1 00:00:02,240 --> 00:00:02,899 At athenahealth, 2 00:00:03,279 --> 00:00:06,480 we know your ambulatory practice wants healthier, a 3 00:00:06,480 --> 00:00:09,779 healthier business, healthier care teams, and healthier patients. 4 00:00:10,160 --> 00:00:12,480 But the complexities of modern health care tech 5 00:00:12,480 --> 00:00:14,240 make it hard for you and your care 6 00:00:14,240 --> 00:00:15,855 teams to focus on what matters 7 00:00:16,414 --> 00:00:19,295 most? That's where athenahealth can help. Our AI 8 00:00:19,295 --> 00:00:22,594 native all in one solutions reduce administrative burdens, 9 00:00:22,894 --> 00:00:25,875 streamline billing and payments, and deliver critical insights 10 00:00:25,934 --> 00:00:28,734 when clinicians need it most. That means fewer 11 00:00:28,734 --> 00:00:31,614 clicks, more time for patients, and stronger bottom 12 00:00:31,614 --> 00:00:31,829 lines. 13 00:00:32,710 --> 00:00:35,989 Practicing medicine is complex, but running a practice 14 00:00:35,989 --> 00:00:37,850 can be that much simpler with athenahealth. 15 00:00:38,549 --> 00:00:42,250 See how simpler is healthier@athenahealth.com. 16 00:00:43,925 --> 00:00:46,405 Hello. This is Francesca Matthews with the Becker's 17 00:00:46,405 --> 00:00:47,625 ASC review podcast. 18 00:00:48,085 --> 00:00:49,844 I'm thrilled to be joined today by EJ 19 00:00:49,844 --> 00:00:50,344 Ledesma, 20 00:00:50,885 --> 00:00:53,625 chief executive author officer of three sixty Orthopedics. 21 00:00:53,844 --> 00:00:55,365 EJ, thank you so much for being here 22 00:00:55,365 --> 00:00:55,865 today. 23 00:00:56,245 --> 00:00:58,800 Yeah. Thank you for having me. Of course. 24 00:00:59,100 --> 00:01:00,859 To start us off, could you please introduce 25 00:01:00,859 --> 00:01:02,300 yourself and tell us a little bit about 26 00:01:02,300 --> 00:01:02,880 your background? 27 00:01:03,899 --> 00:01:05,439 Sure. My name is EJ Ledesma. 28 00:01:06,780 --> 00:01:08,859 I'm the CEO of three sixty Orthopedics, as 29 00:01:08,859 --> 00:01:10,880 you've mentioned. We are a midsize 30 00:01:11,395 --> 00:01:14,194 orthopedic practice in the Sarasota County that we 31 00:01:14,194 --> 00:01:16,215 service Manatee and Sarasota County. 32 00:01:16,594 --> 00:01:17,814 We're multi specialty. 33 00:01:18,594 --> 00:01:19,974 So we have not only 34 00:01:20,594 --> 00:01:23,474 the vast array of specialties within orthopedics, including 35 00:01:23,474 --> 00:01:26,614 joint replacement, spine, pain, foot and ankle, etcetera, 36 00:01:26,900 --> 00:01:28,680 but we also have ancillary services 37 00:01:29,140 --> 00:01:31,219 at each of our three locations. So all 38 00:01:31,219 --> 00:01:31,879 in all, 39 00:01:32,180 --> 00:01:35,219 we see roughly 80,000 patients a year, and 40 00:01:35,219 --> 00:01:37,219 we have roughly a 125 41 00:01:37,219 --> 00:01:37,719 FTEs. 42 00:01:38,500 --> 00:01:40,760 My background is a little bit diverse. I 43 00:01:41,744 --> 00:01:43,765 I have a master's degree in health administration, 44 00:01:44,384 --> 00:01:45,685 but also have additional 45 00:01:46,224 --> 00:01:46,724 education 46 00:01:47,104 --> 00:01:48,084 in in finance, 47 00:01:48,625 --> 00:01:49,125 AI, 48 00:01:50,384 --> 00:01:50,884 etcetera. 49 00:01:51,664 --> 00:01:54,144 I've worked in the not for profit health 50 00:01:54,144 --> 00:01:57,829 care world, big system health care hospital systems. 