Senior Content Marketing Manager
Ep. 2: Alex Taira – The No Surprises Act: Looking Ahead to 2023 | This Week in Surgery Centers
Here’s what to expect on this week’s episode. 🎙️
The No Surprises Act has been a huge topic of conversation (and sometimes controversy) for ASCs and hospitals this year.
Alex Taira, the Ambulatory Surgery Center Association‘s Regulatory Affairs and Research Manager, has been one of the industry’s go-to resources when it comes to this piece of legislation, that unfortunately still has a lot of the industry scratching their heads.
Alex joined our host, Raphael Akinsipe, on this week’s podcast to clear the air on where the industry is today and what we can expect the No Surprises Act to look like in #2023.
➡️ What is holding ASCs back from complying?
➡️ What will 2023 bring? How can we start preparing now?
➡️ Do we expect ASCs to start filing lawsuits as a few hospitals have?
➡️ … and more.
Find us on Apple Podcasts or Spotify to catch the whole episode and learn more about how ASCs can lower the cost of care.
In our news recap, we’ll cover the Great Resignation, the smartest moves made in 2022, and the disparity in the number of Latino doctors and surgeons.
Episode Transcript
0:00
welcome to this week in surgery centers if you’re in the ASC industry then
0:05
you’re in the right place every week we’ll start the episode off by sharing an interesting conversation we had with
0:11
our featured guests and then we’ll close the episode by recapping the latest news impacting surgery centers we’re excited
0:18
to share with you what we have so let’s get started and see what the industry’s been up to [Music]
0:27
hi everyone here’s what you can expect on today’s episode our host Rafael
0:33
akinzapee sits down with Alex Tyra Alex is the Regulatory Affairs and research
0:39
manager at ASCA you probably know his name by now he has become asca’s resident expert on all things related to
0:46
the no surprises act we have the chance to pick his brain about where the industry is at today with this piece of
0:51
legislation but more importantly get an understanding of what the no surprises
0:57
act will look like in 2023 and how ASC should be preparing
1:02
we’ll close the episode with a few news stories we’ll start with how you can ensure your nurses stick around during
1:09
the Great resignation share with you what a few admins consider to be their smartest move in 2022
1:15
look at the big disparity in the number of Latino doctors and surgeons there are and why that matters and of course and
1:23
the new segment with a positive feel-good story about an orthopedic Tech in California
1:29
hope everyone enjoys the episode and here’s what’s going on this week in surgery centers
1:36
thank you all right how’s it going guys I am your host Rafael kinsby here at this week in
1:44
surgery centers we’ve got a super exciting episode this week this week I’m joined by Alex Tyra he is the head of
1:52
Regulatory Affairs and research management at ASCA we’re going to be covering the no surprises act this week
1:58
and he has been leading the charge on this across the industry so we’re pumped to get some of his insights but before
2:04
we jump into any of the questions I’m going to turn over to Alex thank you for joining us and for those who don’t know
2:10
you can you share a bit about yourself yeah hi Raphael thanks I’m super glad to
2:16
be here super glad to be working with HST you know I’ve done some fair amount of work with you guys because I do some EHR related work for ASCA
2:24
um so really happy to be here talking about this topic um I’ve been ataska for about five six
2:29
years now and for those who don’t know where the National Organization that advocates for ASCS
2:35
um the biggest National Organization we have a few thousand members but we advocate for the interests of all six
2:41
thousand plus Medicare certified ASCS I would say a lot of what we do is related
2:46
to Federal regulatory advocacy so Medicare related work is obviously a big component but sometimes stuff like no
2:53
surprises surprise billing stuff that’s being handled on the federal level it affects ases is also very much our
2:59
purview and as you mentioned we’ve been doing a lot of education and Outreach and trying to make sure that our members
3:04
in the ASC industry as a whole is positioned well to respond to some of these new regulations uh that’s super
3:10
helpful and you know I naturally want to jump in and start asking you all these questions but I I had a moment there
3:15
where I was like probably should take a step back for any of our listeners who doesn’t uh who don’t necessarily know what the no surprises Act is and um can
3:23
you can you share a little bit on just what the no surprises Act is uh so that just our listeners are kind of aware
3:29
yeah I mean so people in the healthcare industry have probably heard in recent years about surprise bills or sometimes
3:36
they’re called balance bills you know basically there’s when a patient shows
3:41
up and they receive a bill that’s in excess of what they might expect or maybe some charges for services that
3:46
they didn’t know about going in and it’s become kind of a big publicity issue for health care I think in recent years
3:52
because you see all these news stories horror stories right of people going in for a procedure and you know maybe they
3:59
need something complex to happen and so they go in and they come out perhaps it’s an emergency procedure even and so
4:05
they didn’t really have a say about whether they needed this health care but then they come out with some health care bill that’s in tens of thousands
4:12
hundreds of thousands of dollars right and so there was this kind of willpower to mitigate some of that cost you know
4:18
thinking patients are carrying too much of this cost and we know that healthcare is expensive especially for some of
4:23
these high cost Services complex services but at least patients just have have an expectation of what they’re
4:28
going to pay okay and there should be a limit on what they should pay so these are kind of the new regulations
4:34
I would say that there’s basically two main scenarios that the regulation touches although we’re going to talk
4:39
about a lot of different things but broadly the law is basically concerned with emergency services so like I said
4:46
going in when you need something to happen and making sure the patients aren’t paying too much and then there’s a second circumstance which is
4:52
non-emergency services so elective procedures from out of network providers at in-network facilities and this is
4:58
where ASCS come in because you know an ASC is commonly in a network facility but also contracts with providers
5:05
Physicians external providers like pathology Labs or someone like that that
5:10
might be out of network and that’s kind of the source of a lot of unexpected bills and so that’s one of the major pieces that’s super helpful insight
5:18
there and I think it gives a good perspective on kind of what the legislation is and how ASCS fit into
5:24
that mix so you know kind of throughout the year as we’ve talked with different customers and different players across
5:30
the industry you know the no surprises act has definitely been a point of Commerce station and I think many would say a point of controversy uh throughout
5:38
the year and you know with your pulse at ASCA on the industry how would you say
5:44
uh you know people across the industry are feeling right now about the legislation uh with regards to ASCS
5:52
I think there’s a lot of uncertainty um and part of that comes from the
5:58
rollout of the law itself so this law was passed right at the end of 2020 and
6:04
then last year through 2021 they were issuing these rules this is how the federal government basically creates
6:10
regulation so there were three main rules that came out throughout last year
6:15
that kind of outline all these intricacies of how this new regulation would affect providers and it was very
6:22
dense it was very complicated and one thing that we will get to later is that it’s still being crafted so there’s a
6:28
lot of parts of the law that aren’t concrete yet so I think that contributes
6:33
to a general not just from ASCS from all Healthcare Providers a sense of uncertainty and like you know this thing
6:40
came into being over the course of a year which is not a very long time for people to adjust to this big new
6:45
regulatory framework and on top of that it’s still changing so there’s a sense of like what do we even have to do to be
6:52
in compliance you know and ASC is because a lot of ASCS are independent they’re small they don’t necessarily
6:59
have the resources like a hospital might to devote to this kind of Regulatory Compliance or keeping up with this stuff
7:05
so I think there’s a lot of frustration and struggle to understand you know like what do we need to do are we in
7:10
compliance now will we be in compliance in the future um you know those are tough questions and I think the fact that the law is so
7:18
complex makes it even tougher to kind of provide resources and education yeah that’s a that’s such a good point and
7:24
you know in terms of that complexity you know many times as I’ve talked about the no surprises act with people I feel like
7:30
everyone has this broad overarching idea of what it is but then as we start to get into the nitty-gritty on what this
7:36
