Joan Dentler – What to Know If You’re Considering a Hospital/Physician ASC Joint Venture | This Week in Surgery Centers
Here’s what to expect on this week’s episode. 🎙️
Joint ventures or hospital-owned ASCs are one of the fastest-growing partnerships right now.
Why? Outpatient environments are looking better than ever thanks to payer contracts, value-based care, high deductibles, new technology, improved anesthesia services, and more.
Joan Dentler is the Founder of Avanza Healthcare Strategies, and she is sharing why hospitals are taking an increased interest in ASCs, the challenges both parties will face, and how to achieve short and long-term success. Here are a few takeaways from the episode.
• For hospitals, remember that 50% of something is better than 0% of everything. You can’t consider a potential partnership with an ASC as strictly a money play, but instead, as the industry continues to favor outpatient procedures, it’s a strategy for long-term success.
• For ASCs, there are many scenarios where partnering with a hospital might be the best path forward. One example – if you have many senior partners looking to wind down or retire, it might be the perfect time to start looking at a hospital as a potential buyer.
• A partnership will not be successful without an aligned vision of what success looks like. Other factors include mutual risk tolerance, trust and respect, and constant, transparent communication.
Find the full episode on Apple Podcasts, Spotify, or YouTube to hear all the details.
Episode Transcript
0:00
welcome to this week in surgery centers if you’re in the ASC industry then
0:06
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 if you’re considering
0:33
a hospital physician ASC joint venture or just curious about learning more
0:38
about what that relationship could look like then this episode is for you Joan
0:43
dentler is the founder of avonza healthcare strategies and she’s sharing why hospitals are taking an increased
0:50
interest in ASCS the challenges both parties might face and how to achieve
0:55
both short and long-term term success in our news recap we’ll cover the ASC
1:01
landscape through numbers states that are capping travel nursing rates seven staff retention tips and of
1:08
course end the new segment with a positive story about a cancer pill that was approved in England and Wales
1:15
hope everyone enjoys the episode and here’s what’s going on this week in surgery centers
1:21
[Music] Joan welcome to the show
1:27
thank you happy to be here Gerald can you give us a quick overview of your background in the ASC industry
1:34
sure um well I kind of got into um by being hired by a hospital to
1:42
um sort of be a utility player for them and they were putting together a hospital physician joint venture at ASC
1:49
and this was back in 1996 and so it was a little bit of a baptism of fire
1:55
um since then I’ve worked for private consulting firms I did a little stint
2:01
with an ASE management company and in 2007
2:06
um along with a partner formed a company that was then called ASE strategies
2:12
later rebranded as a banza and with our goal being that we were
2:19
going to be a boutique consulting firm focusing primarily on hospitals that
2:25
wanted to get into the ASC space or large physician groups that hadn’t
2:31
already built ASCS and our model was really to work with them not as a
2:36
management company but more as they a fee for service advisor and work with
2:42
them through the whole process of either building an ASC or if they already had an ASC working with them on
2:50
um fine-tuning those operations uh for as long as that client needed us and then
2:57
in 2014 I rebranded the company avonza health
3:03
care strategies because we started getting requests for things in the outpatient space other than ases like
3:09
Imaging and infusion and some other services so um Avon’s in its current form started uh
3:17
in 2007 and then sort of expanded to take on more outpatient in around 2014.
3:24
so that’s and I’ve been so I’ve been in the ASC space ever since the late 90s
3:31
fantastic and you’ve got a great background for the topic that we wanted to hit on with you today which is really
3:37
this trend around hospitals doing joint ventures with ASCS and so from a high
3:43
level perspective join can you kind of help set the context for us what what what’s kind of the latest in this trend
3:49
of hospitals looking to partner with ASCS and what’s driving it
3:55
well you know it’s interesting to me because a lot of people consider this like a new trend and for those of us
4:00
they’re not many there are absolutely not many of us but for those of us that have been working in this space like I
4:06
said for 20 years almost um it doesn’t seem new at all but it has
4:13
definitely picked up steam and I think I think um the last statistics I saw was that
4:19
the joint ventures or hospital-owned ASCS in general are one of the fastest
4:24
growing groups and I really think that currently as we said in 2013
4:31
um there are a couple drivers one is um covet like covet’s changed everything else in our lives um the idea that
4:38
hospitals are for sick people and most people having surgery outpatient surgery
4:44
and ASC they they aren’t sick that by definition they’re not sick and so they
4:50
don’t necessarily want to be around people who are sick so that is um that’s caused big growth physician
4:57
employment a lot of Physicians that have been employed by hospitals either already owned in ASC or getting an ASC
5:06
for them to operate in was a condition of their employment and then just the whole idea of improved technology
5:12
improved anesthesia Services things like that have really pushed a lot of cases
5:18
from inpatient to outpatient um I definitely think uh that the payers
5:24
have had a huge influence with value-based uh Contracting and
5:30
um has as have um consumers who are having to pay more
5:35
in high deductible plans or hsas for their uh outpatient surgery so I think
5:41
all of those factors coming together uh this time is really a big time for
5:47
hospitals to get into this space um and and we’re seeing it our phone is
5:52
really warning for help in this area yeah and and so that makes sense there’s kind of a long list of factors that you
5:59
mentioned kind of driving this acceleration um from from the hospital perspective
6:05
Joan I’m curious has this been controversial because there’s lots of reasons as you mentioned
6:11
to do it but but at the same time you know moving procedures to an ASC from a
6:17
hospital perspective could be viewed as cannibalizing revenue and so has this been hospital has this been
6:22
controversial to certain folks within a hospital so it’s interesting it really does depend who you speak to the CFOs
6:28
are not um terribly excited about this because in general what it’s doing is
6:34
taking any outpatient procedure and cutting their reimbursement in half and then if the surgery center is joint
6:41
ventured with some Physicians it’s cutting it again and so um
6:47
but if you look at it strictly as a money play it doesn’t make a whole lot of sense if you’re very short-sighted
6:53
um I’ll tell you the hospitals that didn’t do this or haven’t done this are really seeing the damage that all that
7:02
outpatient surgery leaving the hospital you know the people say it all the time you know 50 of something is better than
7:09
zero percent of everything so um I’d say that the finance people
7:14
usually are the hardest people for us to bring around but once you sort of lay it out for them and they see what’s
7:20
happening it makes sense of the strategy people the and the payer Contracting
7:25
people are so excited that we are moving and this you know that their their organization is considering this so
7:33
um I think it sort of breaks down around those lines between strikes of strategy payers and then Finance not quite
7:40
understanding uh the motivation behind this if you look at it strictly from a reimbursement
7:47
standpoint yeah it sounds like there’s some innovators dilemma at play here in terms of these hospitals have to be willing to
7:55
at least you know consider cannibalizing existing revenue streams with lower gross margin business as you mentioned a
8:03
