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Alex Taira - The No Surprises Act: Looking Ahead to 2023 image

Alex Taira - The No Surprises Act: Looking Ahead to 2023

S1 E2 ยท This Week in Surgery Centers
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On this week's episode, our host Raphael Akinsipe chatted with Alex Taira, ASCA's Regulatory Policy and Research Manager about what ASCs can likely expect in 2023 when it comes to the No Surprises Act. In our news recap, we'll cover the Great Resignation, the smartest moves made in 2022, and the disparity in the number of Latino doctors and surgeons.

Articles Mentioned:

How To Ensure Your Nurses Stick Around Through The Great Resignation

The smartest move 3 ASC leaders made in 2022

There's a big disparity in the number of Latino doctors and surgeons

California Hospital Tech Brightens Kids' Casts with Amazing Artwork

Resources Mentioned:

ASCA - General Information

CMS - General Information

CMS - Consent Form for balance billing protections

CMS - Model disclosure notice

IDR Process for Providers and Payers

IDR Process for Providers and Patients

Brought to you by HST Pathways.

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Transcript

Introduction: Latest in Surgery Centers

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 guests, 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.

Interview: Alex Tyra on the No Surprises Act

00:00:27
Speaker
Hi, everyone. Here's what you can expect on today's episode. Our host, Rafael Akinsopi, sits down with Alex Tyra. Alex is the regulatory affairs and research manager at ASCA. You probably know his name by now. He has become ASCA's resident expert on all things related to the No Surprises Act. We had the chance to pick his brain about where the industry is at today with this piece of legislation.
00:00:53
Speaker
But more importantly, get an understanding of what the No Surprises Act will look like in 2023 and how ASC should be preparing. We'll close the episode with a few news stories. We'll start with how you can ensure your nurses stick around during the great resignation. Share with you what a few admins considered to be their smartest move in 2022. Look at the big disparity in the number of Latino doctors and surgeons there are and why that matters.
00:01:22
Speaker
And of course, end the news segment with a positive feel-good story about an orthopedic tech in California. Hope everyone enjoys the episode and here's what's going on this week in Surgery Centers.
00:01:39
Speaker
All right. How's it going, guys? I am your host, Rafael Kinzpe, here at This Week in Surgery Centers. We've got a super exciting episode this week. This week, I'm joined by Alex Tyra. He is the head of regulatory affairs and research management at ASCA.
00:01:55
Speaker
We're going to be covering the No Surprises Act this week, and he has been leading the charge on this across the industry. So we're pumped to get some of his insights. But before we jump into any of the questions, I'm going to turn it over to Alex. Thank you for joining us. And for those who don't know you, can you share a bit about yourself?
00:02:14
Speaker
Yeah, hi, Rafael. Thanks. I'm super glad to be here, super glad to be working with HST. I've done some fair amount of work with you guys because I do some EHR-related work for ASCA. So really happy to be here talking about this topic. I've been at ASCA for about five, six years now. And for those who don't know, we're the national organization that advocates for ASCs. The biggest national organization, we have a few thousand members, but we advocate for the interest of all 6,000 plus.
00:02:42
Speaker
Medicare certified ASCs. I would say a lot of what we do is related to federal regulatory advocacy. So Medicare related work is obviously a big component. But sometimes stuff like no surprises, surprise billing, stuff that's being handled on the federal level that affects ASCs is also very much our purview. And as you mentioned, we've been doing a lot of education and outreach and trying to make sure that our members and the ASC industry as a whole is positioned well to respond to some of these new regulations. That's super helpful.
00:03:10
Speaker
You know, I naturally want to jump in and start asking you all these questions, but I had a moment there where I was like, probably should take a step back for any of our listeners who don't necessarily know what the No Surprises Act is. And can you share a little bit on just what the No Surprises Act is so that just our listeners are kind of aware?
00:03:29
Speaker
Yeah, I mean, so people in the healthcare industry have probably heard in recent years about surprise bills or sometimes they're called balance bills. You know, basically, there's when a patient shows up and they receive a bill that's in excess of what they might expect, or maybe some charges for services that they didn't know about going in.
00:03:48
Speaker
And it's become kind of a big publicity issue for health care, I think, in recent years because you see all these news stories, horror stories, right, of people going in for a procedure and, you know, maybe they need something complex to happen. And so they go in and they come out, perhaps it's an emergency procedure even. And so they didn't really have a say about whether they needed this health care.
00:04:08
Speaker
But then they come out with some health care bill that's in tens of thousands, hundreds of thousands of dollars, right? And so there was this kind of willpower to mitigate some of that cost, you know, thinking patients are carrying too much of this cost. And we know that health care is expensive, especially for some of these high cost services, complex services, but at least patients just have an expectation of what they're going to pay. And there should be a limit on what they should pay. So these are kind of the new regulations
00:04:34
Speaker
I would say that there's basically two main scenarios that the regulation touches, although we're going to talk about a lot of different things. But broadly, the law is basically concerned with emergency services. So like I said, going in when you need something to happen and making sure that patients aren't paying too much.
00:04:50
Speaker
And then there's a second circumstance, which is non-emergency services, so elective procedures from out-of-network providers at in-network facilities. And this is where ASCs come in because, you know, an ASC is commonly in a network facility, but also contracts with providers, physicians, external providers like pathology labs or someone like that.
00:05:09
Speaker
that might be out of network. And that's kind of the source of a lot of unexpected bills. And so that's one of the major pieces of the law. That's super helpful insight there. And I think it gives a good perspective on kind of what the legislation is and how ASCs fit into that mix. So, you know, kind of throughout the year, as we've talked with different customers and different players across the industry,
00:05:31
Speaker
The No Surprises Act has definitely been a point of conversation, and I think many would say a point of controversy throughout the

