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
00:00:44,085 --> 00:00:46,804
Hello. This is Francesca Matthews with the Becker's

17
00:00:46,804 --> 00:00:48,024
ASC review podcast.

18
00:00:48,484 --> 00:00:50,325
I'm thrilled to be joined today by Myra

19
00:00:50,325 --> 00:00:53,545
Ray, manager of surgical services at Franciscan Healthcare.

20
00:00:53,844 --> 00:00:55,524
Myra, thank you so much for being here

21
00:00:55,524 --> 00:00:56,024
today.

22
00:00:56,460 --> 00:00:57,760
Thank you for having me.

23
00:00:58,460 --> 00:01:00,539
To start us off, could you please introduce

24
00:01:00,539 --> 00:01:01,979
yourself and tell us a little bit about

25
00:01:01,979 --> 00:01:02,640
your background?

26
00:01:03,020 --> 00:01:06,299
Sure. I'm Myra Ray. I am a master's

27
00:01:06,299 --> 00:01:06,799
prepared

28
00:01:07,180 --> 00:01:09,819
nurse in nursing leadership at Franciscan Healthcare in

29
00:01:09,819 --> 00:01:10,799
West Point, Nebraska.

30
00:01:12,075 --> 00:01:13,775
I have a background,

31
00:01:14,474 --> 00:01:15,295
that spans

32
00:01:15,594 --> 00:01:16,734
over twenty years.

33
00:01:17,594 --> 00:01:19,055
I have been

34
00:01:19,515 --> 00:01:22,655
everywhere from a level two trauma center OR

35
00:01:22,875 --> 00:01:24,015
to an ASC

36
00:01:24,769 --> 00:01:27,430
and have worked in a variety of perioperative

37
00:01:27,649 --> 00:01:28,869
settings. Currently,

38
00:01:29,569 --> 00:01:30,310
I am

39
00:01:30,769 --> 00:01:31,750
over a preop

40
00:01:32,209 --> 00:01:32,709
OR

41
00:01:33,489 --> 00:01:34,549
in PACU.

42
00:01:36,129 --> 00:01:37,189
So we do

43
00:01:38,174 --> 00:01:40,894
everything from preadmission testing all the way through

44
00:01:40,894 --> 00:01:41,394
discharge.

45
00:01:41,935 --> 00:01:44,015
Yeah. Excited to to get into the discussion

46
00:01:44,015 --> 00:01:44,515
today.

47
00:01:45,134 --> 00:01:47,295
Just to kinda start us off, what are

48
00:01:47,295 --> 00:01:49,295
the top three trends that you're following in

49
00:01:49,295 --> 00:01:51,075
health care and ASCs today?

50
00:01:52,090 --> 00:01:53,630
Well, of course, as with anyone,

51
00:01:54,490 --> 00:01:54,990
we're

52
00:01:55,850 --> 00:01:59,770
trending in monitoring staffing shortages and increased labor

53
00:01:59,770 --> 00:02:00,909
costs. It's always,

54
00:02:01,290 --> 00:02:02,829
something that's on the forefront

55
00:02:04,010 --> 00:02:06,109
in our mind is recruitment and retention,

56
00:02:06,810 --> 00:02:07,310
and

57
00:02:07,814 --> 00:02:09,574
how are we gonna keep up with the

58
00:02:09,574 --> 00:02:10,074
increasing

59
00:02:10,775 --> 00:02:11,914
cost of labor.

60
00:02:12,854 --> 00:02:13,334
Then,

61
00:02:13,655 --> 00:02:15,814
a second thing that we're looking at is

62
00:02:15,814 --> 00:02:17,435
the higher acuity procedures.

63
00:02:17,974 --> 00:02:20,280
We've seen an increase in the last six

64
00:02:20,280 --> 00:02:23,560
months of higher acuity procedures, new procedures that

65
00:02:23,560 --> 00:02:25,500
we haven't done in the past, and,

66
00:02:26,199 --> 00:02:29,419
just looking overall at ASCs across the country

67
00:02:29,479 --> 00:02:31,419
and and what's going on.

68
00:02:32,454 --> 00:02:34,474
The third thing that we look at is

69
00:02:34,534 --> 00:02:37,435
reimbursement and difficulty of prior authorizations.

70
00:02:37,974 --> 00:02:38,634
You know?