lot of times really right at least on the revenue side right um but I have I
8:08
will I wanted to say on that topic I have had people who did not weren’t supportive mainly CFO types who were not
8:16
supportive who later come back and tell me it was the smartest decision they ever made because uh if they are
8:22
fortunate enough to be able to backfill and really put in the cases that are now very appropriate for hospitals they’re
8:28
making more margin off of those cases than they made off their their easy healthy outpatient cases so
8:36
um again those people really then see an uptick overall uptick in reimbursement
8:42
and Revenue great um and that kind of hits on my next
8:48
question for you which is you’ve been kind of participating and observing in these joint ventures for a while what
8:55
have you seen as the critical success factors right both from a hospital perspective in an ASC perspective to
9:03
making these Partnerships work um one of the first ones that we always tell people is
9:12
it it says really asks asking both the Physicians that want to be involved and
9:17
the hospital leadership what what would success in this look like for you making
9:23
sure that everybody is is aligned on what we’re focusing on if I if a group
9:30
of Physicians want a huge you know return on their investment but the
9:36
hospital is looking for a uh a larger facility to maybe offload more cases you
9:43
know sometimes those things can can be counter forces so making sure that
9:48
everybody’s sort of looking at the same having the same measurements for Success Mutual trust and respect you know these
9:56
these first two are sort of they’re not concrete they’re very um sort of soft but people have to
10:02
really talk through this because when we have clients that um are looking you
10:08
know the hospital or the doctors call us after a meeting and say well what I really wanted to say was whatever we
10:16
sort of really really caution them and say this is going to be your business partner you’re entering into a like you
10:22
know something very akin to a marriage if you can’t talk straight to each other uh right in front of each other this
10:29
could maybe not be the right partnership so those two things are very important
10:36
um Mutual risk tolerance when it comes to debt because they’re going to have to agree on things like that and sometimes
10:43
we see that as being a big divide between and all over the place it’s
10:48
interesting um you know some hospitals want to you know you put a lot of cash in these
10:54
deals some doctors you know want to leverage them as high as they can or vice versa even so making sure that
11:02
there’s some agreement in that um I think again the one thing I just said but I just want to reiterate is
11:08
that constant transparent communication if you’re not seeing that
11:15
um it really it really won’t work and I’ve seen Partnerships not that many but a few that were not
11:22
um I we could feel it as we were going into this that there were going to be issues and either they were never able
11:28
to actually um ink a deal or they did and it it was
11:33
just not a successful surgery center got it okay and
11:40
in terms of hospitals that decide hey we want more of an ASE strategy and
11:45
footprint how do you see them going about that is it more Acquisitions of already
11:51
established ASCS is it building their own or have you seen kind of a healthy
11:56
mix of both both of those strategies um pretty much a healthy mix what we’re seeing is a lot of hospitals got
12:02
involved in ASC um let’s say in the last five years that they hadn’t done it before maybe they
12:10
were really really not wanting to take that leap but when they maybe acquired a
12:16
large Physician Group as part of that uh it’s part of that acquisition the
12:23
Physicians also one of their ASC purchased because that’s usually a higher multiple than the uh than the
12:29
practice and so now all of a sudden the hospital is owning an ASC that it hadn’t planned to own we’re seeing that a lot
12:37
more now or maybe a hospital owns five or six ases that it wasn’t planning to own and there’s no strategic reason
12:44
where they’re located things like that so they really have kind of been drug
12:49
into this space um and then we also are seeing sort of on the flip side of that a lot of
12:55
hospitals that understand the move towards Ambulatory Care and outpatient services in general and they’re building
13:02
and what their typically are calling Ambulatory Care Centers or medical malls in a new
13:08
market or in a more suburban area from the main hospital and the as they want
13:13
an ASC to be the anchor tenant of that building because it one reimburses
13:19
probably the best of all the outpatient services and it also can draw a lot of
13:24
people to that space so um and those are what we’re seeing a lot of the de novos that we’re doing now
13:30
with hospitals and Physicians are not just sitting out in a field somewhere but they’re really part of a bigger
13:37
ambulatory outpatient strategy so we’re seeing we’re seeing both of those both the Acquisitions and the and
13:44
the de novos and I think the other Trend that we’re seeing from hospitals is the
13:49
conversion of hopds some a lot of hospitals probably in the early 2000s
13:56
they weren’t ready to go all the way and and cut the reimbursement in half but they were hearing they’re both the
14:01
doctors and the patients saying they really loved the ASE experience so they
14:07
built freestanding hopds or maybe you know connected to the hospital in some
14:13
sort of you know tangential way physically physically tangential uh and
14:19
it was a provider-based entity that was still able to build Hospital rates it was on the hospital license but they
14:25
tried to run it much more like an ASC faster turnaround times more maybe more physician input smaller smaller
14:33
footprint those kind of things and so now what they’re realizing is they do
14:38
need to make the leap all the way into a freestanding ASC and we’re called because converting that space makes the
14:46
most sense from a um uh you know reusing an asset it’s already there uh a lot of
14:54
times the the doctors like that location they’re already used to that location but there’s a whole another set that
15:00
that would be a whole nother podcast because there’s a whole other set of issues involved in when you’re
15:06
converting an hopd to an ASE but that’s sort of a that’s kind of a hybrid between the acquisition of the de novo
15:12
model you know it’s there but it was owned by the hospital and now we’re going to flip it to this new uh
15:18
partnership yeah that seems kind of like the splitting the difference model um so it sounds like there’s a lot there
15:24
to unpack in terms of the hopd side so for your suggestion well we’ll wait to the next episode for that one but but I
15:32
am curious tell me about some of the high level drivers we talked about the high level drivers of hospitals adopting
15:37
an ASC strategy what are some of the high level Drive covers of hopds going all in to become ASCS well like I said
15:46
the location usually is a really nice good good look
15:51
good by nature of CMS definition for that to be an hopd it can’t be a too long of a
15:59
distance from the hospital um and like I said that the speed to Market of getting that in place can can
16:06
be for anybody who’s ever renovated a house they know that sometimes you know a new build is actually faster than a
16:12
renovation but um you you can’t if you don’t have to do too much work to the physical plant
16:19
um there’s there’s a quicker turnaround to get that ASC up and running and now
16:24
the Physicians are part owners and so now they’re sharing the revenue and basically the same building they were in
16:30
before um in general what I’ve seen Physicians like partnering with hospitals
16:37
um you know for a few reasons one is if the hospital certain conditions are met the hospital
16:44
can help with the Contracting for the ASE and most of the time I won’t say always but
16:51
most of the time the hospital can leverage their position with the payers in this new ASC and get the physician
16:59
partnership a higher reimbursement rate than the Physicians would have gotten if they’d gone out and done an ASE on their
