This Week in Surgery Centers: Highlight Reel – What is one thing you can do this week to improve your Surgery Center?

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

Over the last three months, we have had seven amazing ASC leaders on our podcast.

At the end of every discussion, we always ask, “What is one thing our listeners can do this week to improve their surgery centers?” We took all seven of their answers and turned them into this week’s episode.

Topics range from interoperability to finding a strategic partner to profitability and so much more. We hope everyone enjoys this round-up, and a huge thank you to our featured guests:

➡️ Joan Dentler
➡️ Michael Powers
➡️ Angela Mattioda
➡️ Matt Kraemer PT, DPT, FACHE
➡️ Maura Dent Cash
➡️ J. Blake Peart, CMAA
➡️ Erik Sunset

Find the full episode on Apple Podcasts, Spotify, or YouTube to hear all the details.

0:00
welcome to this week in surgery centers
0:03
if you’re in the ASC industry then
0:05
you’re in the right place every week
0:08
we’ll start the episode off by sharing
0:10
an interesting conversation we had with
0:11
our featured guest and then we’ll close
0:13
the episode by recapping the latest news
0:15
impacting surgery centers we’re excited
0:18
to share with you what we have so let’s
0:20
get started and see what the industry’s
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been up to
0:23
[Music]
0:27
hi everyone for today’s episode we are
0:30
going to change it up a bit from our
0:32
usual format and agenda there will be no
0:34
guest interview and no news but instead
0:37
a highlight reel of all the great advice
0:39
our most recent guests have shared over
0:42
the last three months we have had nine
0:44
amazing ASC leaders on our podcast and
0:47
at the end of every discussion we always
0:49
ask them what is one thing our listeners
0:52
can do this week to improve so we took
0:54
all nine of their answers and turned
0:56
them into this week’s recap episode
0:59
topics range from interoperability to
1:02
finding a strategic partner to
1:04
profitability and so much more this is
1:07
one of my favorite episodes that we do
1:09
every quarter so I hope you all enjoy
1:12
what we have for you today and here’s a
1:14
Roundup of things you can do this week
1:16
to improve your surgery center
1:20
[Music]
1:23
um you know one thing because we do work
1:25
with a lot of existing centers that are
1:27
like I said
1:29
maybe thinking about getting acquired in
1:31
a joint venture is I would always say
1:33
it’s sort of like when you have somebody
1:34
come into your house
1:37
and you know they see the dirt and the
1:39
crevices or they see hey if you move
1:41
that chair to that other side of the
1:42
room this room would look a lot better
1:45
um we often say you know invite somebody
1:48
in and when I say somebody somebody who
1:50
knows Healthcare is I mean no surgery
1:52
centers and have them sort of look at
1:55
your operations from top to bottom and
1:57
see if they have any suggestions and
2:00
um because sometimes they pick stuff up
2:02
that the people that are there day in
2:04
and day out don’t notice and I’m not
2:06
talking about just physical things even
2:08
just operations you can watch and say
2:10
why are people you know looks like
2:12
you’re doing double work right there so
2:15
um that’s something that I would say is
2:16
maybe find another administrative ASA
2:18
administrator in the area or
2:21
um you know somebody maybe somebody from
2:23
the hospital who maybe knows things and
2:26
just say will you just walk through and
2:28
just give us you know see if you see
2:30
anything you think we would should
2:31
change
2:33
um and don’t be threatened by that is
2:35
what I would say because most of of the
2:37
time you can pick up at least one or two
2:39
pretty easy to implement ideas from
2:42
those activities
2:44
yeah that’s that’s good advice I think
2:47
oftentimes we start doing things a
2:49
certain way and running any kind of
2:51
business or process right and that just
2:53
becomes the way we do it we don’t
2:55
necessarily go in from that mindset of
2:57
okay let me understand this all with a
2:59
fresh set of eyes and what could you
3:01
tweak or improve and so right I think
3:03
there’s you know I think people in the
3:04
ASC industry in general need to remember
3:06
that first ASC opened back in 1960 a lot
3:10
of people working in ASCS weren’t even
3:11
born back then and so
3:14
um I think that the longer an ASE has
3:18
been open the more likely you’re going
3:20
to see that where people just well this
3:21
