Staffing: Selecting the Best Agency

Ep. 107: Mayte Rechani – Staffing: Selecting the Best Agency

Here’s what to expect on this week’s episode. 🎙️

Staffing agencies are becoming more common in the ASC world. Choosing the right one can make all the difference.

In part 1 of our 3-part series on Staffing Strategies, Mayte Rechani shares how ASCs can evaluate agencies, secure consistent coverage, and ensure staff fit seamlessly into their culture.

Key Takeaways:

✅ Look for transparency & flexibility – The right agency prioritizes your needs, not their agenda.
✅ Plan ahead for peak seasons – A good partner understands ASC cycles and helps secure coverage early.
✅ Set clear cancellation policies – Define expectations upfront to avoid confusion.
✅ Prioritize cultural fit – Interview candidates, even for per diem roles, to ensure they align with your team.

Want to hear the full discussion? Check out the episode now!

Episode Transcript

[00:00:00] Welcome to this week in Surgery Centers. If you are in the ASC industry, then you are in the right place every week. We’ll start the episode off by sharing an interesting conversation we had with our featured guest, and then we’ll close the episode by recapping the latest news impacting surgery centers.

We’re excited to share with you what we have, so let’s get started and see what the industry’s been up to. 

Erica: Hi, everyone. Here’s what you can expect on today’s episode. Today is the first episode of our three part series on staffing strategies for ASCs. Over the next few episodes, we’ll be diving into key staffing considerations that can help surgery centers build and maintain a strong workforce. It’s no secret that the healthcare industry is dealing with unprecedented staffing shortages right now, so I’m hopeful that everyone will be able to walk away from this series with some new ideas that you can use.

But today, specifically, we are kicking things off with Maite [00:01:00] Richani to discuss selecting the best agency. Many ASCs have not tapped into staffing agencies yet, so Maite will break down what to look for in an agency, how to ensure reliable coverage, and other key factors to consider.

Next week, we’ll be joined by Mark Henderson Leary to talk about building a sustainable culture, and we’ll wrap up the series the following week with Maddie Traylor, who will cover the differences between locum hires, contract, or permanent hires, and how to determine the best staffing approach for your ASC.

After my conversation today with Maite, we’ll switch to our Data Insights segment. HST released our annual State of the Industry report in September, which analyzed client data from 590 surgery centers. Today we’ll spend a few minutes breaking down how often outstanding patient bills are worked post data service and the implications that that has.

Hope everyone enjoys the episode, [00:02:00] and here’s what’s going on This Week in Surgery Centers. 

Mayte: Hi, Maite.

Welcome to the podcast. Hi, Erica. Thank you so much for having me.

Erica: Can you please share a little bit about yourself and your ASC experience?

Mayte: Sure. So I’m the executive director here at our staffing solutions for MedIHQ. I’ve been in our business for over nine years, and I’ve worked across the board the last three years I’ve been focused on ASCs.

Erica: Very cool. Thank you. And I’m super excited to have you on today to kick off our three part series that is all about staffing strategies. And today we’re really going to focus on using an agency. So set the landscape for us. How common is it for an ASC to use a staffing agency

Mayte: right now in the [00:03:00] post COVID world is becoming a lot more common.

Before it was not, you know, were very private and they had their own staff and agency is not something that they reached out to, but now their ASCs are really kind of recognizing the help that a staffing agency can provide short term and not long term or both, depending on what their needs are.

Erica: Sure.

And considering, you know, there’s kind of been that shift in the industry and maybe there’s surgery centers who are interested in looking for a staffing agency, but have never gone through that process before. What are some of the key qualities that they should be looking for when they are evaluating different agencies to choose from?

Mayte: They really should be looking for transparency someone who’s really going to be a partner and really focus on their needs versus pushing an agenda. For example, does an needs someone. Short term or long term, you know, what do they want? Do they [00:04:00] want. Specific interview parameters, do they want special credentialing?

It really becomes about working with the right partner who is going to make it. Easy for you. The point is to make it as easy as possible for the ASC administrators who are still busy because

Erica: ASCs move very quickly. Sure, so really the transparency and then seems like flexibility too, right? Just in terms of like, again, here’s what you need.

We can back back into that.

Mayte: 100%. So, not just about what they need is making sure that the ASC comes 1st. What their needs and wants are always paramount to the right agency.

Erica: Got it. And how can surgery centers kind of work with the work with agencies to guarantee consistent coverage? You know, we just went through December.