means for um for everyone across the industry it becomes much more nuanced and it’s harder for people to kind of
7:42
evaluate and kind of make decisions for themselves on what should be happening and you know I was going to ask you you
7:47
know what do you think is kind of holding surgery centers back around the the nose prize act but I think you’re already leaning into that with the
7:53
uncertainty you know what do you think are things that would help surgery centers in terms of understanding
8:00
um some of that on uh kind of overcoming that uncertainty and understanding some of the legislation as it stands today
8:07
yeah I think one thing is that understand that a lot of the provisions
8:12
in the ACT are not necessarily going to be impacting ASCS directly so ASCS are
8:18
kind are certainly subject to many of the regulations but aren’t necessarily involved in all of the intricate aspects
8:25
um you know we might talk about some of the legal cases down in Texas or some of the things that have been taking up news
8:31
stories and you know that’s big news in healthcare but they don’t necessarily affect ASC so that’s one part the second
8:38
part is that there have been a lot of good resources you know we had asked have been trying really hard to push out
8:43
as much education and you know that’s not really even a plug for us as much as like if I can post a link to a model
8:50
form or a model disclosure instead of a center can use instead of creating their own document
8:56
you know that’s something that we’re hoping to get out there that stuff exists out there so I think maybe not trying not feeling like a center has to
9:04
do all of this work themselves that there are these underlying resources that can help them get to where they need to be
9:09
is definitely something big for facilities to understand and I think you know it’s still complex it’s still tough
9:15
to find these resources but uh you know getting some of that will helpful well before before I let you go today I
9:20
definitely want to make sure we cover some of those resources but before we jump into some of those steps that people can take on that side of it
9:27
coming back to kind of the pulse of where things have been in 2022 do you feel like centers are starting to warm
9:32
up to it or do you feel like that uncertainty is kind of keeping a kind of Darker Cloud over it right now
9:39
no I think there’s I think the uncertainty is remaining Supreme right now and um
9:45
one I think part of that is because as I mentioned before the law is still changing so we’re actually expecting
9:51
some expansion of the law of the requirements related to the law in 2023
9:56
and Beyond so as much confusion as there’s been about what you have to do this year in 2022 I think you know these
10:02
requirements are only going to get more um I don’t want to say complex but there are going to be more of them senators
10:09
are going to have to be aware of more things um so I think that contributes to a lot of
10:15
uncertainty um I think also there is a sense from the healthcare industry as a whole
10:22
um you know the federal government hasn’t really been enforcing the requirements related to surprise billing that strongly this year
10:29
um and that’s intentional they said you know this happened really fast and we don’t want to penalize people for
10:34
something that came up basically within the past calendar year um but that also makes it difficult because
10:41
there’s not really a stick there you know for some of these actions so people aren’t sure you know what is the level
10:47
of enforcement going to be in the future you know like there are penalties it could be up to ten thousand dollars per
10:53
violation written into the law you know are they going to be really strict in
10:58
enforcing that and our Center is going to have to be really diligent about keeping up with this or as we’ve seen in
11:03
some other regulatory Frameworks you know is it going to be only kind of the most egregious situations they’re going
11:09
to be enforced yeah that’s tough to know and we really I guess from what you’ve seen with the no surprise act and even with other legislation you know how are
11:17
those things typically approached like is there something that you know as we go into 2023 centers can can expect in
11:23
terms of you know if we do end up in a scenario where they are enforcing it more heavily is there a certain amount
11:29
of checks and balances that are already in place with from a legislation standpoint to to audit a center or to
11:36
um to kind of review the review the estimate centers are putting out is there anything like that that they can
11:42
expect from a from an enforcement standpoint that you’ve seen elsewhere
11:47
yeah I wish I could say that I knew what it was going to look like but I really don’t and I don’t think anybody does yet partially because the federal government
11:54
has laid back for the moment and said we’re not really going to enforce this that strongly
11:59
um you know I think we’ll see this is something that we’re definitely keeping an eye on as this develops there are
12:06
I think pain points that I can already pinpoint that are going to be the crucial elements so you mentioned
12:12
estimates and one thing that is not really being enforced this year but is the interaction between nasc and some of
12:19
their external providers and anesthesiologists or Pathology lab and you know when you’re trying to accumulate a estimate of costs for a
12:27
patient that’s going to be one of the more difficult interactions I think if the center needs to get a cost estimate
12:32
from a provider that they don’t necessarily employ directly that’s you know that’s that might be difficult and
12:37
we’ve already heard I’ve gotten tons of questions about what if they don’t want to give us this estimate or what if they
12:43
won’t respond or all of that and those are certainly valid concerns and I think that’s where enforcement will play a
12:49
part in easing some of those relationships becoming the stick to this um you know new regulatory framework but
12:56
again you know I wish I could say I knew more about how that was going to look operationally and I just don’t and I think we’ll know more over the next yeah
13:02
that’s good perspective I mean I think no one has a true crystal ball all for for what’s going to happen and
13:08
especially when it comes to legislation I feel like anytime you’re dealing with anything that’s um that’s kind of based in the government or a legislative body
13:14
you you kind of are somewhat waiting in the wind because it could be something that’s high on someone’s agenda and that
13:21
the next year is uh is largely enforced or it could be something that’s slightly lower and kind of has a longer Runway
13:27
before there’s some strict enforcement you know
13:32
well I was just going to say and there’s you know as we’re all aware there’s kind of these regular
13:38
government processes that are interrupting this so we just had a changeover from Administration you know
13:44
recently and we’re about to have another election and sometimes it’s unclear how
13:49
um you know a new health and human services department will you know what they will look like in terms of
13:55
enforcing this and certainly we’ve seen in past in the past decade some fluctuations in terms of how strict
14:01
they’ll be and for some of you these other programs and I think that’s just the case with the whole Federal level
14:06
that’s very true there’s definitely a natural fluctuation between different different parties and different bodies that are kind of managing those areas so
14:13
you know without going too heavy on the crystal ball and predictions if you were
14:18
going to you know if you were talking to a center right now on kind of top three things they should prepare for or maybe
14:24
you should expect going into 2023 with regards to the no surprises act what are
14:30
those top three things you would tell them to be thinking about or preparing for
14:36
yeah I think what I said earlier that we’re just at the start and this is just going to expand is something that’s
14:42
really important for example the good faith estimates that we’ve been talking about right now
14:48
those are only applying to uninsured or self-pay patients so a small subset of
14:54
patients in an ASC might see and so I think maybe aacs haven’t had to do very
14:59
many of them or haven’t had to compile this many estimates but I mean we’ve already seen a request for information
15:04
in the past month from the federal government about expanding the good faith estimate requirement to insured
15:09
patients so if you’re not set on the good faith estimates now while it’s just a smaller subset you’re probably going
15:16
to be behind the ball once that expands in the future to all patients right insured patients as well and you know I
15:22
don’t know how fast it’s going to happen it could happen in 2023 as I said it’s just a request for information at this
15:28
point we haven’t seen any actual rulemaking but it’s probably good to start thinking about those things the
15:35
second thing I would say is those relationships um we had already mentioned kind of
15:41
third-party you know anesthesiology pathology building those relationships and making sure that there’s good
15:47
communication those are going to be essential because right now there’s as I mentioned they’re