is the way we’ve always done it you know
3:23
I don’t know why we do it this way but
3:24
this is the way they trained me to do it
3:26
when I started 10 years ago and we’ve
3:28
always done it this way and
3:31
um so most of those are probably great
3:33
things and don’t change them but usually
3:35
you can find one or two time saving or
3:39
money saving ideas when you when you
3:42
have a fresh pair of eyes look at
3:43
operate for you for me is
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um
3:49
number one is
3:53
for us the the focus it’s hard to find
3:57
staff Staffing shortages is a big deal
4:00
so ensuring that you’re competitive on
4:03
compensation 401K matching
4:07
um you know things that you can do you
4:09
could do small things uh just last week
4:12
we brought in a coffee truck and paid
4:15
um for everybody to get a coffee or a
4:17
hot chocolate or whatever just as far as
4:20
celebrate some of the um
4:22
things that we’ve accomplished I think
4:25
from an administrative side to Surgery
4:27
Center side obviously
4:30
if you want to be extremely successful
4:33
work in your or schedule
4:35
maximum knowing what your most
4:38
profitable cases are
4:40
maximizing that knowing your fastest
4:43
Physicians giving them two rooms to flip
4:46
back and forth work in the or schedule
4:49
and such that you’re doing cases that
4:51
make you the most money that you don’t
4:53
have gaps and that you’re doing as many
4:56
cases that you can per day I think
4:58
that’s
4:59
foundational number two is we work and
5:03
we rework every three years every
5:06
contract that we have to get fee
5:09
increases yep so I think staying on top
5:11
of that and we’re and and again you got
5:14
to know your business and if you don’t
5:16
know what your most profitable and your
5:19
most common cases are
5:21
then um you have to very closely watch
5:25
the contracts you negotiate because they
5:28
will sort of want to stay budget neutral
5:31
but what you want is you want the cases
5:33
that you do the most of
5:36
to make the highest profit off of sure
5:39
so having that data and knowing your
5:41
business and then lastly is
5:44
everything that you can to control your
5:47
expenses so I mean you know the bottom
5:51
line is you got to have happy employees
5:52
happy employees will make happy
5:54
positions and happy patients
5:58
uh and then if you want to be profitable
6:00
is knowing your business working your or
6:03
schedule
6:04
increasing your revenues and decreasing
6:07
your expenses I mean that’s it’s
6:09
basically what I call your very basics
6:12
in football of just blocking and
6:14
tackling really well every day in and
6:17
out
6:18
and I think staying connected you know
6:20
through your associations through your
6:22
state or the national associations
6:24
having other administrators or other
6:27
individuals that you network with and
6:29
talk with I I find very invaluable uh
6:33
well I would say keeping it related to
6:37
this specific topic
6:40
strong policies around collecting up
6:44
front
6:46
um having the ability to give the
6:48
patients options whether or not it be
6:51
funding or payment plans uh financial
6:56
hardship whatever those policies may be
7:00
but do your patients a favor give them a
7:05
professional and as close as accurate
7:08
estimation
7:10
up front collect that estimation and
7:14
that just helps the patient I know if
7:16
I’m going in to have surgery I want to
7:18
know how much I’m going to be out of
7:21
pocket
7:22
and I expect to pay that up front
7:25
right and it should be you know the same
7:27
across the board for for other you know
7:29
other centers just focus on patient
7:32
satisfaction and providing them what
7:35
they need so that they can pay up front
7:37
and then that will help reduce Revenue
7:39
leakage on the back end yeah it makes
7:42
total sense so give them an accurate
7:43
estimate up front
7:44
and then and then collect it by what’s
7:47
the best practice should centers be
7:49
asking their patients to pay by data
7:52
service
7:56
you know at the time of service is okay
8:00
uh if they don’t pay then at least have
8:03
that pre-service Financial call
8:07
uh if the you know to tell the patient
8:09
what they owe and what is what is the
8:12
expectation you know provide them with a
8:14
link to pay online through credit card
8:16
is the patient saying they’ll bring a
8:18
check with them on the date of service
8:21
did you set up a payment plan uh and if
8:25
you do set up a payment plan set up an
8:27
auto payment plan
8:29
don’t don’t uh just make a note to say
8:32