I know that’s always a crazy busy time. I saw a tick tock the other day that called it a deductible December, which I’ve never heard before. So especially during peak times and emergencies, how can they work [00:05:00] with the agency to make sure they have the coverage that they need?

Mayte: It really becomes is Again, I’m going to go back to who is the agency who is working with you that understands the cycles and says, you know, I know you’re about to get busy.

Like you said, it’s, you know, deductible December or FSA fund, you know, because your FSA funds are ending. So how do you have the right partner who understands the cycle? And says, I know you’re gonna need somebody for December, maybe even January. Let’s work on a six week contract. Let’s make it work. So you’re covered for that amount of time.

And you’re not worried about cost the rest of the year because you just needed someone for a very short amount of time. Sure.

Erica: What steps should an ASC take to make sure that agency staff assigned to them are properly credentialed and meet all compliance standards?

Mayte: That really, believe it or not, falls on the credentialing team director of operations of the agency because the right agency should be joint commission certified to make [00:06:00] sure that everything is up to standard.

Now, there are times that a credentialing is not necessarily needed, but the ASC has to decide, hey, I don’t need that to get them to start. And at the same time, a right credentialing specialist from the agency will vet every single candidate and will not let not them go in without being properly credentialed.

And again, there’s the minimum credential that the ASC needs, there’s the minimum that the agency requires, and it’s meeting in the middle and saying, Hey, you need them to start in a week and a half. This is our list. Tell me, do you need extra or do you need less? And again, that’s full transparency and it goes back to the partnership and communication.

Definitely. What about cancellation policies? How do those, how does that typically work? In the ASC world, it really, because of the census and the speed, Of the surgeries, it really should be hours worked, hours billed, hours paid. Very simple. And again, the right [00:07:00] partner will make that very clear to their supplier panel as well as the A SC.

And if the a SC says, listen, we’re going into the holidays, if we cancel, we’ll give them extra hours. That really needs to be decided beforehand. And the a SC needs to drive the bus, and then it’s the agencies. You know, they have to take that on and they have to clearly express that and explain that to their supplier partners and to the nurse.

I mean, it’s really clear. And again, clear is the most important thing. It will leave very little room for error and the ASC will be happy.

Erica: Sure, and with those, just with the cancellation policies, is it typically like, as long as, you know, it’s just top of mind for me because we just published our state of the industry report.

And I think we saw an average of 20 percent cases were canceled in an ASC setting and the majority of those are out of the surgery centers control, right? Patient, patient issues or misunderstandings, cancellations, [00:08:00] whatever is. So let’s say the morning of, You know, someone from the staffing agency shows up as planned, but that case has been canceled.

It was out of everybody’s control. Do you still, does he still typically give a stipend or is it, we’re just going to give you more hours?

Mayte: How does that really stipend? What it comes down to is the AC clearly communicates to the nurse. If they can get to her before she gets there, that’s always ideal. But if they’re there typically depends on the, because it’s either agreed upon beforehand, like, listen, we’ll give you a couple hours time and travel or you’re here.

We’ll give you whatever, whatever they decide on the set amount of hours. But all of these things are clearly communicated and written well, before a nurse, even steps foot in the so, in other words, all these issues are kind of preemptively handled ahead of time.

Erica: Love it. That makes sense. [00:09:00] Now, I imagine this next question is a big one.

How can you make sure that the staff that you’re being assigned kind of fits within the ASC’s culture?

Mayte: This is where we come in and, and we we’re really, we like to make sure we let the a SC know if, you know, it’s gonna be kind of a long-term assignment. When they come in for that interview or that team’s interview, this is your time to really identify like, are you gonna be?

And ask those tough questions. You have to remember, we’re not gonna be there with them and they’re gonna be part of your team. The good thing about if they know they wanna hire them outright later. This is where we really recommend why don’t you do a contract to perm maybe, you know, 4 weeks, 8 weeks and you can decide when someone because somebody could be a fantastic clinical fit.

They can have all the skills in the world, but cultural. They’re just not a fit for the team, you know, maybe there’s issues and again, having those parameters clearly identified before the nurse goes in is important because we can say to the agency. Remember, this is a [00:10:00] trial period. You need to, and it can end at any time and that’s.

That really is the key is the ASC having that trust in that agency. That’s going to really be their best partner and go back to that nurse and be like, unfortunately, you know what, this is not going to work. It is not a great fit. You know, X day will be your last day or today was your last day. Whatever the case may be.