17:05
own um obviously in con States having a hospital partner uh will sometimes be
17:13
the only way a group of Physicians can have ownership in an ASC because um a lot of a lot of Physicians either
17:22
can’t afford or uh don’t want to go through the rigmarole of getting a
17:27
certificate of need from the state and then the hospital the big thing that
17:33
I see when Physicians are being very honest is that one thing that the hospital brings to the Physicians
17:39
whether it’s an hopd conversion or a freestanding ASC that they build together
17:45
is the hospital can be the Deep Pockets when it’s time for Physicians to retire
17:51
um or if you know just a group of Physicians owned an ASC and a doctor would like to cash out of some or all of
17:58
his shares or her shares the um there may not always be a willing buyer available
18:05
and what we’ve seen is the hospital is always a willing buyer and
18:10
um so there’s a a really nice uh sort of guaranteed sale for the doctors
18:17
if they have partnered with a hospital in their ASC
18:22
got it okay um so we’ve touched on some of the benefits
18:28
from a physician perspective what about the rest of the staff in the ASC does
18:35
um does partnering up with the hospital impact their day-to-day in in any kind
18:40
of key ways you know that’s a really good question because um
18:45
it there’s not one set answer for that you know sometimes the staff can be a little
18:53
concerned if because they’re they’re nervous about okay now is my whole job going to change
18:59
from the standpoint the hospitals tend to you know have a lot of meetings have a lot of uh things that the staff might
19:07
feel like oh now that now I’m going to be a Hospital employee but they aren’t
19:12
usually they’re remain an employee of the joint venture not there are they are
19:19
now unemployed of the joint venture not the hospital um so they typically and I’m
19:26
watching my words here because sometimes there we have seen some structures where the the joint venture will lease staff
19:33
from the hospital but typically that’s not the case um and so there’s a totally separate
19:41
Personnel policies totally separate um salary structure benefit structure
19:46
everything is for the joint venture it’s not the hospital and sometimes that’s
19:51
disappointing to the hot to the staff because maybe the hospital uh salary
19:57
ranges are higher maybe the hospital’s benefit structure is much richer and so
20:04
um sometimes they’re disappointed to hear they’re not going to be hospital employees so that’s why I’m kind of saying it’s not necessarily either all
20:10
good or all bad um the the if a joint venture is formed
20:17
and it’s a free becomes a freestanding hopd from the uh I’m sorry freestanding
20:22
ASC and it was in ASC usually all of that hopd staff resigns and then only
20:30
the ones that would like to be rehired by the joint venture or that the joint venture wants to hire are brought back
20:37
um so the the staff doesn’t necessarily come with the location if that makes sense
20:43
um because there are some people that don’t want to work in ASC it’s a much faster environment
20:48
um and there’s a lot of uh staff that maybe wouldn’t be appropriate in ASC
20:53
because the AAC is a lot faster environment um you know quick much quicker turning rounds and much quicker discharges and
21:00
things like that so um there’s not a cookie cutter approach to this that’s one reason that’s the
21:06
thing that keeps it interesting from our standpoint is that however you do a joint Finch or you know there’s certain
21:12
things that are pretty the same all over the country and regardless of what the
21:18
deal is but there’s so many factors that are up for grabs depending on the personality of the of the two partners
21:26
got it okay um and and we’ve talked about hospital
21:31
and ASC Partnerships and joint ventures tell me a little bit Joan about
21:37
physician offices and physician groups how are they thinking about their ASC
21:42
strategies and and are you seeing any Trends there that are you know materially different from the hospital
21:49
ASC partnership Dynamics um no I don’t know if you’re talking about
21:56
new uh Physicians that are newly going into ASC space for Physicians that have had most most surgical Specialties
22:04
um if they’re a large group of probably either as a practice or the individual doctors have had some investment in an
22:11
ASE it’s rare we find that we do have a couple actually right now that are large
22:17
physician groups that for whatever reason in the in our the cases of the group so we’re here that they are in con
22:24
States and so it’s that’s sort of what’s kept the Physicians from being able to open their own ASC
22:30
um what we’re seeing with the Physicians that own ASCS that issue that I just talked about where the hospital can buy
22:37
you know can provide a liquidity event for some of the the maybe more senior
22:44
Partners sometimes this is the time when you have a lot of senior more senior
22:49
partners that are winding down it’s a good time maybe for a physician owned
22:55
ASC to start looking to their community hospital or the health system that
23:00
covers their that market as a potential buyer because that can make for a really
23:07
nice acquisition for the hospital if they’ve got a mature Surgery Center that’s been physician owned and a few of
23:13
the Physicians want to be bought completely out maybe some of the other Physicians would like a little bit of a
23:19
liquidity event and the hospital can come in and buy you know a portion of
23:25
the shares and now become an owner in that ASE the Physicians or the senior
23:31
owners they’ve been there longer so a lot of times it’s um it’s really just a financial buy-in
23:38
by the hospital but nothing changes at all in the operations or the ownership it remains exactly as it is
23:45
um and those have been very successful in our experienced ways for hospitals to
23:52
enter in if especially if the hospital is very clear not to want to go in there and start changing things even if it
23:59
becomes let’s say the majority owner which we’ve seen happen where the hospital will come in and by the majority of shares from The Physician
24:05
Partners um you know we always caution the hospital to remember you know it’s been
24:11
operating great before you got there don’t don’t go in there and start making changes and
24:17
um you know really think about things before you think things need to be changed there because if it’s been you
24:24
know if it’s been uh not just financially operating well but from a quality standpoint operating well and
24:30
the community really likes the the that place for surgery so sometimes a
24:36
hospital coming in trying to make changes can really make the deal you know really make the it go south and
24:43
I we don’t see that often but maybe that’s because we really prepped the hospitals on those about not you know
24:49
kind of slapping their hands about don’t touch it it’s fine yeah it seems like you’ve got some you know probably
24:55
Lessons Learned and case studies on on what not to do after acquisition so it’s
25:02
super interesting okay great well Jen one final question for you here um we do this every week
25:08
with our guests what’s one thing our listeners can do this week to improve their surgery centers
25:17
um with a lot of existing centers that are like I said uh maybe thinking about
25:24
getting acquired in a joint venture is I would always say it’s sort of like when you have somebody come into your house
25:31
um and you know they see the dirt and the crevices or they see hey if you move that chair to that other side of the
25:37
room this room would look a lot better um we often say you know invite somebody
25:42
in and when I say somebody somebody who knows Health cares I mean no surgery centers and have them sort of look at
25:49
your operations from top to bottom and see if they have any suggestions and
25:55
um because sometimes they pick stuff up that the people that are there day in and day out don’t notice and I’m not
26:00
talking about just physical things even just operations you can watch and say why are people you know looks like
26:06