51 00:01:58,849 --> 00:02:00,069 I've done some consulting 52 00:02:00,849 --> 00:02:02,849 at, at one of the big five at 53 00:02:02,849 --> 00:02:04,369 the time. Now I think it's the big 54 00:02:04,369 --> 00:02:06,290 three. Done a little bit of life sciences 55 00:02:06,290 --> 00:02:08,310 work, some private equity. So I've done, 56 00:02:08,930 --> 00:02:10,935 had an opportunity to do a a vast 57 00:02:10,935 --> 00:02:13,034 array of different things within the health care 58 00:02:13,175 --> 00:02:13,675 arena, 59 00:02:14,455 --> 00:02:14,955 that 60 00:02:15,495 --> 00:02:17,574 I think puts me in a unique position 61 00:02:17,574 --> 00:02:19,814 to be able to run the orthopedic practice 62 00:02:19,814 --> 00:02:22,294 here, especially with everything that's going on in 63 00:02:22,294 --> 00:02:23,835 the health care landscape today. 64 00:02:24,450 --> 00:02:25,810 Absolutely. I was I was just about to 65 00:02:25,810 --> 00:02:27,170 say it's always great to talk to people 66 00:02:27,170 --> 00:02:28,610 who have kind of a a wide range 67 00:02:28,610 --> 00:02:31,010 of backgrounds and hear sort of, what lessons 68 00:02:31,010 --> 00:02:32,389 you're able to apply to 69 00:02:32,770 --> 00:02:33,750 to administration 70 00:02:34,050 --> 00:02:36,710 and, you know, practice management and whatnot. 71 00:02:37,715 --> 00:02:39,715 Kinda jumping in here, what are the top 72 00:02:39,715 --> 00:02:41,634 three trends that you're following in health care 73 00:02:41,634 --> 00:02:43,014 and ASCs today? 74 00:02:44,594 --> 00:02:46,034 Well, I think it's very interesting. I would 75 00:02:46,034 --> 00:02:48,275 say it's a little bit market specific, and 76 00:02:48,275 --> 00:02:50,034 I would I would preface that with saying, 77 00:02:50,034 --> 00:02:51,634 you know, depending on where you're at, if 78 00:02:51,634 --> 00:02:53,580 you're in a CON state or certificate of 79 00:02:53,580 --> 00:02:54,879 knee state or not, 80 00:02:55,739 --> 00:02:57,739 how big the landscape is in terms of, 81 00:02:57,739 --> 00:03:00,379 I'll call big system health care where big 82 00:03:00,379 --> 00:03:02,479 hospitals have a little bit of an entrenched, 83 00:03:02,860 --> 00:03:05,099 control over the market. But I would say, 84 00:03:05,099 --> 00:03:05,599 generally, 85 00:03:06,254 --> 00:03:08,594 we we we've talked a lot about 86 00:03:08,895 --> 00:03:11,314 what's happening in the world of artificial intelligence 87 00:03:11,375 --> 00:03:14,034 and that how can that benefit an organization, 88 00:03:14,094 --> 00:03:16,254 whether it's an ASC or whether it's a 89 00:03:16,254 --> 00:03:17,715 private practice, etcetera. 90 00:03:18,270 --> 00:03:20,669 The second is we continue to see what 91 00:03:20,669 --> 00:03:22,750 we've already been discussing for the last two 92 00:03:22,750 --> 00:03:24,129 decades, the growth, 93 00:03:25,069 --> 00:03:25,889 or the movement 94 00:03:26,669 --> 00:03:27,889 of cases being, 95 00:03:28,349 --> 00:03:29,250 in the outpatient 96 00:03:29,709 --> 00:03:32,134 setting, whether that be in a hospital outpatient 97 00:03:32,194 --> 00:03:35,014 setting or an ASC, more more so ASC, 98 00:03:35,715 --> 00:03:36,615 and and how 99 00:03:37,074 --> 00:03:39,175 hospital systems are being able to compete 100 00:03:39,634 --> 00:03:41,794 and the dynamics of which depending on the 101 00:03:41,794 --> 00:03:45,014 market, whether it makes it difficult for physicians 102 00:03:45,155 --> 00:03:45,814 to privately 103 00:03:46,389 --> 00:03:48,789 be able to open ASCs, or are they, 104 00:03:48,789 --> 00:03:50,729 in de facto, having to 105 00:03:51,269 --> 00:03:54,310 partner with health care institutions, big systems to 106 00:03:54,310 --> 00:03:56,229 be able to make it work? And then 107 00:03:56,229 --> 00:03:57,209 the last is 108 00:03:57,830 --> 00:03:59,430 is I think there's been a lot of 109 00:03:59,430 --> 00:04:02,625 talk, and, again, market specific depending on how 110 00:04:02,625 --> 00:04:05,425 segmented the market is with, I'll say, de 111 00:04:05,425 --> 00:04:07,925 