Challenges with the No Surprises Act

00:05:38
Speaker
year. And with your pulse at ASCA on the industry, how would you say people across the industry are feeling right now about the legislation with regards to ASCs?
00:05:52
Speaker
I think there's a lot of uncertainty. And part of that comes from the rollout of the law itself. So this law was passed right at the end of 2020. And then last year through 2021, they were issuing these rules. This is how the federal government basically creates regulation. So there were three main rules that came out throughout last year.
00:06:15
Speaker
that kind of outlined all these intricacies of how this new regulation would affect providers. And it was very dense. It was very complicated. And one thing that we will get to later is that it's still being crafted. So there's a lot of parts of the law that aren't concrete yet.
00:06:31
Speaker
So I think that contributes to a general, not just from ASEs, from all health care providers, this sense of uncertainty and like, you know, this thing came into being over the course of a year, which is not a very long time for people to adjust to this big new regulatory framework. And on top of that, it's still changing. So there's this sense of like, what do we even have to do to be in compliance, you know, and ASEs, because a lot of ASEs are independent, they're small,
00:06:58
Speaker
They don't necessarily have the resources like a hospital might to devote to this kind of regulatory compliance or keeping up with this stuff. So I think there's a lot of frustration and struggle to understanding like, what do we need to do? Are we in compliance now? Will we be in compliance in the future? You know, those are tough questions. And I think the fact that the law is so complex makes it even tougher to kind of provide resources and education. Yeah, that's it.
00:07:23
Speaker
That's such a good point. In terms of that complexity, many times as I've talked about the No Surprises Act with people, I feel like everyone has this broad overarching idea of what it is, but then as we start to get into the nitty gritty on what this means for everyone across the industry, it becomes much more nuanced and it's harder for people to evaluate and make decisions for themselves on what should be happening.
00:07:46
Speaker
You know, I was going to ask you, you know, what do you think is kind of holding surgery centers back around the No Surprises Act? But I think you're already leaning into that with the uncertainty. You know, what do you think are things that would help surgery centers in terms of understanding some of that and kind of overcoming that uncertainty and understanding some of the legislation as it stands today?
00:08:07
Speaker
Yeah, I think one thing is that understand that a lot of the provisions in the act are not necessarily going to be impacting ASCs directly. So ASCs are certainly subject to many of the regulations, but aren't necessarily involved in all of the intricate aspects. We might talk about some of the legal cases down in Texas or some of the things that have been taking up news stories and that's big news in healthcare, but they don't necessarily affect ASCs. So that's one part.
00:08:37
Speaker
The second part is that there have been a lot of good resources. We at ASCA have been trying really hard to push out as much education, and that's not really even a plug for us as much as if I can post a link to a model form or a model disclosure that a center can use.
00:08:54
Speaker
instead of creating their own document. That's something that we're hoping to get out there. That stuff exists out there. So I think maybe not trying, not feeling like a center has to do all of this work themselves, that there are these underlying resources that can help them get to where they need to be.