you’re doing double work right there so um that’s something that I would say is maybe find another administrative ASE
26:13
administrator in the area or um you know somebody maybe somebody from
26:18
the hospital who maybe knows things and just say we just walk through and just give us you know see if you see anything
26:24
you think we would should change um and don’t be threatened by that is
26:30
what I would say because most of the time you can pick up at least one or two pretty easy to implement ideas from
26:37
those activities yeah that’s that’s good advice I think oftentimes we start doing things a
26:44
certain way and running any kind of business or process right and that just becomes the way we do it we don’t
26:49
necessarily go in from that mindset of okay let me understand this all with a fresh set of eyes and what could you
26:55
tweak or improve and so right I think there’s you know I think people in the ASC industry in general need to remember
27:01
that first ASC open back 1960 a lot of people working in ASCS weren’t even born
27:06
back then and so um I think the the longer an ASE has
27:12
been open the more likely you’re going to see that where people just well this is the way we’ve always done it you know I don’t know why we do it this way but
27:19
this is the way they trained me to do it when I started 10 years ago and we’ve always done it this way and
27:25
um so most of those are probably great things and don’t change them but usually you can find one or two time saving or
27:34
money saving ideas when you when you have a fresh pair of eyes look at operations for you
27:40
great well Jim thanks so much for joining us today thank you it was fun
27:47
[Music] as always it has been a busy week in
27:52
healthcare so let’s jump right in our first story is a quick one but Becker’s
27:57
ASC published a snapshot of the ASC industry from a numbers perspective and
28:03
I thought a few of these were really interesting so here are the five stats they shared along with the studies where
28:09
they obtained these numbers from so the first hospitals are shifting one-third of their revenue to surgery
28:16
centers office based labs and other outpatient sites according to jll’s
28:22
healthcare and medical office perspective report the average physician compensation
28:28
declined by 2.4 percent in 2022 according to doximity’s 2023 physician
28:36
compensation report the average total cases performed at an
28:41
ASC per day is 20.9 according to vmg
28:46
Health’s multi-specialty ASC benchmarking study 70 of ASCS remain independent as of 2022
28:56
according to another report from vmg health and then lastly the average net
29:02
operating revenue for ASCS is 11.1 million dollars according to another
29:09
report from vmg health so out of those five stats I think the most interesting to me was the first one
29:15
that hospitals are shifting one-third of their revenue to surgery centers and other outpatient sites
29:22
um it shouldn’t be that shocking to a lot of people if you’ve been keeping up with the news
29:28
we’ve been seeing this trend for a little while now but always really exciting to see further proof of that
29:35
the state of Missouri is the latest to introduce legislation aimed at limiting
29:40
the rates of travel nursing companies now this article comes from or manager
29:46
and this legislation known as the Missouri Health Care contract Provisions act would prohibit Health Care
29:53
Facilities from entering into contracts with staffing agencies that charge more
29:58
than 20 percent above the standard rate for nurses supporters of the bill argue that travel
30:05
nursing rates have skyrocketed during covid which everybody kind of Knows by now leading to higher health care costs
30:12
for patients and straining budgets all around they also claim that some staffing agencies engage in price
30:19
gouging and take advantage of the demand for nurses in areas experiencing nursing
30:24
shortages which is certainly true um opponents of the bill however argue
30:30
that it would limit the ability for hospitals and other health care facilities to recruit and retain
30:35
qualified nurses especially in rural areas where nursing nursing shortages are particularly bad
30:42
and lastly they also claim that staffing agencies are necessary to fill critical
30:47
gaps in nursing staff especially during emergencies such as the pandemic
30:54
um but the Missouri legislation is not alone there are similar efforts in other states including California where a law
31:02
was passed last year capping travel nursing rates at 60 percent above the
31:07
standard rate in other states including New Jersey and Massachusetts are considering similar measures so I
31:14
certainly don’t know the perfect answer here but I do feel like legislation like this would be a win for surgery centers
31:20
most ASE budgets cannot compete with the incredibly High hourly wages that travel
31:26
nurses are receiving and would be expected um if they were to settle down in some
31:33
place and surgery centers are losing staff because of how enticing these
31:39
wages are for travel nurses so as always this bill brings pros and cons with it
31:44
and we will keep a close eye on it but those four states to recap are Missouri California New Jersey and Massachusetts
31:51
that are all making strides here our third story is from the news desk of
31:58
outpatient surgery magazine and it is all about strategies and tips for staff retention now I’m always on the lookout
32:05
for good meaningful Staffing Solutions and ideas because I know so many people are struggling with this right now and
32:11
as we know there is no perfect solution this is needs to be a long-term strategy for the healthcare industry as a whole
32:18
to get ahead of this and fix it but I do promise you that none of these tips have
32:23
anything to do with food or pizza parties so here we go here are seven staff retention ideas the first is
32:31
correcting your salary scale so long-term staff can become resentful of
32:37
new hires who are receiving bonuses and even higher salaries than they are
32:42
um so change your pay scale to be based on number of years as a nurse as just
32:48
one idea and also if you are bringing somebody brand new on take a look at the staff
32:53
that have been there the longest and make sure that everybody is being fairly compensated to the best of your ability
33:00
the second tip is to try going per diem instead of salaried this allows for
33:05
schedule flexibility and also for them to control how much money how much money they make
33:12
the third is to stay aware of work-life balance this goes along the lines of flexibility again but you might have
33:18
some nurses who prefer to work 32 hours over four days versus the typical Monday
33:23
through Friday schedule the fourth is to keep it stimulated
33:29
um cross-train anybody who is interested so they keep learning and don’t get
33:34
bored uh focus on workplace culture and they’re suggesting that this actually
33:40
starts with leadership so make sure you appreciate your employees and take genuine interest in their lives as human
33:47
beings instead of just employees um and along the same lines the next tip
33:53
is to understand every employee’s goals preferences and skills and to see them all as individuals so get to know them
34:01
where do they see their career in a year or five years how can you help them get there what is most important to them
34:07
right now are they just looking to make as much money as humanly possible or is
34:12
getting out at 4 pm every day in their best interest so that they can spend more time with their family you know
34:19
trying to figure out what works best for them as individuals will go a long way
34:25
um and lastly mentorship is a proven retention tactic this will encourage
34:31
newer employees to stick around longer will help prepare them for more leadership type roles and just keep
34:37
overall morale high so there you have it seven retention strategies and reminders
34:42
to make sure you keep your best staff and to end our new segment on a positive
34:49
note a cancer pill was approved in England and Wales hundreds of people
34:54
with rare forms of inherited cancer could live longer after the UK’s National Health Service approves the
35:01