novo or unique ideas of how to grow 112 00:04:08,384 --> 00:04:10,784 the their their respective businesses. I see this 113 00:04:10,784 --> 00:04:13,044 a little bit more in private practice where 114 00:04:13,169 --> 00:04:15,330 they're looking of ways to be able to 115 00:04:15,330 --> 00:04:16,310 maintain margins 116 00:04:16,769 --> 00:04:18,790 knowing that the cost curves are 117 00:04:19,250 --> 00:04:21,810 are are not working in their favor and, 118 00:04:22,129 --> 00:04:25,669 diversifying their revenue streams and especially adding either 119 00:04:25,889 --> 00:04:26,629 new specialties 120 00:04:27,089 --> 00:04:27,589 or 121 00:04:29,134 --> 00:04:31,935 creating joint ventures with other orthopedic or health 122 00:04:31,935 --> 00:04:34,574 care organizations in their market to be able 123 00:04:34,574 --> 00:04:37,454 to leverage reimbursement and scale on on areas 124 00:04:37,454 --> 00:04:38,675 that they can seek efficiencies. 125 00:04:39,134 --> 00:04:40,414 So I think those are the three key 126 00:04:40,414 --> 00:04:41,794 things, the AI movement, 127 00:04:42,370 --> 00:04:44,449 the sort of move to outpatient. We've which 128 00:04:44,449 --> 00:04:46,370 we already know, but what does that mean 129 00:04:46,370 --> 00:04:48,470 as it relates to new strategic decisions? 130 00:04:48,930 --> 00:04:51,410 And then the last one is seeking new 131 00:04:51,410 --> 00:04:54,209 alternatives to to grow the revenue base in 132 00:04:54,209 --> 00:04:57,490 specialty practices knowing that the that things are, 133 00:04:57,490 --> 00:04:59,384 you know, are a little bit tough and 134 00:04:59,384 --> 00:05:01,785 and are cost prohibitive, but there is still 135 00:05:01,785 --> 00:05:03,785 a lot of opportunity if there are if 136 00:05:03,785 --> 00:05:06,345 the organizations are willing to think outside the 137 00:05:06,345 --> 00:05:06,845 stereotypical 138 00:05:07,464 --> 00:05:08,925 traditional health care box. 139 00:05:10,024 --> 00:05:12,105 Mhmm. Absolutely. And I think, you know, something 140 00:05:12,105 --> 00:05:14,139 we hear a lot is that ASCs, especially 141 00:05:14,139 --> 00:05:15,360 sort of, you know, 142 00:05:15,900 --> 00:05:18,400 medium sized practices or even small practices, 143 00:05:19,259 --> 00:05:21,259 you know, while some of those the things 144 00:05:21,259 --> 00:05:23,020 that you've mentioned, like ASCs have to be 145 00:05:23,020 --> 00:05:24,779 mindful of sort of their bottom line is 146 00:05:24,779 --> 00:05:26,319 smaller practices. It's also, 147 00:05:26,875 --> 00:05:28,555 they're more easily able to adapt to the 148 00:05:28,555 --> 00:05:30,475 market and can be sort of nimble due 149 00:05:30,475 --> 00:05:31,694 to their size as well. 150 00:05:32,634 --> 00:05:33,134 Absolutely. 151 00:05:34,395 --> 00:05:36,314 And what are you most excited about right 152 00:05:36,314 --> 00:05:37,694 now in health care and ASCs? 153 00:05:40,560 --> 00:05:42,879 Personally and professionally, I would say how to 154 00:05:42,879 --> 00:05:45,759 leverage the AI component because I am not 155 00:05:45,759 --> 00:05:46,900 a clinician, but 156 00:05:47,600 --> 00:05:49,920 what I've seen and I, 100% 157 00:05:49,920 --> 00:05:51,139 endorse is the organizations 158 00:05:51,520 --> 00:05:52,259 to examine 159 00:05:52,985 --> 00:05:55,785 ways to use artificial intelligence to to improve 160 00:05:55,785 --> 00:05:57,245 the customer experience. 161 00:05:57,704 --> 00:05:59,785 And that may be, you know, whether it's, 162 00:06:00,105 --> 00:06:02,024 describing in the clinic to be able to 163 00:06:02,024 --> 00:06:02,524 allow 164 00:06:02,904 --> 00:06:03,644 the the 165 00:06:04,024 --> 00:06:06,185 face to face interaction with a physician and 166 00:06:06,185 --> 00:06:08,400 a provider or a provider and a patient 167 00:06:08,400 --> 00:06:10,259 to be that much better. 