15:53
not really enforcing all of these costs making sure all the costs are accumulated for an estimate right now
15:58
but those will be enforced in the future at some point um so it’ll be important to to have that
16:05
relationship and I think building on that just any any way that you can build a process that makes it easier for your
16:12
Center again ASCS are in hospitals there are I’m sure some that are big multi-or
16:17
facilities that have dedicated staff that can handle this but if you’re an independent one or two or single
16:23
specialty facility um yeah it might be good to start thinking about how these processes are going to work you know you can automate
16:30
it I know HST for example has a partnership or has a technology solution
16:35
that can help with estimates I’m not saying that has to be yours but maybe that can be something that can help you
16:41
along the way thinking about those things to make your life easier now is
16:46
going to be really crucial just because it’s going it’s only going yeah that that’s very true and if I’m if I’m hearing you kind of just recapping those
16:52
those three things you mentioned there so one is being prepared from a good faith estimate standpoint two is having
16:59
those relationships in place and kind of making sure you’re coordinated in that regard and then three is planning around
17:06
the processes and maybe those processes are enabled by technology but having the processes in place to make sure you’re
17:12
able to facilitate that um is that an effective recap on that yeah I think that was awesome yeah
17:18
taking the mental notes you’re you’re given all the The Good the good stuff there I’m just trying to keep up so awesome okay you know you hinted at this
17:25
a little earlier and this is probably one of the the juicier parts of it that people have probably been seeing some
17:30
headlines on so you know with the the different Texas hospitals who have kind
17:36
of pushed back on some of the the no surprises act um there’s been a lot of kind of legal
17:42
court cases that have been in place and they’ve been filing lawsuits both at a state and a federal level with regards
17:48
to this you know do you anticipate that you know what’s happening with hospitals to be something that we can kind of
17:54
start to think or see um as a parallel for what might end up happening with ASCS as we go into this
18:01
next year I don’t really think the court cases the
18:07
legal cases around this law are going to spread to the AIC industry as much
18:13
um certainly there may be some action but at least in my understanding a lot of
18:19
the court cases so far have been about the dispute resolution process so
18:25
basically when a provider an out of network provider and a payer are
18:30
disputing reimbursement right because the law says a patient can only pay this much and that generally will leave an
18:37
out-of-network provider and a payer in this kind of limbo without getting too deep into it you
18:43
know the government set up this process that is supposed to adjudicate these disputes between providers and payers
18:49
and basically said at the center of this process is something called the qualified payment amount the qpa which
18:55
is a median in network rate for your geographic area which sounds reasonable but you can think in practice may have
19:03
some purpose incentives in the sense that you know if a payer for example knows that their starting point for all
19:12
arbitration is going to be their Network rate and they don’t really have an incentive to make that a high rate or to
19:17
keep positions whatsoever so what we’ve been seeing and this continues to happen actually is that local payers will
19:25
look you know basically threaten contract termination to cover providers or lower their Network rates
19:31
significantly understanding that there’s this process being set up that makes their meeting in the work rate you know
19:38
basically the starting point for all these negotiations it’s it’s a tough situation again I
19:44
don’t necessarily want to burden ASCS with too much of this because I don’t think ASCS will be that subject to some
19:50
of these disputes certainly the Physicians who work in ASC as well but for right now one thing that’s important
19:57
for ASCS to note is like if you’re an in-network facility and you contract without a network providers
20:03
you will have some responsibility if you’re an out of network agency you’re not covered by this law whatsoever the
20:10
law does not contemplate how different facilities elective procedures and how to network facilities so if you’re out
20:16
of network with a patient this law doesn’t make any difference to your interaction um so I think you know it’s good it’s
20:24
good to keep an eye on these court cases on some of the legal drama that’s happening but it may not be as applicable to the ASC industry okay it’s
20:30
good to note and I think that that’s probably a good thing for us I think the the complexities from a legal standpoint
20:37
and court case standpoint obviously make it harder for for you know all parties involved to be able to to move forward
20:42
in an effective way but great call outs there in terms of kind of the some of the misalignments on the incentives
20:47
between the various players in the industry so you know as we’re kind of thinking about some of the next steps
20:53
and some of the the opportunities for surgery centers going into 2023 I know you mentioned that uh there’s different
20:59
resources that they can take advantage of and you know I I know you ask us whole kind of publishes a ton of
21:06
different resources but you know are there any key things you would say that surgery centers and any of our listeners
21:12
should maybe go to as great resources with regards to the no surprises Act
21:18
yeah I think for now there’s a few things that they that centers can really take advantage of um one is that as part of the law
21:26
centers are required to disclose to patients protection is offered under the law to them under you know surprise
21:32
billing regulations and the disclosures have a lot of requirements in terms of what the font is like and what language
21:39
it’s presented in and what information has to be applied and it sounds like a lot but there are model forums online so
21:45
you don’t have to necessarily create this by yourself you can just go to the CMS website and or the ask a website we
21:51
posted it there and pull down this form and that can be your status that can satisfy your requirement for a
21:57
disclosure to the patients similar you know this disclosure has to be put on your website you know in your
22:04
physical facility so you can make that a lot easier if you use some of the resources that are there there’s also
22:10
model forms for good faith estimates as well as a clear outlining of all the data elements that need to be included
22:16
in that those things can really help you you don’t need to create these processes by yourself and I’m hoping that as this
22:23
law expands you know there will be more of those things certainly I think even though the law is large and complex and
22:30
confusing CMS has seemed to be in good faith and offering as many resources
22:36
FAQs webinars slide decks as they can so there’s actually maybe too many
22:41
resources happening right now um but I think if you’re thinking about oh there’s this for my need or I’m not
22:47
sure what the language is for this it’s probably out there it’s probably already been formatted for you and you you just
22:53
need to assign it awesome well that’s super helpful maybe what we can do is I will talk to our show producers and try
22:59
and get them to put a couple of those links that you mentioned there into some of the show notes and and we’ll also
23:04
share it across social as well so people have quick access to that uh you know as
23:09
we kind of wrap up our episode today um you know one of the things that we do every week with our guest is we ask them
23:17
you know what is one thing our listeners can do this week to improve their
23:22
Surgery Center doesn’t have to really related to no surprises act just what is one thing they can do to improve their Surgery Center this week
23:30
yeah I love this question and I honestly cannot wait to hear some of the responses you hear from future guests
23:36
because I’m sure it’s just going to be if you compile all these answers it’s just going to be great information Francis
23:42
one thing that I was thinking about that I’m not sure is possible in a week but I think can be started in a week was to
23:48
just be an advocate for your Center you know we still hear on the local level the state level the national level a lot
23:55
of not just uncertainty but people who don’t know about ASCS in particular you know and the advantages that they can
24:01
provide to patients in terms of better patient experience lower costs all of those things that we in the industry
24:07
kind of inherently understand from working here so I think if you can Advocate a little on behalf of your
24:12
Center on behalf you know that Advocates on behalf of the industry as well and that could mean a little social media it
24:18
could mean some volunteer work it could mean giving a lawmaker an official a
24:23
tour of your facility so they see you know you’re not just some random facility you’re a state of the art you know Center that has all the things that