first drug targeting tumors that is caused by a faulty Gene so patients in
35:07
England and Wales who are carrying a mutated version of the brca1 or brca2
35:14
genes will now be eligible for this new pill it in the new pill kills cancer
35:20
cells by stopping them from repairing themselves and has been shown to cut the risk of dying from inherited breast
35:27
cancer by one-third and to extend the lives of patients with incurable prostate cancer
35:32
and that news story officially wraps up this week’s podcast thank you as always for spending a few minutes of your week
35:39
with us make sure to subscribe or leave a review on whichever platform you’re listening from I hope you have a great
35:45
day and we will see you again next week be so alone
35:51
[Music]
welcome to this week in surgery centers if you’re in the ASC industry then
0:06
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 if you’re considering
0:33
a hospital physician ASC joint venture or just curious about learning more
0:38
about what that relationship could look like then this episode is for you Joan
0:43
dentler is the founder of avonza healthcare strategies and she’s sharing why hospitals are taking an increased
0:50
interest in ASCS the challenges both parties might face and how to achieve
0:55
both short and long-term term success in our news recap we’ll cover the ASC
1:01
landscape through numbers states that are capping travel nursing rates seven staff retention tips and of
1:08
course end the new segment with a positive story about a cancer pill that was approved in England and Wales
1:15
hope everyone enjoys the episode and here’s what’s going on this week in surgery centers
1:21
[Music] Joan welcome to the show
1:27
thank you happy to be here Gerald can you give us a quick overview of your background in the ASC industry
1:34
sure um well I kind of got into um by being hired by a hospital to
1:42
um sort of be a utility player for them and they were putting together a hospital physician joint venture at ASC
1:49
and this was back in 1996 and so it was a little bit of a baptism of fire
1:55
um since then I’ve worked for private consulting firms I did a little stint
2:01
with an ASE management company and in 2007
2:06
um along with a partner formed a company that was then called ASE strategies
2:12
later rebranded as a banza and with our goal being that we were
2:19
going to be a boutique consulting firm focusing primarily on hospitals that
2:25
wanted to get into the ASC space or large physician groups that hadn’t
2:31
already built ASCS and our model was really to work with them not as a
2:36
management company but more as they a fee for service advisor and work with
2:42
them through the whole process of either building an ASC or if they already had an ASC working with them on
2:50
um fine-tuning those operations uh for as long as that client needed us and then
2:57
in 2014 I rebranded the company avonza health
3:03
care strategies because we started getting requests for things in the outpatient space other than ases like
3:09
Imaging and infusion and some other services so um Avon’s in its current form started uh
3:17
in 2007 and then sort of expanded to take on more outpatient in around 2014.
3:24
so that’s and I’ve been so I’ve been in the ASC space ever since the late 90s
3:31
fantastic and you’ve got a great background for the topic that we wanted to hit on with you today which is really
3:37
this trend around hospitals doing joint ventures with ASCS and so from a high
3:43
level perspective join can you kind of help set the context for us what what what’s kind of the latest in this trend
3:49
of hospitals looking to partner with ASCS and what’s driving it
3:55
well you know it’s interesting to me because a lot of people consider this like a new trend and for those of us
4:00
they’re not many there are absolutely not many of us but for those of us that have been working in this space like I
4:06
said for 20 years almost um it doesn’t seem new at all but it has
4:13
definitely picked up steam and I think I think um the last statistics I saw was that
4:19
the joint ventures or hospital-owned ASCS in general are one of the fastest
4:24
growing groups and I really think that currently as we said in 2013
4:31
um there are a couple drivers one is um covet like covet’s changed everything else in our lives um the idea that
4:38
hospitals are for sick people and most people having surgery outpatient surgery
4:44
and ASC they they aren’t sick that by definition they’re not sick and so they
4:50
don’t necessarily want to be around people who are sick so that is um that’s caused big growth physician
4:57
employment a lot of Physicians that have been employed by hospitals either already owned in ASC or getting an ASC
5:06
for them to operate in was a condition of their employment and then just the whole idea of improved technology
5:12
improved anesthesia Services things like that have really pushed a lot of cases
5:18
from inpatient to outpatient um I definitely think uh that the payers
5:24
have had a huge influence with value-based uh Contracting and
5:30
um has as have um consumers who are having to pay more
5:35
in high deductible plans or hsas for their uh outpatient surgery so I think
5:41
all of those factors coming together uh this time is really a big time for
5:47
hospitals to get into this space um and and we’re seeing it our phone is
5:52
really warning for help in this area yeah and and so that makes sense there’s kind of a long list of factors that you
5:59
mentioned kind of driving this acceleration um from from the hospital perspective
6:05
Joan I’m curious has this been controversial because there’s lots of reasons as you mentioned
6:11
to do it but but at the same time you know moving procedures to an ASC from a
6:17
hospital perspective could be viewed as cannibalizing revenue and so has this been hospital has this been
6:22
controversial to certain folks within a hospital so it’s interesting it really does depend who you speak to the CFOs
6:28
are not um terribly excited about this because in general what it’s doing is
6:34
taking any outpatient procedure and cutting their reimbursement in half and then if the surgery center is joint
6:41
ventured with some Physicians it’s cutting it again and so um
6:47
but if you look at it strictly as a money play it doesn’t make a whole lot of sense if you’re very short-sighted
6:53
um I’ll tell you the hospitals that didn’t do this or haven’t done this are really seeing the damage that all that
7:02
outpatient surgery leaving the hospital you know the people say it all the time you know 50 of something is better than
7:09
zero percent of everything so um I’d say that the finance people
7:14
usually are the hardest people for us to bring around but once you sort of lay it out for them and they see what’s
7:20
happening it makes sense of the strategy people the and the payer Contracting
7:25
people are so excited that we are moving and this you know that their their organization is considering this so
7:33
um I think it sort of breaks down around those lines between strikes of strategy payers and then Finance not quite
7:40
understanding uh the motivation behind this if you look at it strictly from a reimbursement
7:47
standpoint yeah it sounds like there’s some innovators dilemma at play here in terms of these hospitals have to be willing to
7:55
at least you know consider cannibalizing existing revenue streams with lower gross margin business as you mentioned a
8:03
lot of times really right at least on the revenue side right um but I have I
8:08
will I wanted to say on that topic I have had people who did not weren’t supportive mainly CFO types who were not
8:16
supportive who later come back and tell me it was the smartest decision they ever made because uh if they are
8:22
fortunate enough to be able to backfill and really put in the cases that are now very appropriate for hospitals they’re
8:28
making more margin off of those cases than they made off their their easy healthy outpatient cases so
8:36
um again those people really then see an uptick overall uptick in reimbursement
8:42
and Revenue great um and that kind of hits on my next
8:48
question for you which is you’ve been kind of participating and observing in these joint ventures for a while what
8:55