Resources for ASCs Compliance

00:09:09
Speaker
is definitely something big for facilities to understand. And I think it's still complex. It's still tough to find these resources. But getting some of that will help a lot. Awesome. Well, before I let you go today, I definitely want to make sure we cover some of those resources. But before we jump into some of those steps that people can take on that side of it, coming back to the pulse of where things have been in 2022, do you feel like centers are starting to warm up to it? Or do you feel like that uncertainty is keeping a darker cloud over it right now?
00:09:39
Speaker
No, I think the uncertainty is reigning supreme right now.
00:09:45
Speaker
One, I think part of that is because, as I mentioned before, the law is still changing. So we're actually expecting some expansion of the law, of the requirements related to the law in 2023 and beyond. So as much confusion as there's been about what you have to do this year in 2022, I think these requirements are only going to get more, I don't want to say complex, but there are going to be more of them. Centers are going to have to be aware of more things.
00:10:12
Speaker
So I think that contributes to a lot of uncertainty. I think also there is a sense from the health care industry as a whole, you know, the federal government hasn't really been enforcing the requirements related to surprise billing that strongly this year. And that's intentional. They said, you know, this happened really fast and we don't want to penalize people for something that came up basically within the past calendar year.
00:10:39
Speaker
But that also makes it difficult because there's not really a stick up there for some of these actions. So people aren't sure what is the level of enforcement going to be in the future. There are penalties that could be up to $10,000 per violation written into the law. Are they going to be really strict in enforcing that? And are centers going to have to be really diligent about keeping up with this? Or as we've seen in some other regulatory frameworks,
00:11:05
Speaker
You know, is it going to be only kind of the most egregious situations are going to be enforced? That's tough to know. I guess from what you've seen with the No Surprise Act and even with other legislation, you know, how are those things typically approached? Like, is there something that, you know, as we go into 2023 centers can can expect in terms of?
00:11:23
Speaker
If we do end up in a scenario where they are enforcing it more heavily, is there a certain amount of checks and balances that are already in place from a legislation standpoint to audit a center or to review the estimates that centers are putting out? Is there anything like that that they can expect from an enforcement standpoint that you've seen elsewhere?
00:11:48
Speaker
Yeah, I wish I could say that I knew what it was going to look like, but I really don't. And I don't think anybody does yet, partially because the federal government has laid back for the moment and said, we're not really going to enforce this that strongly.
00:12:00
Speaker
You know, I think we'll see. This is something that we're definitely keeping an eye on as this develops. There are, I think, pain points that I can already pinpoint that are going to be the crucial elements. So you mentioned estimates. And one thing that is not really being enforced this year, but is the interaction between an ASC and some of their external providers, an anesthesiologist or a pathology lab.
00:12:23
Speaker
And when you're trying to accumulate a estimate of costs for a patient, that's going to be one of the more difficult interactions, I think, if the center needs to get a cost estimate from a provider that they don't necessarily employ directly. That might be difficult. And we've already heard, I've gotten tons of questions about what if they don't want to give us this estimate, or what if they won't respond, or all of that.
00:12:45
Speaker
And those are certainly valid concerns, and I think that's where enforcement will play a part in easing some of those relationships, becoming the stick to this new regulatory framework. But again, I wish I could say I knew more about how that was going to look operationally, and I just don't, and I think we'll know more over the next year or two. That's a good perspective. I mean, I think no one has a true crystal ball for what's going to happen, and especially when it comes to legislation, I feel like
00:13:09
Speaker
Anytime you're dealing with anything that's kind of based in the government or legislative body, you kind of are somewhat waiting in the wind because it could be something that's high on someone's agenda and that the next year is largely enforced or it could be something that's slightly lower and kind of has a longer runway before there's some strict enforcement. Oh, go ahead. I'm sorry.
00:13:33
Speaker
Well, I was just going to say, and there's, you know, as we're all aware, there's kind of these regular government processes that are interrupting this. So we just had a changeover administration, you know, recently, and we're about to have another election. And sometimes it's unclear how, you know, a new Health and Human Services Department will, you know, what they will look like in terms of enforcing this.
00:13:56
Speaker
Certainly we've seen in the past decade some fluctuations in terms of how strict they'll be for some of these other programs. And I think that's just the case with the whole federal government. That's very true. There's definitely a natural fluctuation between different parties and different bodies that are kind of managing those areas.
00:14:12
Speaker
So, you know, without going too heavy on the crystal ball and predictions, if you were going to, you know, if you were talking to a center right now on kind of top three things they should prepare for, or maybe should expect going into 2023 with regards to the No Surprises Act, what are those top three things you would tell them to be thinking about or preparing for?