24:30
you might expect to have these procedures done safely I think those things will go a long way and hopefully
24:36
as we kind of build the understanding of the ASE industry at the local and at the national level we’ll get more policies
24:42
that are are favorable to us thank you I love that I think you know one of the things I always talk about maybe this is the you know I used to be a product
24:48
manager so this might be the product manager in me but anytime people can be an advocate or an evangelist for the
24:54
places that they work or the products they work on or you know in many cases for us you know with the patients they
25:00
work with you know that is a massive opportunity so I’m I’m super aligned with that
25:05
um that’s a great one there I think that’s a nugget that’ll go really far you know Alex I have really enjoyed this episode I think we covered some great
25:12
things we got some great nuggets in terms of where the industry is today what we can expect going into 2023 what
25:19
are some of those great resources that people have access to so you provided a ton for our guests where can people find
25:25
you if they want to you know hear more from you or uh see any of the content that you’re sharing um or what’s the
25:32
best place for people to to hear more from you yeah so I do a lot of work with ascan
25:38
right and and pushing out advocacy or educational resources
25:44
um I’m not sure if we’ll be able to share my email but I’m always happy to answer questions and I would say if
25:49
you’re not an ask a member we provide a lot of great resources some of that can be operational in terms of your Medicare
25:54
billing some of that can be keeping up with no surprises act and you know I write for our print magazine and our
26:01
online magazine about these topics every month so um you can certainly find me on the ask website all over our federal regulations
26:08
pages and then Focus Magazine and if if I can I’ll share my email as well so people can reach out directly love it
26:14
well thank you so much for your time Alex this has been a great episode and we we look forward to hopefully having
26:19
you on the podcast again sometime soon thanks Rafael
26:25
[Music] as always it has been a busy week in
26:30
healthcare so let’s Jump Right In as we know nurses are leaving their jobs at higher rates in this country has seen
26:37
in a long time that’s not new for anybody Forbes published an article recently
26:42
titled how to ensure your nurses stick around through the great resignation
26:48
and I feel like every time I read one of these articles as I’m sure you’re all in the same boat I’m looking for something
26:54
new something that is tangible and could actually be effective this article is
26:59
pretty good and there were two tips that I thought were worth sharing and I promise you that neither of them have
27:05
anything to do with free food um tip one is to look at different Talent Solutions and staffing agencies
27:13
maybe you’ve looked at them in the past um but it it might be worth exploring again while it might not always be the
27:20
most economical solution if you can fill in some gaps and reduce the need for double shifts and offer flexibility it
27:27
will hopefully stop your most tenored staff at least from leaving and let them know that you know
27:34
that they need help and and you’re trying to find solutions for them and tip two is to change or get rid of
27:41
systems that just aren’t working for your nurses any longer and I feel like all the time we’re talking about you
27:48
know improving your processes on a day-to-day basis but I think what’s different about this tip is that you’re
27:54
looking at it from the nurse’s perspective what is not working for them anymore and no one can spot a process
28:01
Improvement opportunity better than a nurse can When leaders take feedback from nurses on what can be improved not
28:09
only does do the processes themselves become optimized but the nurses feel like their voices matter and that’s
28:16
what’s key here so it’s really a win-win for the business side of the house and also the clinical side
28:22
so you can set up a committee or a monthly meeting or have one-on-one meetings with all of your nurses to
28:28
collect this valuable feedback and make sure you’re doing it in a way where your nurses are nurses are comfortable
28:33
sharing um and then not only do you need to take their feedback but you need to be extremely transparent on if you plan to
28:40
use it if not why and if you do when
28:46
Second Story here uh Becker’s ASC asked three Surgery Center leaders to look
28:52
back at 2022 and share the smartest moves they made this year I thought that
28:57
was a really interesting way to frame the question as I was reading this article I was
29:02
actually struck by how many ASCS I’ve heard express interest in actually doing
29:08
some of these things and seeing the benefits of it but aren’t quite sure about taking that leap so I thought this
29:15
would be a really good recap to share just in case anyone needed some inspiration to get started or if you’ve
29:20
been looking for your sign here is your sign um one admin in Texas said her smartest
29:27
move was actually building and relocating to a new Surgery Center now I know that’s not an option for
29:32
everybody um but it is on the table for some and no further details were shared but I can’t imagine this was a huge
29:39
undertaking and it sounds like it paid off in one way or another
29:44
a second admin in Colorado shared that they went all in on investing in their nurses so this actually really ties back
29:51
to our first story too we all know how critical Staffing is right now um and this admin in Colorado shared two
29:59
really great ideas one for staff retention and one for staff satisfaction
30:04
um first they went ahead and created a longevity incentive for all staff so
30:11
obviously short-term Solutions are you need to get people in the door right we need to hire
30:17
people immediately but keeping the good ones and keeping the ones who want to stay there
30:23
um can actually be done by this long longevity incentive which I thought was really cool
30:30
um and then second they ensured that Physicians would have the last patient in the pacu by 3 15 PM so that allows
30:39
their staff to leave at a reasonable hour and enjoy a better quality of life um and have a better work-life balance
30:45
and that’s what touches on the staff satisfaction so um just to recap longevity incentive and
30:53
um closing down in a reasonable hour and sticking to it lastly the third admin in California
30:59
said their smartest move in 2022 was implementing an EHR and Outsourcing
31:04
their billing both of those changes had huge impacts on their business by adding visibility and analytics in a way they
31:11
didn’t have before so if you’ve been considering either of those things or any of those things listed might be good
31:18
to to kind of take that first step our third story Advocates are working
31:25
hard to increase the number of Latino Physicians and insurgents so according
31:31
to NBC News and just to kind of give you some numbers here Latinos account for only seven percent of the overall
31:39
physician and surgeon Workforce and at the same time according to the latest 2020 census numbers
31:46
almost 20 percent of Americans are Latino so there’s a pretty significant
31:52
Gap there that needs closing it’s so important that there’s a proper
31:58
balance and representation at all levels but this disparity is also doing patients a huge disservice
32:06
um Studies have shown repeatedly that when a physician speaks the same native language as their patient and they’re
32:12
able to relate to the cultural experiences of their patient they are more likely to have better outcomes and
32:19
of course thinking about the patient first you can understand why this is so
32:24
important there’s just that added sense of safety and comfort and understanding
32:30
especially when it comes to high stress situations like have like your health and having surgery
32:36
um so that’s not the only benefit and aside from all the other ones um if you put yourself in your patient’s
32:43
shoes you’d understand why it’s important that and we should all be doing something about this
32:49
since California does have the largest Latino population a lot of advocacy groups are planning to start there and
32:56
then planning to expand a few that are doing amazing work in this area right now are the California medicine Scholars
33:03
the alliance and mentorship and the national Hispanic Medical Association so
33:09
I recommend checking out any of those and I’m sure there are um others that are also working to increase the number
33:15
of Latino Physicians and surgeons and to end our new segment on a positive
33:21
note people shared a story about an orthopedic technician in California who
33:28
goes out of his way to customize the casts of his young patients so he takes
33:34
the time to draw their favorite cartoon characters sports teams whatever they want onto their casts
33:41
and as you can imagine the kids absolutely love it and are proud to show off their cast instead of being
33:46
embarrassed or feeling different by them um and by now he said he’s painted over
33:51
a thousand casts and if you head to the episode notes of this podcast episode you’ll see the people article and I