168 00:06:10,879 --> 00:06:13,120 The other piece would be in in call 169 00:06:13,120 --> 00:06:15,620 centers or scheduling environments, authorizations, 170 00:06:16,240 --> 00:06:18,720 areas that allow the the individual that's contacting 171 00:06:18,720 --> 00:06:20,180 the practice or the organization 172 00:06:20,854 --> 00:06:22,294 to be able to get the answers that 173 00:06:22,294 --> 00:06:24,774 they need or the direction without having to 174 00:06:24,774 --> 00:06:26,154 wait. So access 175 00:06:26,535 --> 00:06:28,214 to being able to get the answers that 176 00:06:28,214 --> 00:06:29,894 they need is is very big. So I'm 177 00:06:29,894 --> 00:06:31,894 very excited with that. And the other, as 178 00:06:31,894 --> 00:06:33,194 I mentioned, is this, 179 00:06:33,735 --> 00:06:34,235 exploration 180 00:06:35,949 --> 00:06:38,910 of partnerships or collaborations with what what would 181 00:06:38,910 --> 00:06:40,850 have been known as competing organizations 182 00:06:41,550 --> 00:06:43,410 to try and figure out a way to 183 00:06:43,710 --> 00:06:44,210 improve, 184 00:06:45,629 --> 00:06:48,050 their bottom line by taking advantage of 185 00:06:48,444 --> 00:06:49,185 of teams 186 00:06:49,805 --> 00:06:51,805 that do things better than they do and 187 00:06:51,805 --> 00:06:52,785 and try to just 188 00:06:53,165 --> 00:06:54,625 be open ended partners 189 00:06:54,925 --> 00:06:57,084 and and look knowing that we're all facing 190 00:06:57,084 --> 00:06:59,084 the same challenges. And and that takes a 191 00:06:59,084 --> 00:07:00,444 little bit of courage, but those are the 192 00:07:00,444 --> 00:07:02,785 things that excite me the most right now, 193 00:07:03,870 --> 00:07:05,310 and how we can bring that to the 194 00:07:05,470 --> 00:07:08,050 we have a 34% ownership in the ASC. 195 00:07:08,270 --> 00:07:09,870 And one of the things we've been discussing 196 00:07:09,870 --> 00:07:10,850 with them is 197 00:07:11,230 --> 00:07:13,149 is how to look at at the, of 198 00:07:13,149 --> 00:07:15,709 course, the revenue per case and not focus 199 00:07:15,709 --> 00:07:18,029 so much on how much, quote, unquote, volume 200 00:07:18,029 --> 00:07:20,285 we bring in, but more so, what are 201 00:07:20,285 --> 00:07:23,004 the quality of earnings and, and and how 202 00:07:23,004 --> 00:07:25,485 can we get the best value for the 203 00:07:25,485 --> 00:07:27,024 cases that we push through 204 00:07:27,324 --> 00:07:30,545 while maintaining high margins and and by default, 205 00:07:30,925 --> 00:07:33,759 not necessarily having to have the highest level 206 00:07:33,759 --> 00:07:36,040 of staffing or cost structure because at the 207 00:07:36,040 --> 00:07:36,779 end of the day, 208 00:07:37,879 --> 00:07:41,080 you can generate 10,000 cases a year. But 209 00:07:41,080 --> 00:07:43,080 if you're making a 4% margin, it's not 210 00:07:43,080 --> 00:07:45,080 better than 5,000 cases a year with a 211 00:07:45,080 --> 00:07:46,379 35% margin. 212 00:07:47,625 --> 00:07:48,764 Mhmm. Absolutely. 213 00:07:49,145 --> 00:07:50,524 Yeah. And that definitely echoes, 214 00:07:50,985 --> 00:07:52,824 other things that we hear here in our 215 00:07:52,824 --> 00:07:53,324 reporting. 216 00:07:53,785 --> 00:07:56,024 And how are you thinking about growth over 217 00:07:56,024 --> 00:07:57,245 the next twelve months? 