Future Regulations and Compliance Strategies

00:14:36
Speaker
Yeah, I think what I said earlier that we're just at the start and this is just going to expand is something that's really important.
00:14:44
Speaker
For example, the good faith estimates that we've been talking about right now, those are only applying to uninsured or self-paid patients. So a small subset of patients that an ASC might see. And so I think maybe ASCs haven't had to do very many of them or haven't had to compile this many estimates. But I mean, we've already seen a request for information in the past month from the federal government about expanding the good faith estimate requirement to insured patients.
00:15:10
Speaker
So if you're not set on the good faith estimates now, while it's just a smaller subset, you're probably going to be behind the ball once that expands in the future to all patients, right, insured patients as well. And, you know, I don't know how fast that's going to happen. It could happen in 2023. As I said, it's just a request for information at this point, we haven't seen any actual rulemaking. But it's probably good to start thinking about those things. The second thing I would say is those relationships,
00:15:38
Speaker
We had already mentioned third-party anesthesiology, pathology, building those relationships and making sure that there's good communication. Those are going to be essential because right now, as I mentioned, they're not really enforcing all of these costs, making sure all the costs are accumulated for an estimate right now. But those will be enforced in the future at some point.
00:16:03
Speaker
So it'll be important to have that relationship. And I think building on that, just any way that you can build a process that makes it easier for your center. Again, ASCs are in hospitals. There are, I'm sure, some that are big multi-OR facilities that have dedicated staff that can handle this. But if you're an independent one-OR, two-OR, single specialty facility,
00:16:25
Speaker
Yeah, it might be good to start thinking about how these processes are going to work. You know, you can automate it. I know HST, for example, has a partnership or has a technology solution that can help with estimates. I'm not saying that has to be yours, but maybe that can be something that can help you along the way. Thinking about those things to make your life easier now is going to be really crucial just because it's only going
00:16:48
Speaker
That's very true. And if I'm hearing you kind of just recapping those three things you mentioned there. So one is being prepared from a good faith estimate standpoint. Two is having those relationships in place and kind of making sure you're coordinated in that regard. And then three is planning around the processes. And maybe those processes are enabled by technology, but having the processes in place to make sure you're able to facilitate that. Is that an effective recap on that?
00:17:16
Speaker
Yeah, I think that was a great summary. Awesome. Yeah, I'm taking the mental notes. You're giving all the good stuff there. I'm just trying to keep up. So, awesome. Okay, you hinted at this a little earlier, and this is probably one of the juicier parts of it that people have probably been seeing some headlines on.