71
00:02:39,814 --> 00:02:41,754
All the procedures that were once

72
00:02:43,014 --> 00:02:45,894
not requiring prior authorizations, we're finding more and

73
00:02:45,894 --> 00:02:48,530
more frequently that insurers are,

74
00:02:49,229 --> 00:02:50,689
seeking prior authorizations

75
00:02:52,030 --> 00:02:54,189
in things that we didn't have to have

76
00:02:54,189 --> 00:02:54,689
before.

77
00:02:55,949 --> 00:02:58,909
Mhmm. Definitely. Like, I yeah. Those themes that

78
00:02:58,909 --> 00:03:00,289
you you mentioned there

79
00:03:00,750 --> 00:03:03,305
are definitely resonate with, you know, the the

80
00:03:03,305 --> 00:03:06,425
providers and administrators, CEOs that I speak with

81
00:03:06,425 --> 00:03:08,905
every day here at Becker's. And I'm curious

82
00:03:08,905 --> 00:03:10,824
kind of moving from there, what are you

83
00:03:10,824 --> 00:03:12,905
most excited about right now as it relates

84
00:03:12,905 --> 00:03:15,485
to ASCs, health care, anything in between?

85
00:03:16,090 --> 00:03:18,250
You know, two of the things that I'm

86
00:03:18,250 --> 00:03:20,430
most excited about right now

87
00:03:21,050 --> 00:03:22,590
are growth. And,

88
00:03:23,930 --> 00:03:25,849
the growth that we've seen here over the

89
00:03:25,849 --> 00:03:27,854
last six months have led us

90
00:03:28,735 --> 00:03:32,174
to seek a remodel or actually a new

91
00:03:32,174 --> 00:03:32,674
build,

92
00:03:33,455 --> 00:03:37,074
to expand our services. We are, we've expanded

93
00:03:37,375 --> 00:03:38,754
our volumes by

94
00:03:39,854 --> 00:03:41,155
about 25%

95
00:03:41,294 --> 00:03:43,715
in the last six months to a year.

96
00:03:44,229 --> 00:03:46,629
So we're seeing a massive amount of growth.

97
00:03:46,629 --> 00:03:47,930
I'm out of space,

98
00:03:48,790 --> 00:03:51,270
whether it be for equipment or for patients.

99
00:03:51,270 --> 00:03:53,909
We're using unique areas that we haven't used

100
00:03:53,909 --> 00:03:56,629
in the past to preop and discharge patients.

101
00:03:56,629 --> 00:03:57,129
So,

102
00:03:58,344 --> 00:03:59,145
it's a,

103
00:03:59,625 --> 00:04:02,185
a challenge at best, but it's also a

104
00:04:02,185 --> 00:04:04,504
very exciting time to see the growth, to

105
00:04:04,504 --> 00:04:05,164
see the

106
00:04:05,465 --> 00:04:06,284
new potentials

107
00:04:07,544 --> 00:04:09,724
of increased acuity procedures,

108
00:04:10,025 --> 00:04:10,525
and

109
00:04:10,905 --> 00:04:13,145
it's just an exciting time overall and all

110
00:04:13,145 --> 00:04:14,159
the way around here.

111
00:04:15,360 --> 00:04:18,660
Mhmm. Absolutely. Again, that just definitely resonates with

112
00:04:18,959 --> 00:04:20,560
what we're hearing here at Becker's. And, you

113
00:04:20,560 --> 00:04:22,399
know, you mentioned growth. How

114
00:04:23,040 --> 00:04:24,800
curious if you could kind of follow-up on

115
00:04:24,800 --> 00:04:26,560
that. How are you thinking about growth over

116
00:04:26,560 --> 00:04:27,699
the next twelve months?

117
00:04:28,714 --> 00:04:31,995
Prime example, we have a plastic surgeon that

118
00:04:31,995 --> 00:04:33,134
joined us about

119
00:04:33,995 --> 00:04:36,895
six months ago, and he's doing,

120
00:04:37,435 --> 00:04:39,134
several new procedures. We're,

121
00:04:39,915 --> 00:04:41,694
we just did a rib plating.

122
00:04:42,589 --> 00:04:45,329
We are looking at doing rhinoplasties.

123
00:04:46,029 --> 00:04:48,269
Plastics is something that's new for us. We

124
00:04:48,269 --> 00:04:50,769
had not done in the past here.

