1 00:00:01,919 --> 00:00:04,559 Hello. This is Francesca Matthews with the Deckers 2 00:00:04,559 --> 00:00:05,859 ASC Review podcast. 3 00:00:06,240 --> 00:00:08,320 I'm thrilled to be joined today by Kathy 4 00:00:08,320 --> 00:00:08,820 Meccia, 5 00:00:09,199 --> 00:00:09,699 RNBC, 6 00:00:10,480 --> 00:00:10,980 BSN, 7 00:00:11,439 --> 00:00:11,939 CNOR, 8 00:00:12,639 --> 00:00:13,139 CRC, 9 00:00:13,914 --> 00:00:14,414 ST, 10 00:00:14,794 --> 00:00:17,994 nurse administrator at Lake George Surgery Center. Kathy, 11 00:00:17,994 --> 00:00:19,695 thank you so much for being here today. 12 00:00:19,994 --> 00:00:21,695 And thank you for asking me. 13 00:00:22,635 --> 00:00:24,714 Alright. To start off, could you just please 14 00:00:24,714 --> 00:00:26,554 introduce yourself and tell us a little bit 15 00:00:26,554 --> 00:00:27,454 about your background? 16 00:00:28,059 --> 00:00:28,559 Certainly. 17 00:00:29,019 --> 00:00:30,960 My name is Kathy Meccia, as you'd said. 18 00:00:31,579 --> 00:00:33,280 I've been a nurse for 19 00:00:34,059 --> 00:00:35,039 forty two years, 20 00:00:35,420 --> 00:00:35,920 and 21 00:00:36,780 --> 00:00:39,579 I've worked in nursing administration for over thirty 22 00:00:39,579 --> 00:00:41,659 years, and all of that has been in 23 00:00:41,659 --> 00:00:43,679 the perioperative surgical arena. 24 00:00:44,325 --> 00:00:46,825 I was a director at a hospital 25 00:00:47,204 --> 00:00:48,185 for thirty, 26 00:00:49,604 --> 00:00:51,284 let's see. I worked there for thirty two 27 00:00:51,284 --> 00:00:53,204 years, but a lot of that was also 28 00:00:53,204 --> 00:00:57,385 in other administration, pediatric, med surg, CCU, ER. 29 00:00:57,870 --> 00:00:59,870 So the surgical arena I've been in for 30 00:00:59,870 --> 00:01:00,850 over thirty years. 31 00:01:01,229 --> 00:01:04,530 I opened a surgery center five years ago 32 00:01:04,670 --> 00:01:07,329 and have worked in the ASC arena since, 33 00:01:08,189 --> 00:01:10,450 which has been an interesting and challenging 34 00:01:11,150 --> 00:01:11,650 transition. 35 00:01:12,724 --> 00:01:14,325 Yeah. I'm excited to hear more about what 36 00:01:14,325 --> 00:01:15,864 that transition has been like. 37 00:01:16,484 --> 00:01:18,405 What are the top three trends you're following 38 00:01:18,405 --> 00:01:20,185 in health care and ASCs today? 39 00:01:21,524 --> 00:01:24,185 The biggest trend right now for an ASC 40 00:01:24,405 --> 00:01:25,784 is increasing competition. 41 00:01:26,244 --> 00:01:28,879 It has caught on that it is the 42 00:01:29,019 --> 00:01:29,519 future 43 00:01:30,060 --> 00:01:32,079 of surgical health care. 44 00:01:32,459 --> 00:01:34,799 And so most of the ASCs 45 00:01:35,259 --> 00:01:36,479 are consolidating, 46 00:01:37,019 --> 00:01:37,519 partnering, 47 00:01:38,219 --> 00:01:40,399 joining with other facilities, 48 00:01:41,385 --> 00:01:43,244 to market themselves to grow. 49 00:01:43,625 --> 00:01:44,604 And that's been 50 00:01:44,905 --> 00:01:47,644 even the experience for us. We have recently 51 00:01:47,704 --> 00:01:49,004 partnered with a bigger 52 00:01:49,465 --> 00:01:51,244 hospital and health care facility 53 00:01:51,545 --> 00:01:54,185 to be able to grow in ourselves and 54 00:01:54,185 --> 00:01:55,884 in the market of ASCs. 55 00:01:57,359 --> 00:01:59,519 The second trend that I'm seeing a lot 56 00:01:59,519 --> 00:02:00,019 in 57 00:02:01,039 --> 00:02:02,500 is more in the arena 58 00:02:02,959 --> 00:02:05,539 of stack netting reimbursements, if you will. 59 00:02:06,399 --> 00:02:08,739 The collections are poor, 60 00:02:09,805 --> 00:02:12,525 for ASCs. And I imagine even for hospitals, 61 00:02:12,525 --> 00:02:14,944 although they can they can assume a better, 62 00:02:15,564 --> 00:02:18,125 debt than an ASC can. So that's been 63 00:02:18,125 --> 00:02:19,585 quite a trend lately. 