33:58
promise you it’s worth checking these pictures out they’re super cool he’s really really talented
34:05
and that news story officially wraps up this week’s podcast thank you as always for spending a few minutes of your week
34:12
with us make sure you subscribe or leave a review on whichever platform you’re listening from we really appreciate it
34:18
and I hope you have a great day and we’ll see you again next week
34:24
[Music] why are you keeping me
welcome to this week in surgery centers if you’re in the ASC industry then
0:05
you’re in the right place every week we’ll start the episode off by sharing an interesting conversation we had with
0:11
our featured guests and then we’ll close the episode by recapping the latest news impacting surgery centers we’re excited
0:18
to share with you what we have so let’s get started and see what the industry’s been up to [Music]
0:27
hi everyone here’s what you can expect on today’s episode our host Rafael
0:33
akinzapee sits down with Alex Tyra Alex is the Regulatory Affairs and research
0:39
manager at ASCA you probably know his name by now he has become asca’s resident expert on all things related to
0:46
the no surprises act we have the chance to pick his brain about where the industry is at today with this piece of
0:51
legislation but more importantly get an understanding of what the no surprises
0:57
act will look like in 2023 and how ASC should be preparing
1:02
we’ll close the episode with a few news stories we’ll start with how you can ensure your nurses stick around during
1:09
the Great resignation share with you what a few admins consider to be their smartest move in 2022
1:15
look at the big disparity in the number of Latino doctors and surgeons there are and why that matters and of course and
1:23
the new segment with a positive feel-good story about an orthopedic Tech in California
1:29
hope everyone enjoys the episode and here’s what’s going on this week in surgery centers
1:36
thank you all right how’s it going guys I am your host Rafael kinsby here at this week in
1:44
surgery centers we’ve got a super exciting episode this week this week I’m joined by Alex Tyra he is the head of
1:52
Regulatory Affairs and research management at ASCA we’re going to be covering the no surprises act this week
1:58
and he has been leading the charge on this across the industry so we’re pumped to get some of his insights but before
2:04
we jump into any of the questions I’m going to turn over to Alex thank you for joining us and for those who don’t know
2:10
you can you share a bit about yourself yeah hi Raphael thanks I’m super glad to
2:16
be here super glad to be working with HST you know I’ve done some fair amount of work with you guys because I do some EHR related work for ASCA
2:24
um so really happy to be here talking about this topic um I’ve been ataska for about five six
2:29
years now and for those who don’t know where the National Organization that advocates for ASCS
2:35
um the biggest National Organization we have a few thousand members but we advocate for the interests of all six
2:41
thousand plus Medicare certified ASCS I would say a lot of what we do is related
2:46
to Federal regulatory advocacy so Medicare related work is obviously a big component but sometimes stuff like no
2:53
surprises surprise billing stuff that’s being handled on the federal level it affects ases is also very much our
2:59
purview and as you mentioned we’ve been doing a lot of education and Outreach and trying to make sure that our members
3:04
in the ASC industry as a whole is positioned well to respond to some of these new regulations uh that’s super
3:10
helpful and you know I naturally want to jump in and start asking you all these questions but I I had a moment there
3:15
where I was like probably should take a step back for any of our listeners who doesn’t uh who don’t necessarily know what the no surprises Act is and um can
3:23
you can you share a little bit on just what the no surprises Act is uh so that just our listeners are kind of aware
3:29
yeah I mean so people in the healthcare industry have probably heard in recent years about surprise bills or sometimes
3:36
they’re called balance bills you know basically there’s when a patient shows
3:41
up and they receive a bill that’s in excess of what they might expect or maybe some charges for services that
3:46
they didn’t know about going in and it’s become kind of a big publicity issue for health care I think in recent years
3:52
because you see all these news stories horror stories right of people going in for a procedure and you know maybe they
3:59
need something complex to happen and so they go in and they come out perhaps it’s an emergency procedure even and so
4:05
they didn’t really have a say about whether they needed this health care but then they come out with some health care bill that’s in tens of thousands
4:12
hundreds of thousands of dollars right and so there was this kind of willpower to mitigate some of that cost you know
4:18
thinking patients are carrying too much of this cost and we know that healthcare is expensive especially for some of
4:23
these high cost Services complex services but at least patients just have have an expectation of what they’re
4:28
going to pay okay and there should be a limit on what they should pay so these are kind of the new regulations
4:34
I would say that there’s basically two main scenarios that the regulation touches although we’re going to talk
4:39
about a lot of different things but broadly the law is basically concerned with emergency services so like I said
4:46
going in when you need something to happen and making sure the patients aren’t paying too much and then there’s a second circumstance which is
4:52
non-emergency services so elective procedures from out of network providers at in-network facilities and this is
4:58
where ASCS come in because you know an ASC is commonly in a network facility but also contracts with providers
5:05
Physicians external providers like pathology Labs or someone like that that
5:10
might be out of network and that’s kind of the source of a lot of unexpected bills and so that’s one of the major pieces that’s super helpful insight
5:18
there and I think it gives a good perspective on kind of what the legislation is and how ASCS fit into
5:24
that mix so you know kind of throughout the year as we’ve talked with different customers and different players across
5:30
the industry you know the no surprises act has definitely been a point of Commerce station and I think many would say a point of controversy uh throughout
5:38
the year and you know with your pulse at ASCA on the industry how would you say
5:44
uh you know people across the industry are feeling right now about the legislation uh with regards to ASCS
5:52
I think there’s a lot of uncertainty um and part of that comes from the
5:58
rollout of the law itself so this law was passed right at the end of 2020 and
6:04
then last year through 2021 they were issuing these rules this is how the federal government basically creates
6:10
regulation so there were three main rules that came out throughout last year
6:15
that kind of outline all these intricacies of how this new regulation would affect providers and it was very
6:22
dense it was very complicated and one thing that we will get to later is that it’s still being crafted so there’s a
6:28
lot of parts of the law that aren’t concrete yet so I think that contributes
6:33
to a general not just from ASCS from all Healthcare Providers a sense of uncertainty and like you know this thing
6:40
came into being over the course of a year which is not a very long time for people to adjust to this big new
6:45
regulatory framework and on top of that it’s still changing so there’s a sense of like what do we even have to do to be
6:52
in compliance you know and ASC is because a lot of ASCS are independent they’re small they don’t necessarily
6:59
have the resources like a hospital might to devote to this kind of Regulatory Compliance or keeping up with this stuff
7:05
so I think there’s a lot of frustration and struggle to understand you know like what do we need to do are we in
7:10
compliance now will we be in compliance in the future um you know those are tough questions and I think the fact that the law is so
7:18
complex makes it even tougher to kind of provide resources and education yeah that’s a that’s such a good point and
7:24
you know in terms of that complexity you know many times as I’ve talked about the no surprises act with people I feel like
7:30
everyone has this broad overarching idea of what it is but then as we start to get into the nitty-gritty on what this
7:36
means for um for everyone across the industry it becomes much more nuanced and it’s harder for people to kind of
7:42
evaluate and kind of make decisions for themselves on what should be happening and you know I was going to ask you you
7:47
know what do you think is kind of holding surgery centers back around the the nose prize act but I think you’re already leaning into that with the
7:53
uncertainty you know what do you think are things that would help surgery centers in terms of understanding
8:00
um some of that on uh kind of overcoming that uncertainty and understanding some of the legislation as it stands today
8:07
yeah I think one thing is that understand that a lot of the provisions
8:12