for the RCM team on the back end to set
8:36
up a payment plan depending on whatever
8:38
the balance is on the back ends get
8:40
those payment plans set up up front yep
8:43
and it seems that seems like good good
8:46
practice and and common sense
8:50
um but there’s still a lot of centers
8:51
that don’t do that they don’t require
8:52
their patients to even pay at data
8:55
service do you have a sense of why what
8:57
are the common objections
8:59
the most the most common reason for
9:04
centers that I have experience with it’s
9:06
their demographics
9:08
it always comes down to demographics
9:09
it’s the types of of patients it could
9:12
be Medicaid patients or an older
9:16
demographic uh more strained financially
9:21
demographic uh that they tend to be a
9:25
little bit more forgiving uh the other
9:28
reason would be not having those
9:31
policies not reviewing it not kpis key
9:36
perform key performance metrics aren’t
9:39
just for on the back end are Collections
9:42
and volume and charges and AR it also
9:46
should include your upfront collections
9:49
uh you know those types of uh kpis are
9:52
really critical too so they should
9:54
include those
9:55
so sometimes it’s just kind of a lack of
9:57
visibility
9:59
you know kind of into the ability to
10:01
focus on other things uh within the
10:04
surgery center uh you know not getting
10:07
feedback
10:08
uh from the team doing the RCM could be
10:11
also a reason that they don’t realize
10:13
you know that there is more urgency to
10:17
uh improving those processes up front
10:20
um you know just the easy thing to say
10:22
is you know just start looking at these
10:24
things you know start digging into these
10:26
um these details and start kind of
10:27
Performing your own root cause analysis
10:30
um you know we started off by just
10:31
starting to create a spreadsheet I mean
10:33
it was one simple spreadsheet where we
10:35
started to look at case types um by
10:38
Provider by times
10:41
um the the cost of supplies used in
10:43
those cases and then based on our
10:45
general contract averages what we would
10:48
expect to see from a reimbursement
10:49
perspective and then as we started to
10:52
build that um that list out
10:54
um started to notice some Trends you
10:56
know and that might have been a trend by
10:57
case or by a vendor or by a contracted
11:00
payer or provider and then have some
11:03
conversations around that you know um
11:04
this case becomes viable where it might
11:07
not be viable today it might I become
11:09
viable if we’re able to reduce the case
11:10
Time by 10 minutes and what are the
11:13
things that we’re doing as part of our
11:15
pre-operative setup or our closing
11:17
process or our room turnover time in
11:20
order to shave off 10 minutes and if you
11:23
shave off 10 minutes and you save you
11:25
know 100 or a thousand dollars and all
11:28
of a sudden a potential loss on a Case
11:31
um is a gain and you now you can recruit
11:33
more and more of those cases not to
11:35
mention the byproduct typically when
11:37
you’re faster and more efficient is a
11:39
much happier surgeon you know happier
11:42
patient it’s less anesthesia it’s faster
11:44
recoveries and better outcomes
11:49
well if I’m sticking this topic I would
11:52
have to say to have policies and
11:55
procedures that are not just for surveys
11:58
and are not just an exercise on paper
12:01
um you don’t want to set yourself up and
12:04
your team up for failure so sitting down
12:06
with your team and listening to them
12:08
having that heart to heart and not just
12:11
about EHR policies if they say to you
12:13
this policy this procedure is not what
12:17
we’re doing we can’t do this we don’t
12:19
have the time to boost the resources to
12:22
do this we don’t have the the
12:25
environment to do this in change your
12:28
policies make sure that your policies
12:30
are
12:32
yes save for the patient absolutely
12:35
geared towards positive outcomes but
12:38
also they need to be able to be followed
12:40
by the staff that are expected to
12:44
deliver care to the patients and or
12:47
bills to the patient and or medical
12:50
records for those patients
12:52
they have to be able to follow those
12:54
policies and if you can have a
12:55
heart-to-heart with your staff that says
12:57
hey you guys look at these 10 policies
12:59
and tell me if we’re not really doing
13:02
any of this stuff because if you’re not
13:04
really doing it
13:06
then it’s really not a policy and
13:08
procedure
13:10
that’s uh that’s what I would recommend
13:13
to everybody because we are all about