64 00:02:20,365 --> 00:02:21,245 Seems like, 65 00:02:21,564 --> 00:02:23,789 the reimbursements tend to go down, not up. 66 00:02:24,269 --> 00:02:27,069 So covering cost only most of the time 67 00:02:27,069 --> 00:02:28,930 when you're getting collections in. 68 00:02:30,269 --> 00:02:33,629 Analyzing case profitability has been really important for 69 00:02:33,629 --> 00:02:34,930 us and knowing 70 00:02:35,310 --> 00:02:37,469 the balance that you need to have of 71 00:02:37,469 --> 00:02:38,930 the surgical complexity 72 00:02:39,585 --> 00:02:40,485 to be able to offset 73 00:02:41,504 --> 00:02:42,245 the cost, 74 00:02:43,504 --> 00:02:44,405 of doing business. 75 00:02:45,105 --> 00:02:46,705 You have to work with a good billing 76 00:02:46,705 --> 00:02:49,444 company as well when we're talking about reimbursement, 77 00:02:50,545 --> 00:02:53,125 getting getting some good insurance contracts 78 00:02:53,770 --> 00:02:56,430 that, you know, you're getting better collections back. 79 00:02:56,729 --> 00:02:57,870 And then, also, 80 00:02:58,889 --> 00:03:00,810 relative to that is making sure that your 81 00:03:00,810 --> 00:03:03,530 staff, your your front end staff are getting 82 00:03:03,530 --> 00:03:04,349 good preauthorizations 83 00:03:05,689 --> 00:03:07,069 prior to patients coming. 84 00:03:07,405 --> 00:03:09,084 And, of course, in the no surprise act, 85 00:03:09,084 --> 00:03:12,044 letting patients know upfront what is expected of 86 00:03:12,044 --> 00:03:12,544 them 87 00:03:12,844 --> 00:03:14,705 to be paying and what the cost is. 88 00:03:15,245 --> 00:03:17,025 That seems to help a lot in satisfaction, 89 00:03:17,084 --> 00:03:19,564 but also helps a lot with, keeping up 90 00:03:19,564 --> 00:03:21,185 with the reimbursements and collections. 91 00:03:21,959 --> 00:03:23,439 And then the third trend that I see 92 00:03:23,439 --> 00:03:25,959 a lot of is more the rising cost 93 00:03:25,959 --> 00:03:28,120 that goes along with that of everything. Supply 94 00:03:28,120 --> 00:03:31,159 cost, medication costs have went up, and, 95 00:03:32,120 --> 00:03:34,620 I don't wanna be labor it, but anesthesia. 96 00:03:35,159 --> 00:03:38,365 Anesthesia costs are so high right now that 97 00:03:38,365 --> 00:03:40,305 it's very difficult to offset, 98 00:03:42,205 --> 00:03:44,145 what you're getting in collections 99 00:03:44,444 --> 00:03:45,905 and isn't going to 100 00:03:46,205 --> 00:03:47,745 pay the anesthesia providers 101 00:03:48,205 --> 00:03:50,865 because that that that just makes us work 102 00:03:51,650 --> 00:03:52,790 harder on 103 00:03:53,169 --> 00:03:53,669 consolidating 104 00:03:54,210 --> 00:03:56,469 our block times and utilization, 105 00:03:57,330 --> 00:03:59,349 which in the end can be a positive. 106 00:03:59,409 --> 00:04:01,669 Right? If you're using more of your utilization 107 00:04:01,889 --> 00:04:02,790 of your blocks, 108 00:04:03,330 --> 00:04:04,550 then you're also 109 00:04:05,169 --> 00:04:05,909 more efficiently 110 00:04:07,074 --> 00:04:08,215 staffing and, 111 00:04:09,155 --> 00:04:10,534 operating your ASC. 112 00:04:11,955 --> 00:04:15,235 Absolutely. Yeah. The anesthesia component is something we 113 00:04:15,235 --> 00:04:17,095 talk about a lot on this podcast. 114 00:04:18,194 --> 00:04:20,035 So we are not not belaboring. It's it's 115 00:04:20,035 --> 00:04:21,875 just the truth and the reality right now, 116 00:04:21,875 --> 00:04:22,535 it seems. 