in the ACT are not necessarily going to be impacting ASCS directly so ASCS are
8:18
kind are certainly subject to many of the regulations but aren’t necessarily involved in all of the intricate aspects
8:25
um you know we might talk about some of the legal cases down in Texas or some of the things that have been taking up news
8:31
stories and you know that’s big news in healthcare but they don’t necessarily affect ASC so that’s one part the second
8:38
part is that there have been a lot of good resources you know we had asked have been trying really hard to push out
8:43
as much education and you know that’s not really even a plug for us as much as like if I can post a link to a model
8:50
form or a model disclosure instead of a center can use instead of creating their own document
8:56
you know that’s something that we’re hoping to get out there that stuff exists out there so I think maybe not trying not feeling like a center has to
9:04
do all of this work themselves that there are these underlying resources that can help them get to where they need to be
9:09
is definitely something big for facilities to understand and I think you know it’s still complex it’s still tough
9:15
to find these resources but uh you know getting some of that will helpful well before before I let you go today I
9:20
definitely want to make sure we cover some of those resources but before we jump into some of those steps that people can take on that side of it
9:27
coming back to kind of the pulse of where things have been in 2022 do you feel like centers are starting to warm
9:32
up to it or do you feel like that uncertainty is kind of keeping a kind of Darker Cloud over it right now
9:39
no I think there’s I think the uncertainty is remaining Supreme right now and um
9:45
one I think part of that is because as I mentioned before the law is still changing so we’re actually expecting
9:51
some expansion of the law of the requirements related to the law in 2023
9:56
and Beyond so as much confusion as there’s been about what you have to do this year in 2022 I think you know these
10:02
requirements are only going to get more um I don’t want to say complex but there are going to be more of them senators
10:09
are going to have to be aware of more things um so I think that contributes to a lot of
10:15
uncertainty um I think also there is a sense from the healthcare industry as a whole
10:22
um you know the federal government hasn’t really been enforcing the requirements related to surprise billing that strongly this year
10:29
um and that’s intentional they said you know this happened really fast and we don’t want to penalize people for
10:34
something that came up basically within the past calendar year um but that also makes it difficult because
10:41
there’s not really a stick there you know for some of these actions so people aren’t sure you know what is the level
10:47
of enforcement going to be in the future you know like there are penalties it could be up to ten thousand dollars per
10:53
violation written into the law you know are they going to be really strict in
10:58
enforcing that and our Center is going to have to be really diligent about keeping up with this or as we’ve seen in
11:03
some other regulatory Frameworks you know is it going to be only kind of the most egregious situations they’re going
11:09
to be enforced yeah that’s tough to know and we really I guess from what you’ve seen with the no surprise act and even with other legislation you know how are
11:17
those things typically approached like is there something that you know as we go into 2023 centers can can expect in
11:23
terms of you know if we do end up in a scenario where they are enforcing it more heavily is there a certain amount
11:29
of checks and balances that are already in place with from a legislation standpoint to to audit a center or to
11:36
um to kind of review the review the estimate centers are putting out is there anything like that that they can
11:42
expect from a from an enforcement standpoint that you’ve seen elsewhere
11:47
yeah I wish I could say that I knew what it was going to look like but I really don’t and I don’t think anybody does yet partially because the federal government
11:54
has laid back for the moment and said we’re not really going to enforce this that strongly
11:59
um you know I think we’ll see this is something that we’re definitely keeping an eye on as this develops there are
12:06
I think pain points that I can already pinpoint that are going to be the crucial elements so you mentioned
12:12
estimates and one thing that is not really being enforced this year but is the interaction between nasc and some of
12:19
their external providers and anesthesiologists or Pathology lab and you know when you’re trying to accumulate a estimate of costs for a
12:27
patient that’s going to be one of the more difficult interactions I think if the center needs to get a cost estimate
12:32
from a provider that they don’t necessarily employ directly that’s you know that’s that might be difficult and
12:37
we’ve already heard I’ve gotten tons of questions about what if they don’t want to give us this estimate or what if they
12:43
won’t respond or all of that and those are certainly valid concerns and I think that’s where enforcement will play a
12:49
part in easing some of those relationships becoming the stick to this um you know new regulatory framework but
12:56
again you know I wish I could say I knew more about how that was going to look operationally and I just don’t and I think we’ll know more over the next yeah
13:02
that’s good perspective I mean I think no one has a true crystal ball all for for what’s going to happen and
13:08
especially when it comes to legislation I feel like anytime you’re dealing with anything that’s um that’s kind of based in the government or a legislative body
13:14
you you kind of are somewhat waiting in the wind because it could be something that’s high on someone’s agenda and that
13:21
the next year is uh is largely enforced or it could be something that’s slightly lower and kind of has a longer Runway
13:27
before there’s some strict enforcement you know
13:32
well I was just going to say and there’s you know as we’re all aware there’s kind of these regular
13:38
government processes that are interrupting this so we just had a changeover from Administration you know
13:44
recently and we’re about to have another election and sometimes it’s unclear how
13:49
um you know a new health and human services department will you know what they will look like in terms of
13:55
enforcing this and certainly we’ve seen in past in the past decade some fluctuations in terms of how strict
14:01
they’ll be and for some of you these other programs and I think that’s just the case with the whole Federal level
14:06
that’s very true there’s definitely a natural fluctuation between different different parties and different bodies that are kind of managing those areas so
14:13
you know without going too heavy on the crystal ball and predictions if you were
14:18
going to you know if you were talking to a center right now on kind of top three things they should prepare for or maybe
14:24
you should expect going into 2023 with regards to the no surprises act what are
14:30
those top three things you would tell them to be thinking about or preparing for
14:36
yeah I think what I said earlier that we’re just at the start and this is just going to expand is something that’s
14:42
really important for example the good faith estimates that we’ve been talking about right now
14:48
those are only applying to uninsured or self-pay patients so a small subset of
14:54
patients in an ASC might see and so I think maybe aacs haven’t had to do very
14:59
many of them or haven’t had to compile this many estimates but I mean we’ve already seen a request for information
15:04
in the past month from the federal government about expanding the good faith estimate requirement to insured
15:09
patients so if you’re not set on the good faith estimates now while it’s just a smaller subset you’re probably going
15:16
to be behind the ball once that expands in the future to all patients right insured patients as well and you know I
15:22
don’t know how fast it’s going to happen it could happen in 2023 as I said it’s just a request for information at this
15:28
point we haven’t seen any actual rulemaking but it’s probably good to start thinking about those things the
15:35
second thing I would say is those relationships um we had already mentioned kind of
15:41
third-party you know anesthesiology pathology building those relationships and making sure that there’s good
15:47
communication those are going to be essential because right now there’s as I mentioned they’re
15:53
not really enforcing all of these costs making sure all the costs are accumulated for an estimate right now
15:58
but those will be enforced in the future at some point um so it’ll be important to to have that
16:05
relationship and I think building on that just any any way that you can build a process that makes it easier for your
16:12
Center again ASCS are in hospitals there are I’m sure some that are big multi-or
16:17
facilities that have dedicated staff that can handle this but if you’re an independent one or two or single
16:23
specialty facility um yeah it might be good to start thinking about how these processes are going to work you know you can automate
16:30
