself.
Absolutely. Well, John, I wanna thank you once
again for your time today and for sharing
your insights on the Becker's Healthcare podcast. Thank
you so much.