117 00:04:24,000 --> 00:04:25,759 But onto, you know, kind of more exciting 118 00:04:25,759 --> 00:04:27,759 good news things. What are you most excited 119 00:04:27,759 --> 00:04:30,339 about in the ASC world right now? 120 00:04:31,600 --> 00:04:33,680 That's a that's a better topic. Yes. We're, 121 00:04:34,720 --> 00:04:38,000 getting more excited about transitioning. I've noticed now 122 00:04:38,000 --> 00:04:38,475 that, 123 00:04:38,875 --> 00:04:41,455 we're getting referrals from actual insurance companies 124 00:04:41,915 --> 00:04:43,535 where they're telling the patients 125 00:04:43,915 --> 00:04:45,514 that they'll approve them to go to an 126 00:04:45,514 --> 00:04:47,134 ASC, but not to a hospital. 127 00:04:47,514 --> 00:04:49,514 So that's exciting for us to see the 128 00:04:49,514 --> 00:04:52,154 insurance companies are really picking up on the 129 00:04:52,154 --> 00:04:52,975 lower cost 130 00:04:53,379 --> 00:04:54,360 that an ASC 131 00:04:54,740 --> 00:04:55,639 is gonna bill, 132 00:04:56,180 --> 00:04:58,339 versus what a hospital will bill for the 133 00:04:58,339 --> 00:04:58,839 procedures. 134 00:04:59,379 --> 00:05:01,939 So that's exciting. It will be exciting to 135 00:05:01,939 --> 00:05:04,500 see if CMS can, give us a little 136 00:05:04,500 --> 00:05:05,235 bit more, 137 00:05:06,435 --> 00:05:08,594 from that inpatient only list so that we 138 00:05:08,594 --> 00:05:10,454 can do a little more in the ASC 139 00:05:10,594 --> 00:05:12,615 off of that for the Medicare patients. 140 00:05:14,274 --> 00:05:15,894 And then also when you, 141 00:05:16,274 --> 00:05:18,514 see that the ASC market is becoming more 142 00:05:18,514 --> 00:05:19,014 attractive 143 00:05:19,520 --> 00:05:20,259 to physicians. 144 00:05:20,639 --> 00:05:22,720 Right? So we're seeing more surgeons that are 145 00:05:22,720 --> 00:05:24,100 attracted to the ASCs 146 00:05:24,800 --> 00:05:26,480 for many reasons, but, 147 00:05:26,960 --> 00:05:29,300 biggest reason being safety and efficiency. 148 00:05:30,160 --> 00:05:32,000 They're seeing it as well, so it's becoming 149 00:05:32,000 --> 00:05:35,055 more attractive to them to move over to, 150 00:05:35,595 --> 00:05:37,995 doing more cases at an ASC versus a 151 00:05:37,995 --> 00:05:38,495 hospital. 152 00:05:40,954 --> 00:05:43,194 Absolutely. Yeah. No. That trend you mentioned of, 153 00:05:43,194 --> 00:05:44,095 you know, seeing 154 00:05:44,475 --> 00:05:45,535 insurance companies, 155 00:05:46,074 --> 00:05:48,314 you know, kind of push increasingly towards ASCs. 156 00:05:48,314 --> 00:05:50,370 It's something we've definitely picked up on here 157 00:05:50,370 --> 00:05:53,090 at Becker's as well and something definitely just 158 00:05:53,090 --> 00:05:54,389 very interesting to hear. 159 00:05:54,850 --> 00:05:55,350 Mhmm. 160 00:05:56,529 --> 00:05:58,529 And how are you thinking about growth over 161 00:05:58,529 --> 00:05:59,670 the next twelve months? 162 00:06:01,090 --> 00:06:03,544 Growth for an ASC is it's it that 163 00:06:03,544 --> 00:06:05,944 actually is quite exciting as well. So looking 164 00:06:05,944 --> 00:06:06,685 at growth 165 00:06:07,144 --> 00:06:08,685 as adding multidisciplinary, 166 00:06:09,704 --> 00:06:11,805 adding more surgeons, adding more specialties. 167 00:06:12,425 --> 00:06:14,524 So my center is a multidisciplinary 168 00:06:15,384 --> 00:06:16,920 center, which is good. 169 00:06:17,240 --> 00:06:19,960 It costs more for a start up and 170 00:06:19,960 --> 00:06:22,600 to run just because of the capital outlay 171 00:06:22,600 --> 00:06:24,220 and the, varying 172 00:06:24,600 --> 00:06:26,360 supply costs that you have to have for 173 00:06:26,360 --> 00:06:27,100 the multispecialties. 