it I know HST for example has a partnership or has a technology solution
16:35
that can help with estimates I’m not saying that has to be yours but maybe that can be something that can help you
16:41
along the way thinking about those things to make your life easier now is
16:46
going to be really crucial just because it’s going it’s only going yeah that that’s very true and if I’m if I’m hearing you kind of just recapping those
16:52
those three things you mentioned there so one is being prepared from a good faith estimate standpoint two is having
16:59
those relationships in place and kind of making sure you’re coordinated in that regard and then three is planning around
17:06
the processes and maybe those processes are enabled by technology but having the processes in place to make sure you’re
17:12
able to facilitate that um is that an effective recap on that yeah I think that was awesome yeah
17:18
taking the mental notes you’re you’re given all the The Good the good stuff there I’m just trying to keep up so awesome okay you know you hinted at this
17:25
a little earlier and this is probably one of the the juicier parts of it that people have probably been seeing some
17:30
headlines on so you know with the the different Texas hospitals who have kind
17:36
of pushed back on some of the the no surprises act um there’s been a lot of kind of legal
17:42
court cases that have been in place and they’ve been filing lawsuits both at a state and a federal level with regards
17:48
to this you know do you anticipate that you know what’s happening with hospitals to be something that we can kind of
17:54
start to think or see um as a parallel for what might end up happening with ASCS as we go into this
18:01
next year I don’t really think the court cases the
18:07
legal cases around this law are going to spread to the AIC industry as much
18:13
um certainly there may be some action but at least in my understanding a lot of
18:19
the court cases so far have been about the dispute resolution process so
18:25
basically when a provider an out of network provider and a payer are
18:30
disputing reimbursement right because the law says a patient can only pay this much and that generally will leave an
18:37
out-of-network provider and a payer in this kind of limbo without getting too deep into it you
18:43
know the government set up this process that is supposed to adjudicate these disputes between providers and payers
18:49
and basically said at the center of this process is something called the qualified payment amount the qpa which
18:55
is a median in network rate for your geographic area which sounds reasonable but you can think in practice may have
19:03
some purpose incentives in the sense that you know if a payer for example knows that their starting point for all
19:12
arbitration is going to be their Network rate and they don’t really have an incentive to make that a high rate or to
19:17
keep positions whatsoever so what we’ve been seeing and this continues to happen actually is that local payers will
19:25
look you know basically threaten contract termination to cover providers or lower their Network rates
19:31
significantly understanding that there’s this process being set up that makes their meeting in the work rate you know
19:38
basically the starting point for all these negotiations it’s it’s a tough situation again I
19:44
don’t necessarily want to burden ASCS with too much of this because I don’t think ASCS will be that subject to some
19:50
of these disputes certainly the Physicians who work in ASC as well but for right now one thing that’s important
19:57
for ASCS to note is like if you’re an in-network facility and you contract without a network providers
20:03
you will have some responsibility if you’re an out of network agency you’re not covered by this law whatsoever the
20:10
law does not contemplate how different facilities elective procedures and how to network facilities so if you’re out
20:16
of network with a patient this law doesn’t make any difference to your interaction um so I think you know it’s good it’s
20:24
good to keep an eye on these court cases on some of the legal drama that’s happening but it may not be as applicable to the ASC industry okay it’s
20:30
good to note and I think that that’s probably a good thing for us I think the the complexities from a legal standpoint
20:37
and court case standpoint obviously make it harder for for you know all parties involved to be able to to move forward
20:42
in an effective way but great call outs there in terms of kind of the some of the misalignments on the incentives
20:47
between the various players in the industry so you know as we’re kind of thinking about some of the next steps
20:53
and some of the the opportunities for surgery centers going into 2023 I know you mentioned that uh there’s different
20:59
resources that they can take advantage of and you know I I know you ask us whole kind of publishes a ton of
21:06
different resources but you know are there any key things you would say that surgery centers and any of our listeners
21:12
should maybe go to as great resources with regards to the no surprises Act
21:18
yeah I think for now there’s a few things that they that centers can really take advantage of um one is that as part of the law
21:26
centers are required to disclose to patients protection is offered under the law to them under you know surprise
21:32
billing regulations and the disclosures have a lot of requirements in terms of what the font is like and what language
21:39
it’s presented in and what information has to be applied and it sounds like a lot but there are model forums online so
21:45
you don’t have to necessarily create this by yourself you can just go to the CMS website and or the ask a website we
21:51
posted it there and pull down this form and that can be your status that can satisfy your requirement for a
21:57
disclosure to the patients similar you know this disclosure has to be put on your website you know in your
22:04
physical facility so you can make that a lot easier if you use some of the resources that are there there’s also
22:10
model forms for good faith estimates as well as a clear outlining of all the data elements that need to be included
22:16
in that those things can really help you you don’t need to create these processes by yourself and I’m hoping that as this
22:23
law expands you know there will be more of those things certainly I think even though the law is large and complex and
22:30
confusing CMS has seemed to be in good faith and offering as many resources
22:36
FAQs webinars slide decks as they can so there’s actually maybe too many
22:41
resources happening right now um but I think if you’re thinking about oh there’s this for my need or I’m not
22:47
sure what the language is for this it’s probably out there it’s probably already been formatted for you and you you just
22:53
need to assign it awesome well that’s super helpful maybe what we can do is I will talk to our show producers and try
22:59
and get them to put a couple of those links that you mentioned there into some of the show notes and and we’ll also
23:04
share it across social as well so people have quick access to that uh you know as
23:09
we kind of wrap up our episode today um you know one of the things that we do every week with our guest is we ask them
23:17
you know what is one thing our listeners can do this week to improve their
23:22
Surgery Center doesn’t have to really related to no surprises act just what is one thing they can do to improve their Surgery Center this week
23:30
yeah I love this question and I honestly cannot wait to hear some of the responses you hear from future guests
23:36
because I’m sure it’s just going to be if you compile all these answers it’s just going to be great information Francis
23:42
one thing that I was thinking about that I’m not sure is possible in a week but I think can be started in a week was to
23:48
just be an advocate for your Center you know we still hear on the local level the state level the national level a lot
23:55
of not just uncertainty but people who don’t know about ASCS in particular you know and the advantages that they can
24:01
provide to patients in terms of better patient experience lower costs all of those things that we in the industry
24:07
kind of inherently understand from working here so I think if you can Advocate a little on behalf of your
24:12
Center on behalf you know that Advocates on behalf of the industry as well and that could mean a little social media it
24:18
could mean some volunteer work it could mean giving a lawmaker an official a
24:23
tour of your facility so they see you know you’re not just some random facility you’re a state of the art you know Center that has all the things that
24:30
you might expect to have these procedures done safely I think those things will go a long way and hopefully
24:36
as we kind of build the understanding of the ASE industry at the local and at the national level we’ll get more policies
24:42
that are are favorable to us thank you I love that I think you know one of the things I always talk about maybe this is the you know I used to be a product
24:48
manager so this might be the product manager in me but anytime people can be an advocate or an evangelist for the
24:54
places that they work or the products they work on or you know in many cases for us you know with the patients they
25:00