125
00:04:51,310 --> 00:04:55,004
So looking at expanding services that we offer

126
00:04:55,004 --> 00:04:58,064
in a very rural area of Nebraska

127
00:04:58,685 --> 00:05:01,564
that haven't been seen around here, patients not

128
00:05:01,564 --> 00:05:03,185
having to travel as far,

129
00:05:03,805 --> 00:05:04,305
it's,

130
00:05:05,164 --> 00:05:06,384
you know, just amazing

131
00:05:06,845 --> 00:05:07,345
at

132
00:05:08,399 --> 00:05:11,360
being able to offer services that have not

133
00:05:11,360 --> 00:05:12,899
been in this region.

134
00:05:14,319 --> 00:05:16,160
Mhmm. Yeah. I was about to say, I

135
00:05:16,160 --> 00:05:18,720
can imagine just being in ASC, which I

136
00:05:18,720 --> 00:05:20,800
think everyone in the ASC space is looking

137
00:05:20,800 --> 00:05:22,714
at a lot of potential for growth and

138
00:05:22,714 --> 00:05:24,495
then, yeah, being in an area where there's

139
00:05:24,795 --> 00:05:25,694
limited access.

140
00:05:26,634 --> 00:05:28,074
Yeah. It seems like there's a a lot

141
00:05:28,074 --> 00:05:30,154
on the horizon as far as where where

142
00:05:30,154 --> 00:05:31,375
we can go from here.

143
00:05:31,995 --> 00:05:34,050
And, you know, with that, you know, with

144
00:05:34,050 --> 00:05:36,389
the growth and the excitement of it also

145
00:05:36,529 --> 00:05:38,709
comes the the challenge of staffing.

146
00:05:39,169 --> 00:05:41,009
You know, how do you being in a

147
00:05:41,009 --> 00:05:43,589
rural area, how do you come up with

148
00:05:43,889 --> 00:05:46,689
staffing that you haven't had before? And it

149
00:05:46,689 --> 00:05:48,709
leads to a whole plethora of

150
00:05:49,365 --> 00:05:51,845
a a new exciting venture. And if I

151
00:05:51,845 --> 00:05:55,045
could say anything, it's partner with your nursing

152
00:05:55,045 --> 00:05:57,925
programs, the colleges that have nursing programs. And

153
00:05:57,925 --> 00:05:59,444
one of the things that we've done to

154
00:05:59,444 --> 00:06:00,105
try to

155
00:06:00,485 --> 00:06:03,769
recruit new nurses is we've created a scholarship

156
00:06:03,910 --> 00:06:04,889
program so

157
00:06:05,189 --> 00:06:06,889
that we pay ahead

158
00:06:07,669 --> 00:06:10,790
of the nurse going to school so that

159
00:06:10,790 --> 00:06:12,970
they don't have the out of pocket expense.

160
00:06:13,350 --> 00:06:16,935
So rather than an alternative to tuition reimbursement

161
00:06:17,235 --> 00:06:19,394
is the scholarship program. So we provide a

162
00:06:19,394 --> 00:06:20,375
two year scholarship

163
00:06:21,074 --> 00:06:24,834
for a associate degree program here at the

164
00:06:24,834 --> 00:06:25,735
local college.

165
00:06:26,514 --> 00:06:28,535
And we've expanded that to

166
00:06:29,129 --> 00:06:31,230
other universities in the area.

167
00:06:32,569 --> 00:06:34,490
Super interesting that you mentioned that. Yeah. I

168
00:06:34,490 --> 00:06:36,410
feel like I feel like among the rural

169
00:06:36,410 --> 00:06:38,410
ASU leaders I speak with or even in

170
00:06:38,410 --> 00:06:40,910
just, like, you know, less super crowded areas,

171
00:06:41,930 --> 00:06:43,210
do you think that fit when when I

172
00:06:43,210 --> 00:06:44,985
ask, you know, kind of how are you

173
00:06:44,985 --> 00:06:47,064
getting creative to talk about to figure out

174
00:06:47,064 --> 00:06:49,464
staffing? How how do you stay afloat when

175
00:06:49,464 --> 00:06:50,504
a lot of the times the cards are

176
00:06:50,504 --> 00:06:52,685
stacked against you? It's that connection to community

177
00:06:52,745 --> 00:06:53,404
and that,

178
00:06:54,345 --> 00:06:56,345
you know, kind of yeah. Leaning on the

179
00:06:56,345 --> 00:06:58,345
community for support and having that that connection

180
00:06:58,345 --> 00:07:00,160
there that is can kinda set you apart

181
00:07:00,160 --> 00:07:01,460
and keep keep you afloat.