174 00:06:28,040 --> 00:06:31,500 However, it is nice to have an ASC 175 00:06:31,639 --> 00:06:32,620 that does. 176 00:06:33,175 --> 00:06:35,654 We do ophthalmology, we do podiatry, we do 177 00:06:35,654 --> 00:06:36,154 orthopedics, 178 00:06:36,535 --> 00:06:39,415 we do pain, and we do general surgery 179 00:06:39,415 --> 00:06:41,595 including endoscopy right now. 180 00:06:41,975 --> 00:06:42,454 So, 181 00:06:43,254 --> 00:06:45,914 growth and adding more specialty, more procedures 182 00:06:46,375 --> 00:06:48,879 is very exciting for us. The other thing 183 00:06:48,879 --> 00:06:50,399 that we're looking at for growth is a 184 00:06:50,399 --> 00:06:53,060 possibility of opening up on a weekend day. 185 00:06:53,199 --> 00:06:55,759 So maybe a Saturday for half day, full 186 00:06:55,759 --> 00:06:58,240 day, but that's something that I think would 187 00:06:58,240 --> 00:06:58,899 be beneficial 188 00:06:59,680 --> 00:07:00,579 for the communities 189 00:07:01,039 --> 00:07:03,625 to have that because everybody works not everybody. 190 00:07:03,625 --> 00:07:05,324 A lot of people work Monday through Friday, 191 00:07:05,384 --> 00:07:07,865 and having that availability as an option, I 192 00:07:07,865 --> 00:07:09,404 think, will help us grow as 193 00:07:10,584 --> 00:07:12,745 well. Absolutely. Yeah. And I think something that's 194 00:07:12,745 --> 00:07:15,305 always interesting about ASCs is just being nimble 195 00:07:15,305 --> 00:07:17,550 and able to make those accommodations and adjustments 196 00:07:17,870 --> 00:07:20,529 more quickly than, you know, some larger organizations 197 00:07:20,829 --> 00:07:23,409 and, accommodate community needs in that way. 198 00:07:24,029 --> 00:07:24,529 Absolutely. 199 00:07:25,709 --> 00:07:28,189 And is there anything else relevant to this 200 00:07:28,189 --> 00:07:30,689 conversation that you think is important to share? 201 00:07:31,444 --> 00:07:33,764 Just that I mean, ASCs are becoming more 202 00:07:33,764 --> 00:07:35,704 exciting because they're becoming more 203 00:07:36,165 --> 00:07:39,685 the trend for minor surgeries and a lot 204 00:07:39,685 --> 00:07:40,985 of even major surgeries. 205 00:07:41,365 --> 00:07:43,845 And I have found that from transitioning from 206 00:07:43,845 --> 00:07:46,504 a hospital setting to the ASC setting, 207 00:07:46,949 --> 00:07:48,329 the customer satisfaction 208 00:07:49,110 --> 00:07:51,509 is off the charts. So it's nice to 209 00:07:51,509 --> 00:07:53,769 have that from both physicians, 210 00:07:54,149 --> 00:07:56,709 patients, but not just patients and visitors that 211 00:07:56,709 --> 00:07:59,189 come with them. So it's safe to come 212 00:07:59,189 --> 00:08:00,870 to an ASC. We don't take care of 213 00:08:00,870 --> 00:08:02,345 sick patients, and, 214 00:08:03,045 --> 00:08:05,305 it's nice to see that, you know, that 215 00:08:05,605 --> 00:08:09,525 overall patient satisfaction and physician satisfaction. It makes 216 00:08:09,525 --> 00:08:10,504 work fun again. 217 00:08:11,764 --> 00:08:13,845 Absolutely. I like I like ending on that 218 00:08:13,845 --> 00:08:15,605 note because that is all for you all 219 00:08:15,605 --> 00:08:17,145 I have for you today, Kathy. 220 00:08:17,479 --> 00:08:19,560 But thank you so much for joining us 221 00:08:19,560 --> 00:08:20,060 today. 222 00:08:20,439 --> 00:08:22,680 It's been a pleasure speaking with you, and 223 00:08:22,680 --> 00:08:24,360 I look forward to connecting with you again 224 00:08:24,360 --> 00:08:26,459 in the future. Thanks so much, Franchesca.