218 00:07:58,585 --> 00:08:00,585 So we're we are currently and we're we're 219 00:08:00,585 --> 00:08:01,324 doing this. 220 00:08:02,819 --> 00:08:05,540 Our our approach is twofold. The first one, 221 00:08:05,540 --> 00:08:07,560 which is a little bit easier, is 222 00:08:08,419 --> 00:08:11,079 if it it being in orthopedics, it's, 223 00:08:11,620 --> 00:08:13,720 I'm just gonna use our example, is 224 00:08:14,845 --> 00:08:16,384 a lot of our joint doctors 225 00:08:16,925 --> 00:08:17,425 see 226 00:08:17,725 --> 00:08:20,365 individuals that have venous insufficiency. And we know 227 00:08:20,365 --> 00:08:22,285 that there are vein centers that do vein 228 00:08:22,285 --> 00:08:22,785 ablations, 229 00:08:23,165 --> 00:08:24,225 either in a vascular, 230 00:08:24,925 --> 00:08:28,225 specialty setting or in an interventional radiology office. 231 00:08:29,419 --> 00:08:30,800 Our data show that 232 00:08:31,100 --> 00:08:33,039 roughly fifty percent of our, 233 00:08:33,659 --> 00:08:35,740 population that's 50 and over that come to 234 00:08:35,740 --> 00:08:36,480 our practice 235 00:08:37,179 --> 00:08:39,200 probably have some sort of venous insufficiency. 236 00:08:39,899 --> 00:08:41,980 So it's thousands of patients a year that 237 00:08:41,980 --> 00:08:42,960 we are now 238 00:08:43,404 --> 00:08:44,625 poised to launch 239 00:08:45,644 --> 00:08:48,044 our vein program in the clinic. So we 240 00:08:48,044 --> 00:08:49,024 will be providing 241 00:08:49,725 --> 00:08:51,504 those services to our patients 242 00:08:51,964 --> 00:08:54,445 rather than than referring them out. So it's 243 00:08:54,445 --> 00:08:56,464 a it's, again, it's a additional 244 00:08:57,269 --> 00:08:57,769 revenue, 245 00:08:58,470 --> 00:09:00,570 line for the practice that can generate 246 00:09:01,029 --> 00:09:02,250 significant return 247 00:09:02,550 --> 00:09:05,670 while providing great customer satisfaction because what we 248 00:09:05,670 --> 00:09:07,050 try to do in our organizations 249 00:09:08,790 --> 00:09:11,430 is try to provide as many services as 250 00:09:11,430 --> 00:09:13,404 possible so that we can retain the patient 251 00:09:13,404 --> 00:09:15,644 in our in our circle. So this adds 252 00:09:15,644 --> 00:09:16,144 another 253 00:09:16,605 --> 00:09:17,745 wonderful addition 254 00:09:18,365 --> 00:09:20,445 to to what we can offer the patients 255 00:09:20,445 --> 00:09:21,745 in our in our communities. 256 00:09:22,445 --> 00:09:25,930 So that's that's very exciting because we're we're 257 00:09:25,930 --> 00:09:28,670 expanding our our reach beyond orthopedics 258 00:09:29,450 --> 00:09:30,830 with the same population. 259 00:09:31,370 --> 00:09:32,350 The the second 260 00:09:32,810 --> 00:09:33,310 one 261 00:09:33,690 --> 00:09:34,190 is 262 00:09:34,889 --> 00:09:37,690 what I'll call the affiliate model. So we 263 00:09:37,690 --> 00:09:40,750 are in the process of having conversations with 264 00:09:41,254 --> 00:09:43,815 a practice that's south of us that we 265 00:09:43,815 --> 00:09:45,414 are very friendly with, but they have their 266 00:09:45,414 --> 00:09:47,495 own market share, their own providers. They do 267 00:09:47,495 --> 00:09:48,235 great work, 268 00:09:48,855 --> 00:09:49,595 but they're 269 00:09:50,214 --> 00:09:50,714 facing 270 00:09:51,014 --> 00:09:52,855 what a lot of other small practice are 271 00:09:52,855 --> 00:09:55,539 facing, which is higher cost. They are they 272 00:09:55,539 --> 00:09:58,339 don't have the negotiating power to seek better 273 00:09:58,339 --> 00:09:58,839 reimbursement. 