Everything has to be very clearly communicated and that really at the end of the day, that is the best case scenario for the ASC. They are the happiest. And more importantly, it’s about patient outcomes and their team.

Erica: Definitely, and when you had mentioned an interview, is that with anybody that, like, let’s say the agency is like, okay, we’re sending Erica, you know, does the admin interview everybody before they get to they, you know, even if it’s a, like a per diem

Mayte: situation, 100%, they should always interview.

It is [00:11:00] always for my team. And I’ve made a very clear best practices. The nurse either has to have a phone screen or a team’s interview in the land of how you and I are speaking now. This is really what we advocate for, because you want to be able to have a bit of a sense of who is coming in. At the end of the day, ASEs are very family oriented.

They’re a family. They’re small. You want the right person to come to your house. That’s how I look at it. You want the right person to take care of your family, having, getting to know them. However, that long that teams meeting or phone screen may be. Some ASCs have asked for the person to come in face to face.

And maybe spend a couple hours there. So whatever the ASC wants to do is what we will push for and what we will demand.

Erica: Love it. And I’m sure physicians probably have a lot of feedback on who’s in the operating room with them and give feedback to, you know, whether it goes admin to agency, whatever it might [00:12:00] be, I would imagine they have some thoughts as well.

Mayte: 100 percent and not, you know, at the end of the, you know, there’s a difference between the nurses in the OR versus the nurses not in the OR because the nurses not in the OR may not necessarily have that constant interaction with the surgeons versus the nurse that is in and that is the most important interview.

You want to make sure that that nurse will be a good partner to the surgeon for that time. So typically the surgeon is. Either in that team’s interview, or, you know, they’re really are evaluating when they’re 1st there if they, you know, the admin loves them. Yes. We’re gonna have them come in. Let’s have them start.

You know, it could be day 3 and the surgeon. They’re just not a good fit for that surgeon, so they can either pivot and move them to a different surgery or at that time. Unfortunately, we just move on to the next candidate.

Erica: Sure, that makes sense. And what does the contract to hire potentially look [00:13:00] like?

Mayte: Contract to hire, so we’re going to send the ASC a few different profiles.

It’s never just one. Let them decide who they’re going to interview or bring in. And once they come in, essentially, for the term of that contract, they can decide this is the perfect fit all around and all in compassing perfect nurse, or they can decide, you know, what, there may be some remediation, but we’re willing to stick it out to the end of the contract.

And a couple of things can happen at the end of the contract. They’re going to say, this is wonderful. Let’s move on the higher, or they can say, you know what? We really needed her, but I think we just, we’re not going to have a need for her. Beyond this date, or it’s happened midway through the, we love her.

How do we move to hire her right now? You know, it’s almost like a fork in the road, depending on where the wants to drive and we’re just happy to facilitate that for them.

Erica: Yeah. Yeah. And do you find most of the people that work for you want that contract to hire or do they kind of like, [00:14:00] and I don’t want to say bopping around, but you know, they kind of like trying out different things.

Mayte: It depends on the nurse and I’m going to be really transparent with, in the sense, you know, a lot of us that have been doing this for a long time agency, we recognize when someone is just here for a good time. And not a long time, that’s my favorite phrase about it, by the way, so we do, we’ve gotten really good at recognizing that what we have found is in the post coven world.

Unfortunately, a lot of nurses that were in the or in the acute setting are really ready for that for that, you know, 5 days a week, census driven, not on call it, you know, it depends and you get a sense of that before we send them to the. So, not only is the ASC having that interview, we are relying on having those skills and reading over their resume and their cover letter and all those [00:15:00] things that help us make the right decision before we put them in front of the ASC.

So, it’s almost like a pre screen always, you know, there’s always checks in place.

Erica: Yeah,

Mayte: yeah. Perfect.

Erica: All right. Well, thank you so much for all of your great advice. I have one final question for you. We do this every week with our guests. What is one thing our listeners can do this week to improve their surgery centers?

Mayte: That’s a tough 1. I have 2 answers. I don’t know. I’m trying to decide. Okay, I’ll take 1. Okay I will say, while we are not a mind reader, we’re not a mind reader. If you recognize that you’re going to have an exceptional amount of surgeries in the coming weeks, try to be prepared because you cannot guarantee that one of your staff will not, you cannot guarantee that there [00:16:00] will not be an emergency.