13:16
keeping our staff happy keeping them in
13:20
their jobs that they’re doing and what
13:23
what can better let these people know
13:26
that they’re valued than hearing them
13:29
and listening to them and making the
13:31
changes that make their job easier
13:34
well I think you know first of all as a
13:37
former you know clinician myself and and
13:40
I I think it’s always you know Do no
13:42
harm uh make sure you’re always working
13:45
you know to provide the best services
13:48
for your patient uh you’re monitoring uh
13:52
compliance risk you know you’re
13:54
addressing wrongs you’re addressing all
13:56
the things that need to be done
13:58
if you know protect your staff that are
14:01
your great staff that you may have you
14:03
know professional uh nurses techs are
14:07
worth their weight in gold as we all
14:09
know right now uh you know take care of
14:12
your staff keep them there work in a
14:14
bunch of contract people and it not that
14:16
we we’ve all done it but it’s not the
14:18
same thing as having people who you know
14:19
you rely on the hentai
14:22
um I think that’s that’s the two factors
14:24
so if you’re taking care of your
14:25
patients you’re doing everything right
14:27
you’re forming everything’s safe I do
14:29
truly believe a lot of the revenue and
14:32
things will come and it’s just keeping
14:35
mitigating that process and
14:37
understanding it don’t you know get what
14:39
you need to get
14:42
um buy what you need to enhance your
14:43
business
14:44
and if you find yourself in a position
14:46
where as a position that I I have a
14:50
harder time getting in the OR than I did
14:53
before
14:54
then again start thinking about how you
14:56
can change that
14:58
and sometimes it can be some internal
14:59
processes and sometimes it can be what
15:01
we we started our topic about is maybe I
15:04
need to find a partner to take some of
15:06
these operational and HR components and
15:09
some of the things I find myself being
15:11
entangled in every day off the table so
15:14
I can spend more time doing what I want
15:16
to yeah 15 20 years of school to do and
15:19
focus on that and I think that to me is
15:22
just a factor of quality of life and it
15:25
also helps
15:27
mitigate like I said a lot of the
15:29
pressures that everybody has to go
15:31
through when you’re running these
15:32
surgery centers that are very
15:33
complicated and there’s a lot of
15:35
processes to get them right have someone
15:37
else take some of that burden off of you
15:39
and I you know and look a happier half
15:42
your surgeon is a happier Center so you
15:44
know I think sometimes that sometimes
15:45
the best combination
15:48
so we’ve talked about ways technology
15:50
can improve your surgery center and what
15:53
I would do my recommendations here
15:55
listeners would be to list out the
15:58
processes that you’re managing manually
16:00
something that you’d call the old way
16:02
something that isn’t technology enabled
16:05
let’s be clear not everything has to be
16:07
technology enabled to be good but you
16:09
end up with a process that you can
16:10
control and manage much better with
16:12
technology so now that we’ve got that
16:13
caveat out of the way list all of your
16:16
processes you’re handling the old way
16:18
rank them in the order of the most
16:20
painful to the least painful that could
16:23
be time that could be cost that could
16:25
just be frustration with what it is that
16:27
you’re doing now
16:29
and this may be a somewhat self-serving
16:31
for both of us even Erica but it’s to
16:33
start shopping once you’ve identified
16:35
the key areas or the number one issue
16:38
that’s causing you pain at your ASC get
16:41
a cost benefit analysis together and
16:43
start talking to vendors
16:45
and the reason for that is that most
16:47
often than not anything that you can
16:49
purchase off the shelf that’s
16:51
commercially available will do better
16:53
for you than something that’s brewed
16:54
from home you end up with much better
16:56
support you end up with a community of
16:58
like-minded users to help you through
17:00
that process and then as you rinse and
17:02
repeat through that list of identifying
17:05
processes where it’s strictly manual or
17:08
it’s the old way and being able to
17:10
replace them with technology take that
17:12
to your board and say hey I think I’m on
17:14
to something here we can save x amount
17:16
of time per week or we’ll have this much
17:17
less waste if we look at technology
17:26
why are you keeping me
17:28
[Music]