274 00:09:59,699 --> 00:10:01,079 So they're facing something, 275 00:10:01,940 --> 00:10:03,699 that they know is gonna come over the 276 00:10:03,699 --> 00:10:05,879 next twelve months, which is potentially 277 00:10:06,500 --> 00:10:07,879 significant margin erosion 278 00:10:08,179 --> 00:10:10,605 while having two of their providers aging out. 279 00:10:10,764 --> 00:10:12,605 So we are gonna be speaking to them 280 00:10:12,605 --> 00:10:15,324 next month about an opportunity to join our 281 00:10:15,324 --> 00:10:16,464 group as an affiliate, 282 00:10:16,845 --> 00:10:19,324 which allows them to benefit from our our 283 00:10:19,324 --> 00:10:19,824 reimbursement 284 00:10:20,125 --> 00:10:21,184 model, which is, 285 00:10:21,964 --> 00:10:23,345 the best in our area 286 00:10:23,809 --> 00:10:26,470 in addition to seeking economies of scale 287 00:10:27,250 --> 00:10:30,129 through our revenue cycle, our authorizations team, our 288 00:10:30,129 --> 00:10:32,129 scheduling department. So at the end of the 289 00:10:32,129 --> 00:10:32,629 day, 290 00:10:33,009 --> 00:10:36,149 both practices can can work together to create 291 00:10:36,209 --> 00:10:36,709 a 292 00:10:37,089 --> 00:10:38,070 a more profitable 293 00:10:38,595 --> 00:10:39,095 organization 294 00:10:39,875 --> 00:10:42,375 that allows our affiliate practices 295 00:10:42,834 --> 00:10:46,115 to retain their independence, their brand, etcetera. So 296 00:10:46,115 --> 00:10:48,434 we're providing, if you will, those management services 297 00:10:48,434 --> 00:10:49,414 on the back end 298 00:10:49,875 --> 00:10:51,894 to to benefit both organizations. 299 00:10:52,274 --> 00:10:53,414 I I think 300 00:10:53,730 --> 00:10:56,289 and I would hope that other organizations, whether 301 00:10:56,289 --> 00:10:57,589 orthopedics or not, 302 00:10:58,049 --> 00:10:59,990 would look at that as as an opportunity 303 00:11:00,129 --> 00:11:00,949 for the future 304 00:11:01,250 --> 00:11:03,649 if indeed they're not looking to sell to 305 00:11:03,649 --> 00:11:06,610 private equity. They're looking to improve their bottom 306 00:11:06,610 --> 00:11:08,709 line, and they're open to 307 00:11:09,215 --> 00:11:12,115 to seeking best practices and economies of scale, 308 00:11:12,575 --> 00:11:15,134 without having to entrench in each other's market 309 00:11:15,134 --> 00:11:15,634 share. 310 00:11:16,735 --> 00:11:19,294 Mhmm. Absolutely. And I think those those kind 311 00:11:19,294 --> 00:11:21,875 of, you know, exploring new types of 312 00:11:22,500 --> 00:11:26,040 nontraditional acquisition models, partnerships, joint ventures, that's definitely, 313 00:11:26,420 --> 00:11:28,179 something we're talking about a lot with leaders 314 00:11:28,179 --> 00:11:29,240 over here at Becker's. 315 00:11:30,019 --> 00:11:31,860 Is there anything else I haven't touched on 316 00:11:31,860 --> 00:11:33,379 or asked you about today that you'd like 317 00:11:33,379 --> 00:11:33,960 to add? 318 00:11:36,225 --> 00:11:38,144 No. I I but I I I've been 319 00:11:38,144 --> 00:11:39,825 thinking, and I don't know if this is 320 00:11:39,825 --> 00:11:42,144 something that your organization, your team has talked 321 00:11:42,144 --> 00:11:42,965 about. But 322 00:11:43,504 --> 00:11:45,184 in all the conferences that I've been with 323 00:11:45,184 --> 00:11:47,264 Becker's, I mean, I as you may know, 324 00:11:47,264 --> 00:11:49,024 AI is a is a big thing they're 325 00:11:49,024 --> 00:11:52,110 talking about, whether it's robotics in the clinical 326 00:11:52,649 --> 00:11:55,149 setting or or AI as it relates to 327 00:11:55,450 --> 00:11:58,250 support services, back office, etcetera. And one of 328 00:11:58,250 --> 00:12:00,410 the things that I just can't help to 329 00:12:00,410 --> 00:12:01,230 think is, 330 00:12:02,570 --> 00:12:04,570 will it be a matter of time before 331 00:12:04,570 --> 00:12:06,910 CMS or other payer entities 332 00:12:07,664 --> 00:12:08,164 start 333 00:12:09,424 --> 00:12:09,924 to 334 00:12:11,184 --> 00:12:12,325 lower reimbursement 335 00:12:12,705 --> 00:12:14,384 on average, like they have been over