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Staffing: Selecting the Best Agency
9 Plays21 minutes ago
Today is the first episode of our new three-part series on Staffing Strategies for ASCs! Over the next few episodes, we’ll discuss key staffing considerations that can help surgery centers build and maintain a strong workforce. 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 to use.
Today, we’re kicking things off with Mayte Rechani to discuss Selecting the Best Agency. Many ASCs haven’t tapped into staffing agencies yet, so Mayte will break down what to look for in an agency, how to ensure reliable coverage, and other key factors to consider.
After my conversation with Mayte, 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-date-of-service.
Resources Mentioned:
HST’s State of the Industry Report – https://www.hstpathways.com/resources/surgery-center-industry-report/
Brought to you by HST Pathways.
Recommended
Transcript
Introduction to ASC Staffing Series
00:00:01
Speaker
Welcome to This Week in Surgery Centers. If you're in the ASC industry, then you're in the right place. Every week, we'll start the episode off by sharing an interesting conversation we had with our featured guest.
00:00:12
Speaker
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.
Choosing the Right Staffing Agency
00:00:27
Speaker
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.
00:00:46
Speaker
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.
00:00:57
Speaker
But today, specifically, we are kicking things off with MyTay 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.
00:01:14
Speaker
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.
Data Insights: HST's Industry Report
00:01:32
Speaker
After my conversation today with Maite, we'll switch to our data and insights segment. HST released our annual State of the Industry report in September, which analyzed client data from 590 surgery centers.
00:01:45
Speaker
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, and here's what's going on this week in surgery centers.
00:02:02
Speaker
Hi, Maite. Welcome to the podcast. Hi, Erica. Thank you so much for having me. Can you please share a little bit about yourself and your ASC experience? Sure.
00:02:12
Speaker
So I'm the executive director here at our Staffing Solutions for MedHQ. 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.
00:02:32
Speaker
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.
00:02:44
Speaker
So set the landscape for us. How common is it for an ASC to use a staffing agency? Right now in the post-COVID world, it's becoming a lot more common.
00:02:55
Speaker
Before, it was not. You know, ASCs 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 ah staffing agency can provide short term and not long term or both, depending on what their needs are.
00:03:17
Speaker
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?
00:03:34
Speaker
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 ASC need someone short-term or long-term? you know What do they want? do they 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.
00:04:01
Speaker
The point is to make it as easy as possible for the ASC administrators who are so busy because 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.
00:04:19
Speaker
A hundred percent. So not just about what they need is making sure that the ASC comes first. What their needs and wants are always paramount to the right agency.
00:04:31
Speaker
Got it. And how can surgery centers kind of work with those work with agencies to guarantee consistent
Ensuring Consistent Staffing Coverage
00:04:38
Speaker
coverage? You know, we just went through December. I know that's always a crazy busy time.
00:04:42
Speaker
I saw a TikTok the other day that called it ah deductible December, which I've never heard before. yeah um So especially during peak times and emergencies, how can they work with the agency to make sure they have the coverage that they need?
00:04:55
Speaker
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 funds.
00:05:09
Speaker
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 going to need somebody for December, maybe even January. Let's work on a six week contract. Let's make it work.
00:05:22
Speaker
So you are 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. And what steps should an ASC take to make sure that agency staff assigned to them are properly credentialed and meet all compliance standards?
Credentialing and Compliance for Agency Staff
00:05:40
Speaker
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 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.
00:05:59
Speaker
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.
00:06:11
Speaker
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.
00:06:22
Speaker
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.
Handling Cancellations in ASCs
00:06:32
Speaker
Definitely. What about cancellation policies? How do those how does that typically work?
00:06:37
Speaker
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.
00:06:48
Speaker
And again, the right partner will make that very clear to their supplier panel, as well as the ASC. And if the ASC says, listen, we're going into the holidays, if we cancel, we'll give them extra hours, that really needs to be decided beforehand.
00:07:03
Speaker
And the ASC 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.
00:07:16
Speaker
I mean, it's really clear. And again, clear is the most important thing. there' it It will leave very little room for error. and the ASC will be happy.
00:07:27
Speaker
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% cases were canceled in an ASC setting.
00:07:43
Speaker
And the majority of those are out of the surgery center's control, right? patient Patient issues or misunderstandings, cancellations, 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.
00:08:01
Speaker
ahucuced it Does the ASE still typically give a stipend or is it, we're just going to give you more hours? How does that usually look? Not really a stipend. What it comes down to is the ASE clearly communicates to the nurse. If they can get to her before she gets there, that's always ideal.
00:08:18
Speaker
But if they're there, Typically, it depends on the ASC 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.
00:08:31
Speaker
Whatever they decide on the set amount of hours, but all these things are clearly communicated and written well before a nurse, even steps foot in the ASC.
00:08:42
Speaker
So in other words, all these issues are kind of preemptively handled ahead of time. Love it. That makes sense.
Cultural Fit and Long-term Staffing Strategies
00:08:50
Speaker
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? This is where we come in and we're really, we like to make sure we let the ASC know. If you know it's going to 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.