have you seen as the critical success factors right both from a hospital perspective in an ASC perspective to
9:03
making these Partnerships work um one of the first ones that we always tell people is
9:12
it it says really asks asking both the Physicians that want to be involved and
9:17
the hospital leadership what what would success in this look like for you making
9:23
sure that everybody is is aligned on what we’re focusing on if I if a group
9:30
of Physicians want a huge you know return on their investment but the
9:36
hospital is looking for a uh a larger facility to maybe offload more cases you
9:43
know sometimes those things can can be counter forces so making sure that
9:48
everybody’s sort of looking at the same having the same measurements for Success Mutual trust and respect you know these
9:56
these first two are sort of they’re not concrete they’re very um sort of soft but people have to
10:02
really talk through this because when we have clients that um are looking you
10:08
know the hospital or the doctors call us after a meeting and say well what I really wanted to say was whatever we
10:16
sort of really really caution them and say this is going to be your business partner you’re entering into a like you
10:22
know something very akin to a marriage if you can’t talk straight to each other uh right in front of each other this
10:29
could maybe not be the right partnership so those two things are very important
10:36
um Mutual risk tolerance when it comes to debt because they’re going to have to agree on things like that and sometimes
10:43
we see that as being a big divide between and all over the place it’s
10:48
interesting um you know some hospitals want to you know you put a lot of cash in these
10:54
deals some doctors you know want to leverage them as high as they can or vice versa even so making sure that
11:02
there’s some agreement in that um I think again the one thing I just said but I just want to reiterate is
11:08
that constant transparent communication if you’re not seeing that
11:15
um it really it really won’t work and I’ve seen Partnerships not that many but a few that were not
11:22
um I we could feel it as we were going into this that there were going to be issues and either they were never able
11:28
to actually um ink a deal or they did and it it was
11:33
just not a successful surgery center got it okay and
11:40
in terms of hospitals that decide hey we want more of an ASE strategy and
11:45
footprint how do you see them going about that is it more Acquisitions of already
11:51
established ASCS is it building their own or have you seen kind of a healthy
11:56
mix of both both of those strategies um pretty much a healthy mix what we’re seeing is a lot of hospitals got
12:02
involved in ASC um let’s say in the last five years that they hadn’t done it before maybe they
12:10
were really really not wanting to take that leap but when they maybe acquired a
12:16
large Physician Group as part of that uh it’s part of that acquisition the
12:23
Physicians also one of their ASC purchased because that’s usually a higher multiple than the uh than the
12:29
practice and so now all of a sudden the hospital is owning an ASC that it hadn’t planned to own we’re seeing that a lot
12:37
more now or maybe a hospital owns five or six ases that it wasn’t planning to own and there’s no strategic reason
12:44
where they’re located things like that so they really have kind of been drug
12:49
into this space um and then we also are seeing sort of on the flip side of that a lot of
12:55
hospitals that understand the move towards Ambulatory Care and outpatient services in general and they’re building
13:02
and what their typically are calling Ambulatory Care Centers or medical malls in a new
13:08
market or in a more suburban area from the main hospital and the as they want
13:13
an ASC to be the anchor tenant of that building because it one reimburses
13:19
probably the best of all the outpatient services and it also can draw a lot of
13:24
people to that space so um and those are what we’re seeing a lot of the de novos that we’re doing now
13:30
with hospitals and Physicians are not just sitting out in a field somewhere but they’re really part of a bigger
13:37
ambulatory outpatient strategy so we’re seeing we’re seeing both of those both the Acquisitions and the and
13:44
the de novos and I think the other Trend that we’re seeing from hospitals is the
13:49
conversion of hopds some a lot of hospitals probably in the early 2000s
13:56
they weren’t ready to go all the way and and cut the reimbursement in half but they were hearing they’re both the
14:01
doctors and the patients saying they really loved the ASE experience so they
14:07
built freestanding hopds or maybe you know connected to the hospital in some
14:13
sort of you know tangential way physically physically tangential uh and
14:19
it was a provider-based entity that was still able to build Hospital rates it was on the hospital license but they
14:25
tried to run it much more like an ASC faster turnaround times more maybe more physician input smaller smaller
14:33
footprint those kind of things and so now what they’re realizing is they do
14:38
need to make the leap all the way into a freestanding ASC and we’re called because converting that space makes the
14:46
most sense from a um uh you know reusing an asset it’s already there uh a lot of
14:54
times the the doctors like that location they’re already used to that location but there’s a whole another set that
15:00
that would be a whole nother podcast because there’s a whole other set of issues involved in when you’re
15:06
converting an hopd to an ASE but that’s sort of a that’s kind of a hybrid between the acquisition of the de novo
15:12
model you know it’s there but it was owned by the hospital and now we’re going to flip it to this new uh
15:18
partnership yeah that seems kind of like the splitting the difference model um so it sounds like there’s a lot there
15:24
to unpack in terms of the hopd side so for your suggestion well we’ll wait to the next episode for that one but but I
15:32
am curious tell me about some of the high level drivers we talked about the high level drivers of hospitals adopting
15:37
an ASC strategy what are some of the high level Drive covers of hopds going all in to become ASCS well like I said
15:46
the location usually is a really nice good good look
15:51
good by nature of CMS definition for that to be an hopd it can’t be a too long of a
15:59
distance from the hospital um and like I said that the speed to Market of getting that in place can can
16:06
be for anybody who’s ever renovated a house they know that sometimes you know a new build is actually faster than a
16:12
renovation but um you you can’t if you don’t have to do too much work to the physical plant
16:19
um there’s there’s a quicker turnaround to get that ASC up and running and now
16:24
the Physicians are part owners and so now they’re sharing the revenue and basically the same building they were in
16:30
before um in general what I’ve seen Physicians like partnering with hospitals
16:37
um you know for a few reasons one is if the hospital certain conditions are met the hospital
16:44
can help with the Contracting for the ASE and most of the time I won’t say always but
16:51
most of the time the hospital can leverage their position with the payers in this new ASC and get the physician
16:59
partnership a higher reimbursement rate than the Physicians would have gotten if they’d gone out and done an ASE on their
17:05
own um obviously in con States having a hospital partner uh will sometimes be
17:13
the only way a group of Physicians can have ownership in an ASC because um a lot of a lot of Physicians either
17:22
can’t afford or uh don’t want to go through the rigmarole of getting a
17:27
certificate of need from the state and then the hospital the big thing that
17:33
I see when Physicians are being very honest is that one thing that the hospital brings to the Physicians
17:39
whether it’s an hopd conversion or a freestanding ASC that they build together
17:45
is the hospital can be the Deep Pockets when it’s time for Physicians to retire
17:51
um or if you know just a group of Physicians owned an ASC and a doctor would like to cash out of some or all of
17:58