the 336 00:12:14,384 --> 00:12:16,644 last couple of years because the assumption is 337 00:12:16,945 --> 00:12:17,445 efficiencies, 338 00:12:19,024 --> 00:12:20,804 create value, and and therefore, 339 00:12:21,184 --> 00:12:23,679 what used to pay at, using this number 340 00:12:23,679 --> 00:12:26,159 a $100 cannot pay at $90 because the 341 00:12:26,159 --> 00:12:27,779 cost to deliver those services 342 00:12:28,240 --> 00:12:31,360 are lower based on technology, etcetera. So I 343 00:12:31,360 --> 00:12:32,580 would not be surprised 344 00:12:33,679 --> 00:12:35,779 if over the next five years we see 345 00:12:36,384 --> 00:12:37,284 changes in reimbursement 346 00:12:37,824 --> 00:12:39,684 and not to the better, 347 00:12:40,784 --> 00:12:44,565 but lower because these agencies are gonna apply 348 00:12:44,865 --> 00:12:46,944 AI to their systems if they already have 349 00:12:47,024 --> 00:12:49,504 which they've already had in many cases, but 350 00:12:49,504 --> 00:12:51,365 they're going to, by default, 351 00:12:52,080 --> 00:12:55,620 push private practices, push hospitals, etcetera, 352 00:12:56,160 --> 00:12:57,300 to adopt AI 353 00:12:57,680 --> 00:12:58,660 in their organizations 354 00:12:59,680 --> 00:13:02,320 as a means to define lower reimbursement because 355 00:13:02,320 --> 00:13:04,420 there's opportunities to seek better efficiencies. 356 00:13:05,355 --> 00:13:07,754 And, and I I think that that may 357 00:13:07,754 --> 00:13:10,235 happen. I I really do, and it's gonna 358 00:13:10,235 --> 00:13:10,735 force 359 00:13:11,115 --> 00:13:12,095 smaller organizations 360 00:13:12,715 --> 00:13:15,434 or organizations that not are not very AI 361 00:13:15,434 --> 00:13:17,434 focused right now to have to look at 362 00:13:17,434 --> 00:13:19,215 that as a ways to compete. 363 00:13:20,480 --> 00:13:23,279 Mhmm. Absolutely. I could definitely I could definitely 364 00:13:23,279 --> 00:13:25,220 see that happening being the case. I mean, 365 00:13:25,759 --> 00:13:27,600 I definitely it reminds me of one conversation 366 00:13:27,600 --> 00:13:29,459 I had at our health IT conference, 367 00:13:29,839 --> 00:13:31,360 where someone asked a question of sort of 368 00:13:31,440 --> 00:13:32,179 yeah. Like, 369 00:13:32,615 --> 00:13:33,975 you know, we have AI, but it it 370 00:13:34,054 --> 00:13:35,414 it's only as good as sort of the 371 00:13:35,414 --> 00:13:37,174 system that it exists in. And if it's, 372 00:13:37,174 --> 00:13:39,334 you know, modeled and sort of molded in 373 00:13:39,334 --> 00:13:41,195 a system based on, you know, 374 00:13:41,575 --> 00:13:44,454 the processes we have for reimbursement, then, you 375 00:13:44,454 --> 00:13:46,954 know, something like that is definitely a possibility, 376 00:13:47,095 --> 00:13:47,914 it would seem. 377 00:13:49,070 --> 00:13:49,570 Yep. 378 00:13:50,350 --> 00:13:52,269 But, yeah, that that's actually all I have 379 00:13:52,269 --> 00:13:54,929 for you today, EJ, unless there's anything else. 380 00:13:55,790 --> 00:13:56,910 Well, I said, I would say, first of 381 00:13:56,910 --> 00:13:59,070 all, thank you so much. My experience with 382 00:13:59,070 --> 00:14:00,290 Becker so far, 383 00:14:01,045 --> 00:14:04,245 has been fantastic. The first, meeting I went 384 00:14:04,245 --> 00:14:06,325 to was almost twenty years ago and then 385 00:14:06,325 --> 00:14:08,485 took a little sabbatical and then started going 386 00:14:08,485 --> 00:14:10,825 back in in June. I've had a 387 00:14:11,524 --> 00:14:13,445 a tremendous amount of fun, have learned a 388 00:14:13,445 --> 00:14:14,504 tremendous amount. 