work with you know that is a massive opportunity so I’m I’m super aligned with that
25:05
um that’s a great one there I think that’s a nugget that’ll go really far you know Alex I have really enjoyed this episode I think we covered some great
25:12
things we got some great nuggets in terms of where the industry is today what we can expect going into 2023 what
25:19
are some of those great resources that people have access to so you provided a ton for our guests where can people find
25:25
you if they want to you know hear more from you or uh see any of the content that you’re sharing um or what’s the
25:32
best place for people to to hear more from you yeah so I do a lot of work with ascan
25:38
right and and pushing out advocacy or educational resources
25:44
um I’m not sure if we’ll be able to share my email but I’m always happy to answer questions and I would say if
25:49
you’re not an ask a member we provide a lot of great resources some of that can be operational in terms of your Medicare
25:54
billing some of that can be keeping up with no surprises act and you know I write for our print magazine and our
26:01
online magazine about these topics every month so um you can certainly find me on the ask website all over our federal regulations
26:08
pages and then Focus Magazine and if if I can I’ll share my email as well so people can reach out directly love it
26:14
well thank you so much for your time Alex this has been a great episode and we we look forward to hopefully having
26:19
you on the podcast again sometime soon thanks Rafael
26:25
[Music] as always it has been a busy week in
26:30
healthcare so let’s Jump Right In as we know nurses are leaving their jobs at higher rates in this country has seen
26:37
in a long time that’s not new for anybody Forbes published an article recently
26:42
titled how to ensure your nurses stick around through the great resignation
26:48
and I feel like every time I read one of these articles as I’m sure you’re all in the same boat I’m looking for something
26:54
new something that is tangible and could actually be effective this article is
26:59
pretty good and there were two tips that I thought were worth sharing and I promise you that neither of them have
27:05
anything to do with free food um tip one is to look at different Talent Solutions and staffing agencies
27:13
maybe you’ve looked at them in the past um but it it might be worth exploring again while it might not always be the
27:20
most economical solution if you can fill in some gaps and reduce the need for double shifts and offer flexibility it
27:27
will hopefully stop your most tenored staff at least from leaving and let them know that you know
27:34
that they need help and and you’re trying to find solutions for them and tip two is to change or get rid of
27:41
systems that just aren’t working for your nurses any longer and I feel like all the time we’re talking about you
27:48
know improving your processes on a day-to-day basis but I think what’s different about this tip is that you’re
27:54
looking at it from the nurse’s perspective what is not working for them anymore and no one can spot a process
28:01
Improvement opportunity better than a nurse can When leaders take feedback from nurses on what can be improved not
28:09
only does do the processes themselves become optimized but the nurses feel like their voices matter and that’s
28:16
what’s key here so it’s really a win-win for the business side of the house and also the clinical side
28:22
so you can set up a committee or a monthly meeting or have one-on-one meetings with all of your nurses to
28:28
collect this valuable feedback and make sure you’re doing it in a way where your nurses are nurses are comfortable
28:33
sharing um and then not only do you need to take their feedback but you need to be extremely transparent on if you plan to
28:40
use it if not why and if you do when
28:46
Second Story here uh Becker’s ASC asked three Surgery Center leaders to look
28:52
back at 2022 and share the smartest moves they made this year I thought that
28:57
was a really interesting way to frame the question as I was reading this article I was
29:02
actually struck by how many ASCS I’ve heard express interest in actually doing
29:08
some of these things and seeing the benefits of it but aren’t quite sure about taking that leap so I thought this
29:15
would be a really good recap to share just in case anyone needed some inspiration to get started or if you’ve
29:20
been looking for your sign here is your sign um one admin in Texas said her smartest
29:27
move was actually building and relocating to a new Surgery Center now I know that’s not an option for
29:32
everybody um but it is on the table for some and no further details were shared but I can’t imagine this was a huge
29:39
undertaking and it sounds like it paid off in one way or another
29:44
a second admin in Colorado shared that they went all in on investing in their nurses so this actually really ties back
29:51
to our first story too we all know how critical Staffing is right now um and this admin in Colorado shared two
29:59
really great ideas one for staff retention and one for staff satisfaction
30:04
um first they went ahead and created a longevity incentive for all staff so
30:11
obviously short-term Solutions are you need to get people in the door right we need to hire
30:17
people immediately but keeping the good ones and keeping the ones who want to stay there
30:23
um can actually be done by this long longevity incentive which I thought was really cool
30:30
um and then second they ensured that Physicians would have the last patient in the pacu by 3 15 PM so that allows
30:39
their staff to leave at a reasonable hour and enjoy a better quality of life um and have a better work-life balance
30:45
and that’s what touches on the staff satisfaction so um just to recap longevity incentive and
30:53
um closing down in a reasonable hour and sticking to it lastly the third admin in California
30:59
said their smartest move in 2022 was implementing an EHR and Outsourcing
31:04
their billing both of those changes had huge impacts on their business by adding visibility and analytics in a way they
31:11
didn’t have before so if you’ve been considering either of those things or any of those things listed might be good
31:18
to to kind of take that first step our third story Advocates are working
31:25
hard to increase the number of Latino Physicians and insurgents so according
31:31
to NBC News and just to kind of give you some numbers here Latinos account for only seven percent of the overall
31:39
physician and surgeon Workforce and at the same time according to the latest 2020 census numbers
31:46
almost 20 percent of Americans are Latino so there’s a pretty significant
31:52
Gap there that needs closing it’s so important that there’s a proper
31:58
balance and representation at all levels but this disparity is also doing patients a huge disservice
32:06
um Studies have shown repeatedly that when a physician speaks the same native language as their patient and they’re
32:12
able to relate to the cultural experiences of their patient they are more likely to have better outcomes and
32:19
of course thinking about the patient first you can understand why this is so
32:24
important there’s just that added sense of safety and comfort and understanding
32:30
especially when it comes to high stress situations like have like your health and having surgery
32:36
um so that’s not the only benefit and aside from all the other ones um if you put yourself in your patient’s
32:43
shoes you’d understand why it’s important that and we should all be doing something about this
32:49
since California does have the largest Latino population a lot of advocacy groups are planning to start there and
32:56
then planning to expand a few that are doing amazing work in this area right now are the California medicine Scholars
33:03
the alliance and mentorship and the national Hispanic Medical Association so
33:09
I recommend checking out any of those and I’m sure there are um others that are also working to increase the number
33:15
of Latino Physicians and surgeons and to end our new segment on a positive
33:21
note people shared a story about an orthopedic technician in California who
33:28
goes out of his way to customize the casts of his young patients so he takes
33:34
the time to draw their favorite cartoon characters sports teams whatever they want onto their casts
33:41
and as you can imagine the kids absolutely love it and are proud to show off their cast instead of being
33:46
embarrassed or feeling different by them um and by now he said he’s painted over
33:51
a thousand casts and if you head to the episode notes of this podcast episode you’ll see the people article and I
33:58
promise you it’s worth checking these pictures out they’re super cool he’s really really talented
34:05
and that news story officially wraps up this week’s podcast thank you as always for spending a few minutes of your week
34:12
with us make sure you subscribe or leave a review on whichever platform you’re listening from we really appreciate it
34:18
and I hope you have a great day and we’ll see you again next week
34:24
[Music] why are you keeping me
Don’t miss out on the good stuff – Subscribe to HST’s Blog & Podcast!
Every month we’ll email you our newest podcast episodes and articles. No fluff – just helpful content delivered right to your inbox.