Right? So, it’s better for me to be overly prepared at the same time that I don’t over promise, but, you know, changes can be made beforehand versus being not prepared. And then all of a sudden, everything is a fire. Right, understanding at the end of the day, the right agency partner is here to help you.

We’re not here to say, oh, you need to have someone for 13 weeks. Now, the right partner will say, listen, you only have a high census for 4 weeks. You don’t need to hire someone for 4 weeks and in curl that cost, let the agency take care of it. It’s 4 weeks. That person is guaranteed to be there. That’s why they’re signing that contract.

So, I guess, you know, be prepared and really rely on your agency, really rely, not even agency because it’s such an ugly word, rely on your partner because that’s what they’re there for. They’re there to work for you and with you. [00:17:00]

Erica: That is great advice. Thank you so much for coming on today. We really appreciate it.

Thanks, Erica.  

HST Pathways released an updated version of our state of the industry report in September, highlighting best practices, key process steps, and KPIs for every step of the patient journey and for nearly every recurring administrative duty. Most importantly, using our own unique dataset from our clients, we were able to extract data points so that anyone in the industry could compare themselves to their peers.

Two quick disclaimers, we only pulled data from clients who gave us permission and we omitted any extreme outliers. So today we’re going to take a look at patient bills that go unworked post data service. This is an issue that directly impacts cash flow, and if not managed properly, can put a serious strain on a surgery center’s revenue cycle.

So let’s start with what we mean by unworked bills. In this case, we’re talking about patient accounts that [00:18:00] have had no activity, so no follow up, no outreach, since the date of service. The longer these bills go unworked, the harder they are to collect. Here’s how the typical working cadence breaks down.

Cases that are 1 to 90 years old. Oops.

Cases that are 1 to 90 days old, on average, are worked once a month. Cases that are 90 to 150 days old, on average, are worked once every two months. And then cases that are 150 plus days old, on average, are worked every two and a half months. This tells us very clearly that as patient bills age, follow up efforts decrease.

But that doesn’t mean they should fall off the radar. When accounts go unworked for too long, the likelihood of successful collection drops, leading to increased write offs, more work for the collections team, and a higher percentage of delinquent accounts. Now, what can [00:19:00] ASCs do to keep patient bills from going unworked and ensure they’re staying on top of collections?

Here’s some key strategies. The first is to prioritize high value accounts. So, not all accounts are created equal. Large balances that go unworked have the biggest impact on cash flow, so centers should implement a system that flags high dollar accounts for immediate follow up. This ensures the most valuable accounts are worked first, maximizing that revenue collection.

The second tip is to leverage automated reminders. Automation is a game changer in preventing unworked bills. An automated system can track when a payment is missed and trigger reminders at specific intervals, reducing the manual workload for your team while ensuring no account goes unworked for long.

And those automated reminders can be internal to staff or external to patients. The third is to offer flexible payment options, giving patients multiple ways to pay. So online via an app or through installment [00:20:00] plans makes it easier for them to engage with their bills and reduces payment delays. The more convenient you make it, the less likely bills, uh, are to remain unworked.

It’s, let’s say a patient owes you 1, 000. It’s certainly much better for your surgery center to collect that 1, 000 over the course of a year than, let’s say, not at all, or maybe just 100. The fourth tip is to incorporate early intervention with phone calls. Automated reminders are great, but personal phone calls can make a significant difference.

Calling patients early can help resolve any issues, whether it’s an insurance denial, confusion over charges, or a simple misunderstanding that might prevent, that might be preventing payment. And the fifth and final tip, outsource RCM support if you need it. If your team is struggling to keep up with unworked bills, outsourcing RCM support can be a very smart and effective solution.

An experienced RCM partner can take on billing follow ups and [00:21:00] collections, allowing your team to focus on higher priority tasks and making sure accounts don’t slip through the cracks. At the end of the day, though, unworked bills don’t just delay cashflow. They make collections harder, increase the risk of bad debt, and put unnecessary strain on your revenue cycle.

And by prioritizing those high value accounts, automating reminders, offering flexible payment options, and implementing early intervention strategies, you can stay ahead of these unworked bills and improve overall financial performance. If you’re interested in more data points and use cases, head to our website to check out the full state of the industry report to get your hands on even more data.

And that officially wraps up this week’s podcast. Thank you as always for spending a few minutes of your week with us. Make sure to subscribe or leave a review on whichever platform you’re listening from. I hope you have a great day and we will see you again next week.[00:22:00]