182
00:07:02,080 --> 00:07:04,160
Absolutely. And, you know, being in a rural

183
00:07:04,160 --> 00:07:06,740
area, it is so important that you have

184
00:07:07,120 --> 00:07:10,399
the support of the community and getting them

185
00:07:10,399 --> 00:07:13,300
involved in helping the hospital to grow,

186
00:07:13,754 --> 00:07:15,435
ensuring that they want to come to your

187
00:07:15,435 --> 00:07:17,455
facility, that you're getting the quality

188
00:07:18,074 --> 00:07:20,955
care that you could receive anywhere. I mean,

189
00:07:20,955 --> 00:07:23,595
we're an hour from Omaha, an hour and

190
00:07:23,595 --> 00:07:24,655
a half from Lincoln.

191
00:07:25,115 --> 00:07:27,514
They could easily travel there and back in

192
00:07:27,514 --> 00:07:28,975
a day's time, but

193
00:07:29,430 --> 00:07:32,389
we provide things here in town with the

194
00:07:32,389 --> 00:07:33,290
highest quality

195
00:07:33,830 --> 00:07:35,930
and physicians that actually come from

196
00:07:36,470 --> 00:07:38,089
Omaha or Norfolk or,

197
00:07:39,269 --> 00:07:39,769
Lincoln,

198
00:07:40,069 --> 00:07:41,990
you know, physicians that are traveling to other

199
00:07:42,230 --> 00:07:44,745
from other larger areas to come here and

200
00:07:44,824 --> 00:07:45,725
practice in rural

201
00:07:46,345 --> 00:07:46,845
Nebraska.

202
00:07:48,104 --> 00:07:48,604
Absolutely.

203
00:07:50,024 --> 00:07:52,044
Is there anything else that I haven't

204
00:07:52,425 --> 00:07:53,944
touched on so far that you feel like

205
00:07:53,944 --> 00:07:57,084
is important to discuss in this conversation?

206
00:07:57,990 --> 00:07:59,449
I well, I think,

207
00:07:59,910 --> 00:08:02,329
overall, one of the biggest things is

208
00:08:02,709 --> 00:08:05,769
you're looking at not just patient satisfaction,

209
00:08:06,629 --> 00:08:09,050
but we also have to look at employee

210
00:08:09,110 --> 00:08:11,595
satisfaction. So if you're going back to the

211
00:08:11,595 --> 00:08:14,714
staffing shortage and the increasing labor cost, you

212
00:08:14,714 --> 00:08:17,134
have to come up with unique ways to

213
00:08:17,834 --> 00:08:19,055
attract staff.

214
00:08:19,675 --> 00:08:21,055
So you have to

215
00:08:21,914 --> 00:08:23,214
be open minded

216
00:08:23,910 --> 00:08:26,709
and creative when it comes to scheduling, when

217
00:08:26,709 --> 00:08:27,689
it comes to,

218
00:08:28,789 --> 00:08:29,289
compensation.

219
00:08:29,750 --> 00:08:32,490
So, you know, if you want a quality

220
00:08:32,549 --> 00:08:35,269
nurse, it's not all about compensation. It's about

221
00:08:35,269 --> 00:08:37,350
the benefits that you give them. So if

222
00:08:37,350 --> 00:08:40,065
you give them the benefit of self scheduling

223
00:08:40,764 --> 00:08:41,264
of,

224
00:08:41,884 --> 00:08:42,205
hey.

225
00:08:43,085 --> 00:08:44,305
We're in rural Nebraska.

226
00:08:44,685 --> 00:08:45,345
We have

227
00:08:45,965 --> 00:08:48,545
nurses that their spouses are farmers.

228
00:08:49,004 --> 00:08:52,125
That means it it's harvest right now. It's

229
00:08:52,125 --> 00:08:54,465
the time of year that their husbands are

230
00:08:54,970 --> 00:08:57,470
in the field at 05:30 in the morning.