389 00:14:14,909 --> 00:14:16,350 But one of the things that I take 390 00:14:16,350 --> 00:14:16,850 away 391 00:14:17,470 --> 00:14:19,970 every time I I go to the the 392 00:14:20,110 --> 00:14:21,329 the conferences is, 393 00:14:22,350 --> 00:14:24,829 how a lot of organizations are are trying 394 00:14:24,829 --> 00:14:26,450 different things. And I would encourage 395 00:14:27,455 --> 00:14:30,894 organizations, whether ASCs or or medical practices or 396 00:14:30,894 --> 00:14:33,715 hospitals, to continue to think outside the box 397 00:14:34,415 --> 00:14:36,434 and and look outside of health care 398 00:14:36,815 --> 00:14:37,794 to find opportunities 399 00:14:38,095 --> 00:14:38,754 to scale 400 00:14:39,215 --> 00:14:41,794 and, create better strategies to deliver 401 00:14:42,250 --> 00:14:44,889 care and, be members of their communities and 402 00:14:44,889 --> 00:14:46,730 have strong roots in the communities that they 403 00:14:46,730 --> 00:14:48,750 serve and and make sure that they always 404 00:14:48,970 --> 00:14:50,269 put the patient first, 405 00:14:50,889 --> 00:14:52,809 even though we all struggle in with the 406 00:14:52,809 --> 00:14:55,610 challenges of of the ever changing dynamics in 407 00:14:55,610 --> 00:14:57,950 health care. And and the fact is, 408 00:14:58,945 --> 00:15:00,485 we have to do the right thing, 409 00:15:01,105 --> 00:15:03,024 even if it means we have to work 410 00:15:03,024 --> 00:15:04,865 a little harder at that. And and in 411 00:15:04,865 --> 00:15:06,865 the short term, might be a little bit 412 00:15:06,865 --> 00:15:09,264 challenging, but but if the long term is 413 00:15:09,264 --> 00:15:10,945 what we're all looking for, which I hope 414 00:15:10,945 --> 00:15:11,684 we are, 415 00:15:12,110 --> 00:15:14,750 Our strategic outlook, I think, looks bright if 416 00:15:14,750 --> 00:15:15,330 we have 417 00:15:16,029 --> 00:15:18,430 a good diverse a set of diverse opinions 418 00:15:18,430 --> 00:15:19,090 and thoughts, 419 00:15:19,470 --> 00:15:21,310 at the table, regardless of whether you're at 420 00:15:21,310 --> 00:15:24,290 hospitals or ASCs or private practice, etcetera. 421 00:15:25,675 --> 00:15:27,675 Absolutely. I like I like ending it there. 422 00:15:27,995 --> 00:15:29,754 Well, thank you so much for joining us 423 00:15:29,754 --> 00:15:30,254 today. 424 00:15:30,555 --> 00:15:32,634 It's been a pleasure speaking with you, and 425 00:15:32,634 --> 00:15:34,075 I look forward to connecting with you again 426 00:15:34,075 --> 00:15:36,175 in the future. Thank you so much, Francesca. 427 00:15:36,235 --> 00:15:38,335 Have a wonderful day. You too. 428 00:15:40,549 --> 00:15:41,289 At athenahealth, 429 00:15:41,669 --> 00:15:44,330 we know your ambulatory practice wants healthier, 430 00:15:44,709 --> 00:15:47,589 a healthier business, healthier care teams, and healthier 431 00:15:47,589 --> 00:15:48,089 patients. 432 00:15:48,549 --> 00:15:50,870 But the complexities of modern health care tech 433 00:15:50,870 --> 00:15:52,709 make it hard for you and your care 434 00:15:52,709 --> 00:15:54,254 teams to focus on what matters 435 00:15:54,815 --> 00:15:57,695 most? That's where athenahealth can help. Our AI 436 00:15:57,695 --> 00:16:00,995 native all in one solutions reduce administrative burdens, 437 00:16:01,294 --> 00:16:04,274 streamline billing and payments, and deliver critical insights 438 00:16:04,335 --> 00:16:07,134 when clinicians need it most. That means fewer 439 00:16:07,134 --> 00:16:10,014 clicks, more time for patients, and stronger bottom 440 00:16:10,014 --> 00:16:10,230 lines. 441 00:16:11,110 --> 00:16:14,389 Practicing medicine is complex, but running a practice 442 00:16:14,389 --> 00:16:16,250 can be that much simpler with athenahealth. 443 00:16:16,949 --> 00:16:20,649 See how simpler is healthier at athenahealth.com.