Legal Challenges and Dispute Resolution

00:17:31
Speaker
So, with the different Texas hospitals who have kind of pushed back on some of the No Surprises Act,
00:17:38
Speaker
There's been a lot of legal court cases that have been in place and they've been filing lawsuits both at a state and a federal level with regards to this. Do you anticipate that what's happening with hospitals to be something that we can start to think or see as a parallel for what might end up happening with ASCs as we go into this next year?
00:18:04
Speaker
I don't really think the court cases, the legal cases around this law are going to spread to the ASC industry as much. Certainly there may be some action, but at least in my understanding, a lot of the court cases so far have been about
00:18:23
Speaker
the dispute resolution process, so basically when a provider, an out-of-network provider and a payer are disputing reimbursement, right? Because the law says a patient can only pay this much and that generally will leave an out-of-network provider and a payer in this kind of limbo without getting too deep into it. You know, the government set up this process that is supposed to adjudicate these disputes between providers and payers
00:18:49
Speaker
and basically said at the center of this process is something called the Qualified Payment Amount, the QPA, which is a median in-network rate for your geographic area, which sounds reasonable, but you can think in practice may have some perverse incentives in the sense that if a payer, for example, knows that their starting point from all arbitration is going to be their in-network rate, then they don't really have an incentive to make that a high rate or to keep positions in them whatsoever.
00:19:19
Speaker
So what we've been seeing, and this continues to happen actually, is that local payers will basically threaten contract termination to cover providers or lower their in-network rate significantly, understanding that there's this process being set up that makes their median in-network rate basically the starting point for all these negotiations.
00:19:42
Speaker
It's a tough situation. Again, I don't necessarily want to burden ASCs with too much of this because I don't think ASCs will be that subject to some of these disputes. Certainly the physicians who work in ASCs will. But for right now, one thing that's important for ASCs to note is if you're an in-network facility and you contract with out-of-network providers,
00:20:04
Speaker
you will have some responsibility. If you're an out-of-network ASC, you're not covered by this law whatsoever. The law does not contemplate out-of-network facilities, elective procedures, and out-of-network facilities. So if you're out-of-network with a patient, this law doesn't make any difference to your interaction.
00:20:21
Speaker
So I think it's good to keep an eye on these court cases on some of the legal drama that's happening, but it may not be as applicable to the AFC industry. Okay, that's good to note. And I think that's probably a good thing for us. I think the complexities from a legal standpoint and court case standpoint obviously make it harder for all parties involved to be able to move forward in an effective way.
00:20:43
Speaker
great call outs there in terms of some of the misalignments on the incentives between the various players in the industry. As we're thinking about some of the next steps and some of the opportunities for surgery centers going into 2023, I know you mentioned that there's different resources that they can take advantage of. I know ASCA as a whole publishes a ton of different resources, but
00:21:07
Speaker
Are there any key things you would say that surgery centers and any of our listeners should maybe go to as great resources with regards to the No Surprises Act?
00:21:18
Speaker
Yeah, I think for now, there's a few things that centers can really take advantage of. One is that as part of the law, centers are required to disclose to patients protections offered under the law to them under, you know, surprise billing regulations. And the disclosures have a lot of requirements in terms of what the font is like and what language it's presented in and what information has to be applied.
00:21:42
Speaker
And it sounds like a lot, but there are model forms online, so you don't have to necessarily create this by yourself. You can just go to the CMS website, or the ASCA website, we posted it there, and pull down this form, and that can satisfy your requirement for a disclosure to the patients.
00:21:59
Speaker
similar, you know, this disclosure has to be put on your website, you know, in your physical facility. So you can make that a lot easier if you use some of the resources that are there. There's also model forms for good faith estimates, as well as a clear outlining of all the data elements that need to be included in that those things can really help you, you don't need to create these processes by yourself.
00:22:21
Speaker
And I'm hoping that as this law expands, you know, there will be more of those things. Certainly, I think even though the law is large and complex and confusing, CMS has seemed to be in good faith in offering as many resources, FAQs, webinars, slide decks as they can.
00:22:39
Speaker
So there's actually maybe two new resources happening right now. But I think if you're thinking about, oh, there's this form I need, or I'm not sure what the language is for this, it's probably out there and it's probably already been formatted for you and you just need to go find it. Awesome. Well, that's super helpful. Maybe what we can do is I will talk to our show producers and try and get them to
00:22:59
Speaker
put a couple of those links that you mentioned there into some of the show notes and we'll also share it across social as well. So people have quick access to that. You know, as we kind of wrap up our episode today, you know, one of the things that we do every week with our guests is we ask them, you know, what is one thing our listeners can do this week to improve their surgery center?