00:09:14
Speaker
Like, are you going to be, and ask those tough questions. You have to remember, we're not going to be there with them and they're going to be part of your team. The good thing about if they know they want to hire them outright later, this is where we really recommend, why don't you do a contract to perm, maybe, you know, four weeks, eight 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.
00:09:40
Speaker
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 trial period. and You need to, and 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.
00:10:09
Speaker
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 And that really, at the end of the day, that is the best case scenario for the ASC. They are the happiest.
00:10:23
Speaker
And more importantly, it's about patient outcomes and their team. Definitely. And when you had mentioned in an interview, is that with anybody that, like, let's say the agency is like, okay, we're sending Erica,
00:10:39
Speaker
you know, does the admin interview everybody before they get to, they you know, even if it's a like a per diem situation? A hundred percent. They should always interview. It is always for my team. And I've made a very clear best practices.
00:10:53
Speaker
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, ASCs are very family oriented. They're a family. They're small.
00:11:11
Speaker
You want the right person to come to your house. That's how I look at it. You want the right person take care of your family. So having, getting to know them, however that long that team's 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.
00:11:30
Speaker
So whatever the ASE wants to do is what we will push for and what we will demand. Love it. And I'm sure physicians probably have a lot of feedback on who's in the the operating room with them and give feedback to, you know, whether it goes admin to agency, whatever it might be, I would imagine they have some thoughts as well.
00:11:52
Speaker
A hundred percent and not. You know, at the end, of that you know, there's a difference between the nurse that's in the OR versus the nurse who's not in the OR because the nurse 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 ah good partner to the surgeon for that time.
00:12:16
Speaker
So typically the surgeon is either in that team's interview or, you know, they really are evaluating. when they're first there. If they you know the admin loves them, yes we're gonna have them come in, but let's have them start.
00:12:29
Speaker
you know It could be day three 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.
00:12:41
Speaker
Sure. That makes sense. And what does a contract to hire potentially look like? Contract to hire. So we're going to send the ASC a few different profiles. There's never just one.
00:12:54
Speaker
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, an all-encompassing, 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.
00:13:13
Speaker
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 to hire. Or they can say, you know what, we really needed her, but i think we're just We're not going to have a need for her beyond this date.
00:13:26
Speaker
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 a fork in the road, depending on where the ASC wants to drive.
00:13:38
Speaker
And we're just happy to facilitate that for them. 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 and I don't want to say bopping around, but, you know, they kind of like trying out different things. oh It depends on the nurse that 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.
00:14:07
Speaker
That's my favorite phrase about agency, by the way. So we do, we've gotten really good at recognizing that. What we have found is in the post-COVID world, unfortunately, a lot of nurses that were in the OR, in the acute setting, are really ready for that ASC, for that you know five days a week, census-driven, on call.
00:14:29
Speaker
it you know It depends. And you you get a sense of that before we send them to the ASC. 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 things that help us make the right decision before we put them in front of the ASC.
00:14:53
Speaker
So it's almost like a pre-screen always, you know, there's always checks in place. Yeah. Yeah. Perfect. 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.
00:15:06
Speaker
What is one thing our listeners can do this week to improve their surgery centers? That's a tough one. have two answers. I don't know. I'm trying to decide. Okay. I'll take two.
00:15:18
Speaker
Okay. I will say, while we are not a mine 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.
00:15:32
Speaker
Because you cannot guarantee that one of your staff will not, you cannot guarantee that there would 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? um Understanding at the end of the day, the right agency partner is here to help you.
00:16:02
Speaker
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 four weeks. You don't need to hire someone for four weeks and incur that cost.
00:16:15
Speaker
Let the agency take care of it. It's four 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.
00:16:27
Speaker
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. That is great advice.
00:16:39
Speaker
Thank you so much for coming on today. We really appreciate it. Thanks, Erica.
HST Pathways Industry Report Update
00:16:48
Speaker
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.
00:17:01
Speaker
Most importantly, using our own unique data set 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.
00:17:16
Speaker
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.
00:17:30
Speaker
So let's start with what we mean by unworked bills.
Managing Unworked Patient Bills
00:17:33
Speaker
In this case, we're talking about patient accounts that have had no activity. So no follow-up, no outreach since the date of service.
00:17:41
Speaker
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 days old on average are worked once a month.
00:17:54
Speaker
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 to every two and a half months.
00:18:08
Speaker
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 higher percentage of delinquent accounts.
00:18:27
Speaker
Now, what can 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.
00:18:39
Speaker
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.
00:18:51
Speaker
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.
00:19:04
Speaker
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.
00:19:15
Speaker
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 plans, makes it easier for them to engage with their bills and reduces payment delays.
00:19:34
Speaker
The more convenient you make it, the less likely bills ah 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.
00:19:53
Speaker
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.
00:20:13
Speaker
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.
00:20:25
Speaker
An experienced RCM partner can take on billing follow-ups and 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 cash flow. They make collections harder, increase the risk of bad debt, and put unnecessary strain on your revenue cycle.
00:20:46
Speaker
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.
Podcast Wrap-up and Listener Engagement
00:20:59
Speaker
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.
00:21:10
Speaker
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.