231
00:08:57,929 --> 00:09:00,169
So day cares don't open till seven or

232
00:09:00,169 --> 00:09:00,990
07:30.

233
00:09:01,210 --> 00:09:03,470
You give them the opportunity to say, hey.

234
00:09:03,929 --> 00:09:04,590
You know,

235
00:09:05,289 --> 00:09:07,610
I'll cover your early morning shift. I'll come

236
00:09:07,610 --> 00:09:09,870
in early. What time can you get here?

237
00:09:10,304 --> 00:09:13,445
And then you're gonna cover the late shift.

238
00:09:13,825 --> 00:09:16,404
So you can come in at 07:30

239
00:09:16,865 --> 00:09:18,085
and stay until

240
00:09:18,625 --> 00:09:20,004
04:30, 05:00.

241
00:09:20,225 --> 00:09:22,325
You'll be our late person this evening.

242
00:09:22,980 --> 00:09:25,379
Giving the opportunity for that sometimes is a

243
00:09:25,379 --> 00:09:26,279
lot more important

244
00:09:26,899 --> 00:09:27,959
to them than

245
00:09:28,500 --> 00:09:30,419
maybe another dollar or 2 on the hour.

246
00:09:30,419 --> 00:09:32,039
They're not gonna drive to Omaha

247
00:09:32,580 --> 00:09:34,019
for a dollar or 2 an hour when

248
00:09:34,019 --> 00:09:35,879
you give them the opportunity for

249
00:09:36,274 --> 00:09:38,195
their children who are in school a block

250
00:09:38,195 --> 00:09:39,095
and a half away

251
00:09:39,475 --> 00:09:41,955
to come over and do their homework in

252
00:09:41,955 --> 00:09:43,955
the cafeteria until they're ready to go home

253
00:09:43,955 --> 00:09:44,615
in the evening,

254
00:09:45,634 --> 00:09:46,855
giving them the opportunity

255
00:09:47,235 --> 00:09:48,695
to be a parent

256
00:09:49,089 --> 00:09:50,149
at the same time

257
00:09:50,610 --> 00:09:52,629
of being able to provide for their family.

258
00:09:53,570 --> 00:09:54,070
Absolutely.

259
00:09:54,450 --> 00:09:56,610
Yeah. Yeah. Definitely. I think that that rings

260
00:09:56,610 --> 00:09:58,470
true in in rural areas specifically.

261
00:09:59,649 --> 00:10:01,169
Well, that is actually all I have for

262
00:10:01,169 --> 00:10:03,089
you today, Myra. Thank you so much for

263
00:10:03,089 --> 00:10:03,909
joining us.

264
00:10:04,245 --> 00:10:07,065
Thank you, Franchesca. You have a wonderful day.

265
00:10:07,365 --> 00:10:08,884
Yep. It's been a pleasure speaking with you,

266
00:10:08,884 --> 00:10:10,164
and I look forward to connecting with you

267
00:10:10,164 --> 00:10:12,105
again in the future. Sounds great.

268
00:10:14,325 --> 00:10:17,205
At athena Health, we know your ambulatory practice

269
00:10:17,205 --> 00:10:18,090
wants healthier,

270
00:10:18,570 --> 00:10:21,450
a healthier business, healthier care teams, and healthier

271
00:10:21,450 --> 00:10:21,950
patients.

272
00:10:22,410 --> 00:10:24,809
But the complexities of modern healthcare tech make

273
00:10:24,809 --> 00:10:26,809
it hard for you and your care teams

274
00:10:26,809 --> 00:10:29,290
to focus on what matters most. That's where

275
00:10:29,290 --> 00:10:32,164
athena Health can help. Our AI native all

276
00:10:32,164 --> 00:10:34,824
in one solutions reduce administrative burdens,

277
00:10:35,204 --> 00:10:38,105
streamline billing and payments, and deliver critical insights

278
00:10:38,164 --> 00:10:39,704
when clinicians need it most.

279
00:10:40,004 --> 00:10:42,664
That means fewer clicks, more time for patients,

280
00:10:42,725 --> 00:10:43,464
and stronger

281
00:10:44,690 --> 00:10:47,730
lines. Practicing medicine is complex, but running a

282
00:10:47,730 --> 00:10:50,070
practice can be that much simpler with athenahealth.

283
00:10:50,690 --> 00:10:54,389
See how simpler is healthier at athenahealth.com.