Advocacy for ASC Industry

00:23:23
Speaker
Doesn't have to be related to no surprises, just what is one thing they can do to improve their surgery center this week?
00:23:30
Speaker
Yeah, I love this question. And I honestly cannot wait to hear some of the responses you hear from future guests, because I'm sure it's just going to be, if you compile all these answers, it's just going to be great information for ASCs. One thing that I was thinking about that I'm not sure is possible in a week, but I think can be started in a week was to just be an advocate for your center.
00:23:51
Speaker
You know, we still hear on the local level, the state level, the national level, a lot of not just uncertainty, but people who don't know about ASCs in particular, you know, and the advantages that they can provide to patients in terms of better patient experience, lower costs, all of those things that we in the industry kind of inherently understand from working here.
00:24:09
Speaker
So I think if you can advocate a little on behalf of your center, that advocates on behalf of the industry as well. And that could mean a little social media, it could mean some volunteer work, it could mean giving a lawmaker an official a tour of your facility so they see you're not just some random facility, you're a state of the art center that has all of the things that you might expect to have these procedures done safely.
00:24:33
Speaker
I think those things will go a long way and hopefully as we kind of build the understanding of the ASE industry at the local and at the national level, we'll get more policies that are favorable to our industry. I love that. I think one of the things I always talk about, maybe this is I used to be a product manager.
00:24:49
Speaker
This might be the product manager in me, but anytime people can be an advocate or an evangelist for the places that they work or the products they work on, or in many cases for us, with the patients they work with, that is a massive opportunity. So I'm super aligned with that. That's a great one there. I think that's a nugget that'll go really far.
00:25:08
Speaker
You know, Alex, I have really enjoyed this episode. I think we covered some great things. We got some great nuggets in terms of where the industry is today, what we can expect going into 2023. What are some of those great resources that people have access to? So you provided a ton for our guests. Where can people find you if they want to hear more from you or see any of the content that you're sharing? What's the best place for people to hear more from you?
00:25:36
Speaker
Yeah, so I do a lot of work with ASCA and pushing out advocacy or educational resources. I'm not sure if we'll be able to share my email, but I'm always happy to answer questions. And I would say if you're not an ASCA member, we provide a lot of great resources. Some of that can be operational in terms of your Medicare billing, some of that can be Keeping Up with No Surprises Act. And I write for
00:25:59
Speaker
our print magazine and our online magazine about these topics every month. So you can certainly find me on the ESCA website, all over our federal regulations pages and in Focus magazine. And if I can, I'll share my email as well so people can reach out directly with any questions. Awesome. Love it. Well, thank you so much for your time, Alex. This has been a great episode and we look forward to hopefully having you on the podcast again sometime soon. Thanks, Rafael.

Nurse Retention Strategies during the Great Resignation

00:26:28
Speaker
As always, it has been a busy week in healthcare, so let's jump right in. As we know, nurses are leaving their jobs at higher rates than this country has seen in a long time. That's not new for anybody. Forbes published an article recently titled, How to Ensure Your Nurses Stick Around Through the Great Resignation. And I feel like every time I read one of these articles, as I'm sure you're all in the same boat,
00:26:53
Speaker
I'm looking for something new, something that is tangible and could actually be effective. This article is pretty good, and there were two tips that I thought were worth sharing, and I promise you that neither of them have anything to do with free food. Tip one is to look at different talent solutions in staffing agencies. Maybe you've looked at them in the past, but it might be worth exploring again. While it might not always be the most economical solution,
00:27:22
Speaker
If you can fill in some gaps and reduce the need for double shifts and offer flexibility, it will hopefully stop your most tenured staff at least from leaving and let them know that you know that they need help and you're trying to find solutions for them. And tip two is to change or get rid of systems that just aren't working for your nurses any longer. And I feel like all the time we're talking about improving your processes on a day-to-day basis
00:27:51
Speaker
But I think what's different about this tip is that you're looking at it from the nurses' perspective. What is not working for them anymore? And no one can spot a process improvement opportunity better than a nurse can. When leaders take feedback from nurses on what can be improved, not only do the processes themselves become optimized, but the nurses feel like their voices matter, and that's what's key here. So it's really a win-win for the business side of the house and also the clinical side.
00:28:22
Speaker
So you can set up a committee or a monthly meeting or have one-on-one meetings with all of your nurses to collect this valuable feedback and make sure you're doing it in a way where your nurses are comfortable sharing. And then not only do you need to take their feedback, but you need to be extremely transparent on if you plan to use it, if not why, and if you do when. Second story