his shares or her shares the um there may not always be a willing buyer available
18:05
and what we’ve seen is the hospital is always a willing buyer and
18:10
um so there’s a a really nice uh sort of guaranteed sale for the doctors
18:17
if they have partnered with a hospital in their ASC
18:22
got it okay um so we’ve touched on some of the benefits
18:28
from a physician perspective what about the rest of the staff in the ASC does
18:35
um does partnering up with the hospital impact their day-to-day in in any kind
18:40
of key ways you know that’s a really good question because um
18:45
it there’s not one set answer for that you know sometimes the staff can be a little
18:53
concerned if because they’re they’re nervous about okay now is my whole job going to change
18:59
from the standpoint the hospitals tend to you know have a lot of meetings have a lot of uh things that the staff might
19:07
feel like oh now that now I’m going to be a Hospital employee but they aren’t
19:12
usually they’re remain an employee of the joint venture not there are they are
19:19
now unemployed of the joint venture not the hospital um so they typically and I’m
19:26
watching my words here because sometimes there we have seen some structures where the the joint venture will lease staff
19:33
from the hospital but typically that’s not the case um and so there’s a totally separate
19:41
Personnel policies totally separate um salary structure benefit structure
19:46
everything is for the joint venture it’s not the hospital and sometimes that’s
19:51
disappointing to the hot to the staff because maybe the hospital uh salary
19:57
ranges are higher maybe the hospital’s benefit structure is much richer and so
20:04
um sometimes they’re disappointed to hear they’re not going to be hospital employees so that’s why I’m kind of saying it’s not necessarily either all
20:10
good or all bad um the the if a joint venture is formed
20:17
and it’s a free becomes a freestanding hopd from the uh I’m sorry freestanding
20:22
ASC and it was in ASC usually all of that hopd staff resigns and then only
20:30
the ones that would like to be rehired by the joint venture or that the joint venture wants to hire are brought back
20:37
um so the the staff doesn’t necessarily come with the location if that makes sense
20:43
um because there are some people that don’t want to work in ASC it’s a much faster environment
20:48
um and there’s a lot of uh staff that maybe wouldn’t be appropriate in ASC
20:53
because the AAC is a lot faster environment um you know quick much quicker turning rounds and much quicker discharges and
21:00
things like that so um there’s not a cookie cutter approach to this that’s one reason that’s the
21:06
thing that keeps it interesting from our standpoint is that however you do a joint Finch or you know there’s certain
21:12
things that are pretty the same all over the country and regardless of what the
21:18
deal is but there’s so many factors that are up for grabs depending on the personality of the of the two partners
21:26
got it okay um and and we’ve talked about hospital
21:31
and ASC Partnerships and joint ventures tell me a little bit Joan about
21:37
physician offices and physician groups how are they thinking about their ASC
21:42
strategies and and are you seeing any Trends there that are you know materially different from the hospital
21:49
ASC partnership Dynamics um no I don’t know if you’re talking about
21:56
new uh Physicians that are newly going into ASC space for Physicians that have had most most surgical Specialties
22:04
um if they’re a large group of probably either as a practice or the individual doctors have had some investment in an
22:11
ASE it’s rare we find that we do have a couple actually right now that are large
22:17
physician groups that for whatever reason in the in our the cases of the group so we’re here that they are in con
22:24
States and so it’s that’s sort of what’s kept the Physicians from being able to open their own ASC
22:30
um what we’re seeing with the Physicians that own ASCS that issue that I just talked about where the hospital can buy
22:37
you know can provide a liquidity event for some of the the maybe more senior
22:44
Partners sometimes this is the time when you have a lot of senior more senior
22:49
partners that are winding down it’s a good time maybe for a physician owned
22:55
ASC to start looking to their community hospital or the health system that
23:00
covers their that market as a potential buyer because that can make for a really
23:07
nice acquisition for the hospital if they’ve got a mature Surgery Center that’s been physician owned and a few of
23:13
the Physicians want to be bought completely out maybe some of the other Physicians would like a little bit of a
23:19
liquidity event and the hospital can come in and buy you know a portion of
23:25
the shares and now become an owner in that ASE the Physicians or the senior
23:31
owners they’ve been there longer so a lot of times it’s um it’s really just a financial buy-in
23:38
by the hospital but nothing changes at all in the operations or the ownership it remains exactly as it is
23:45
um and those have been very successful in our experienced ways for hospitals to
23:52
enter in if especially if the hospital is very clear not to want to go in there and start changing things even if it
23:59
becomes let’s say the majority owner which we’ve seen happen where the hospital will come in and by the majority of shares from The Physician
24:05
Partners um you know we always caution the hospital to remember you know it’s been
24:11
operating great before you got there don’t don’t go in there and start making changes and
24:17
um you know really think about things before you think things need to be changed there because if it’s been you
24:24
know if it’s been uh not just financially operating well but from a quality standpoint operating well and
24:30
the community really likes the the that place for surgery so sometimes a
24:36
hospital coming in trying to make changes can really make the deal you know really make the it go south and
24:43
I we don’t see that often but maybe that’s because we really prepped the hospitals on those about not you know
24:49
kind of slapping their hands about don’t touch it it’s fine yeah it seems like you’ve got some you know probably
24:55
Lessons Learned and case studies on on what not to do after acquisition so it’s
25:02
super interesting okay great well Jen one final question for you here um we do this every week
25:08
with our guests what’s one thing our listeners can do this week to improve their surgery centers
25:17
um with a lot of existing centers that are like I said uh maybe thinking about
25:24
getting acquired in a joint venture is I would always say it’s sort of like when you have somebody come into your house
25:31
um and you know they see the dirt and the crevices or they see hey if you move that chair to that other side of the
25:37
room this room would look a lot better um we often say you know invite somebody
25:42
in and when I say somebody somebody who knows Health cares I mean no surgery centers and have them sort of look at
25:49
your operations from top to bottom and see if they have any suggestions and
25:55
um because sometimes they pick stuff up that the people that are there day in and day out don’t notice and I’m not
26:00
talking about just physical things even just operations you can watch and say why are people you know looks like
26:06
you’re doing double work right there so um that’s something that I would say is maybe find another administrative ASE
26:13
administrator in the area or um you know somebody maybe somebody from
26:18
the hospital who maybe knows things and just say we just walk through and just give us you know see if you see anything
26:24
you think we would should change um and don’t be threatened by that is
26:30
what I would say because most of the time you can pick up at least one or two pretty easy to implement ideas from
26:37
those activities yeah that’s that’s good advice I think oftentimes we start doing things a
26:44
certain way and running any kind of business or process right and that just becomes the way we do it we don’t
26:49
necessarily go in from that mindset of okay let me understand this all with a fresh set of eyes and what could you
26:55
tweak or improve and so right I think there’s you know I think people in the ASC industry in general need to remember
27:01
that first ASC open back 1960 a lot of people working in ASCS weren’t even born
27:06
back then and so um I think the the longer an ASE has
27:12
been open the more likely you’re going to see that where people just well this is the way we’ve always done it you know I don’t know why we do it this way but
27:19
this is the way they trained me to do it when I started 10 years ago and we’ve always done it this way and
27:25
um so most of those are probably great things and don’t change them but usually you can find one or two time saving or
27:34
money saving ideas when you when you have a fresh pair of eyes look at operations for you
27:40
great well Jim thanks so much for joining us today thank you it was fun
27:47
[Music] as always it has been a busy week in
27:52
healthcare so let’s jump right in our first story is a quick one but Becker’s
27:57
ASC published a snapshot of the ASC industry from a numbers perspective and
28:03
I thought a few of these were really interesting so here are the five stats they shared along with the studies where
28:09
they obtained these numbers from so the first hospitals are shifting one-third of their revenue to surgery
28:16
centers office based labs and other outpatient sites according to jll’s
28:22
healthcare and medical office perspective report the average physician compensation
28:28
declined by 2.4 percent in 2022 according to doximity’s 2023 physician
28:36
compensation report the average total cases performed at an
28:41
ASC per day is 20.9 according to vmg
28:46
Health’s multi-specialty ASC benchmarking study 70 of ASCS remain independent as of 2022
28:56
according to another report from vmg health and then lastly the average net
29:02
operating revenue for ASCS is 11.1 million dollars according to another
29:09
report from vmg health so out of those five stats I think the most interesting to me was the first one
29:15
that hospitals are shifting one-third of their revenue to surgery centers and other outpatient sites
29:22
um it shouldn’t be that shocking to a lot of people if you’ve been keeping up with the news
29:28
we’ve been seeing this trend for a little while now but always really exciting to see further proof of that
29:35
the state of Missouri is the latest to introduce legislation aimed at limiting
29:40
the rates of travel nursing companies now this article comes from or manager
29:46
and this legislation known as the Missouri Health Care contract Provisions act would prohibit Health Care
29:53
Facilities from entering into contracts with staffing agencies that charge more
29:58
than 20 percent above the standard rate for nurses supporters of the bill argue that travel
30:05
nursing rates have skyrocketed during covid which everybody kind of Knows by now leading to higher health care costs
30:12
for patients and straining budgets all around they also claim that some staffing agencies engage in price
30:19
gouging and take advantage of the demand for nurses in areas experiencing nursing
30:24
shortages which is certainly true um opponents of the bill however argue
30:30
that it would limit the ability for hospitals and other health care facilities to recruit and retain
30:35
qualified nurses especially in rural areas where nursing nursing shortages are particularly bad
30:42
and lastly they also claim that staffing agencies are necessary to fill critical
30:47
gaps in nursing staff especially during emergencies such as the pandemic
30:54
um but the Missouri legislation is not alone there are similar efforts in other states including California where a law
31:02
was passed last year capping travel nursing rates at 60 percent above the
31:07
standard rate in other states including New Jersey and Massachusetts are considering similar measures so I
31:14
certainly don’t know the perfect answer here but I do feel like legislation like this would be a win for surgery centers
31:20
most ASE budgets cannot compete with the incredibly High hourly wages that travel
31:26
nurses are receiving and would be expected um if they were to settle down in some
31:33
place and surgery centers are losing staff because of how enticing these
31:39
wages are for travel nurses so as always this bill brings pros and cons with it
31:44
and we will keep a close eye on it but those four states to recap are Missouri California New Jersey and Massachusetts
31:51
that are all making strides here our third story is from the news desk of
31:58
outpatient surgery magazine and it is all about strategies and tips for staff retention now I’m always on the lookout
32:05
for good meaningful Staffing Solutions and ideas because I know so many people are struggling with this right now and
32:11
as we know there is no perfect solution this is needs to be a long-term strategy for the healthcare industry as a whole
32:18
to get ahead of this and fix it but I do promise you that none of these tips have
32:23
anything to do with food or pizza parties so here we go here are seven staff retention ideas the first is
32:31
correcting your salary scale so long-term staff can become resentful of
32:37
new hires who are receiving bonuses and even higher salaries than they are
32:42
um so change your pay scale to be based on number of years as a nurse as just
32:48
one idea and also if you are bringing somebody brand new on take a look at the staff
32:53
that have been there the longest and make sure that everybody is being fairly compensated to the best of your ability
33:00
the second tip is to try going per diem instead of salaried this allows for
33:05
schedule flexibility and also for them to control how much money how much money they make
33:12
the third is to stay aware of work-life balance this goes along the lines of flexibility again but you might have
33:18
some nurses who prefer to work 32 hours over four days versus the typical Monday
33:23
through Friday schedule the fourth is to keep it stimulated
33:29
um cross-train anybody who is interested so they keep learning and don’t get
33:34
bored uh focus on workplace culture and they’re suggesting that this actually
33:40
starts with leadership so make sure you appreciate your employees and take genuine interest in their lives as human
33:47
beings instead of just employees um and along the same lines the next tip
33:53
is to understand every employee’s goals preferences and skills and to see them all as individuals so get to know them
34:01
where do they see their career in a year or five years how can you help them get there what is most important to them
34:07
right now are they just looking to make as much money as humanly possible or is
34:12
getting out at 4 pm every day in their best interest so that they can spend more time with their family you know
34:19
trying to figure out what works best for them as individuals will go a long way
34:25
um and lastly mentorship is a proven retention tactic this will encourage
34:31
newer employees to stick around longer will help prepare them for more leadership type roles and just keep
34:37
overall morale high so there you have it seven retention strategies and reminders
34:42
to make sure you keep your best staff and to end our new segment on a positive
34:49
note a cancer pill was approved in England and Wales hundreds of people
34:54
with rare forms of inherited cancer could live longer after the UK’s National Health Service approves the
35:01
first drug targeting tumors that is caused by a faulty Gene so patients in
35:07
England and Wales who are carrying a mutated version of the brca1 or brca2
35:14
genes will now be eligible for this new pill it in the new pill kills cancer
35:20
cells by stopping them from repairing themselves and has been shown to cut the risk of dying from inherited breast
35:27
cancer by one-third and to extend the lives of patients with incurable prostate cancer
35:32
and that news story officially wraps up this week’s podcast thank you as always for spending a few minutes of your week
35:39
with us make sure to subscribe or leave a review on whichever platform you’re listening from I hope you have a great
35:45
day and we will see you again next week be so alone
35:51
[Music]
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.