Strategic Moves for ASCs

00:28:47
Speaker
here.
00:28:47
Speaker
Becker's ASC asked three surgery center leaders to look back at 2022 and share the smartest moves they made this year. I thought that was a really interesting way to frame the question. As I was reading this article, I was actually struck by how many ASCs I've heard express interest in actually doing some of these things and seeing the benefits of it, but aren't quite sure about taking that leap.
00:29:14
Speaker
I thought this would be a really good recap to share just in case anyone needed some inspiration to get started or if you've been looking for your sign, here is your sign. One admin in Texas said her smartest move was actually building and relocating to a new surgery center. Now I know this is not an option for everybody, but it is on the table for some and no further details were shared, but I can't imagine this was a huge undertaking and it sounds like it paid off in one way or another.
00:29:44
Speaker
A second admin in Colorado shared that they went all in on investing in their nurses. This actually really ties back to our first story too. We all know how critical staffing is right now. This admin in Colorado shared two really great ideas, one for staff retention and one for staff satisfaction. First, they went ahead and created a longevity incentive for all staff.
00:30:11
Speaker
Obviously, short-term solutions are you need to get people in the door, right? We need to hire people immediately. But keeping the good ones and keeping the ones who want to stay there can actually be done by this longevity incentive, which I thought was really cool. And then second, they ensured that physicians would have the last patient in the PACU by 3.15 p.m.
00:30:38
Speaker
So that allows their staff to leave at a reasonable hour and enjoy a better quality of life and have a better work-life balance. And that's what touches on the staff satisfaction. So just to recap, longevity incentive and closing down at a reasonable hour and sticking to it. Lastly, the third admin in California said their smartest move in 2022 was implementing an EHR and outsourcing their billing.
00:31:05
Speaker
Both of those changes had huge impacts on their business by adding visibility and analytics in a way they didn't have before. So if we've been considering either of those things or any of those things listed, might be good to kind of take that first step. Our third story, advocates are working hard to increase the number of Latino physicians and surgeons.

Cultural Representation in Healthcare

00:31:30
Speaker
So according to NBC News, and just to kind of give you some numbers here,
00:31:35
Speaker
Latinos account for only 7% of the overall physician and surgeon workforce. And at the same time, according to the latest 2020 census numbers, almost 20% of Americans are Latino. So there's a pretty significant gap there that needs closing. It's so important that there's a proper balance and representation at all levels.
00:32:01
Speaker
But this disparity is also doing patients a huge disservice. Studies have shown repeatedly that when a physician speaks the same native language as their patient, and they're able to relate to the cultural experiences of their patient, they are more likely to have better outcomes. And of course, thinking about the patient first, you can understand why this is so important. There's just that added sense of safety and comfort and understanding
00:32:30
Speaker
especially when it comes to high stress situations like your health and having surgery. So that's not the only benefit. And aside from all the other ones, if you put yourself in your patient's shoes, you'd understand why it's important and we should all be doing something about this. Since California does have the largest Latino population, a lot of advocacy groups are planning to start there and then planning to expand.
00:32:58
Speaker
A few that are doing amazing work in this area right now are the California Medicine Scholars, the Alliance and Mentorship, and the National Hispanic Medical Association. So I recommend checking out any of those. And I'm sure there are others that are also working to increase the number of Latino physicians and surgeons.

Heartwarming Story: Custom Casts for Kids

00:33:19
Speaker
And to end our news segment on a positive note,
00:33:22
Speaker
People shared a story about an orthopedic technician in California who goes out of his way to customize the cast of his young patients. So he takes the time to draw their favorite cartoon characters, sports teams, whatever they want onto their casts. And as you can imagine, the kids absolutely love it and are proud to show off their cast instead of being embarrassed or feeling different by them.
00:33:49
Speaker
And by now he said he's painted over a thousand casts. And if you head to the episode notes of this podcast episode, you'll see the people article. And I promise you it's worth checking these pictures out. They're super cool. He's really, really talented. And that news story officially wraps up this week's podcast. Thank you as always for spending a few minutes of your week with us. Make sure you subscribe or leave a review on whichever platform you're listening from. We really appreciate it.
00:34:18
Speaker
And I hope you have a great day and we'll see you again next week.