Transcript
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.
Speaker: Hi, everyone. Here's what you can expect on today's episode. Marie Yarbrough is the administrator of Skyway Surgery Center in Chico, California, and she's here today to talk to us about the top five KPIs that all ASCs should be tracking. There's that very popular saying, you've probably heard a million times, if you can't measure it, you can't manage it, and that's certainly true when it comes to surgery centers.
Speaker: We get to talk with Marie about the top KPIs, how she determines what to measure, how she collects the data, the results she's seen, and so much more. In our news recap, we'll cover the new Outpatient Surgery Quality and Access Act, the latest on the No Surprises Act, a new gastric balloon that does not require surgery, and of course, end the new segment with a positive story about a couple who fell in love after going through heart surgery together.
Speaker: Hope everyone enjoys the episode and here's what's going on this week in Surgery Centers. Marie, welcome to the show. Thank you. Appreciate you. Appreciate you joining us today. Can you tell me a little bit about your background in the AOC industry? Yeah. Thanks for having me on today. My name is Marie Yarbrough. I live and work in Northern California.
Speaker: which I've been a resident of my whole life. I'm a certified ASC administrator. I have my degree in business and in a few more months I'll have my MBA. I've worked in healthcare my whole life and I've been an ASC administrator for 15 years now. Fantastic, great background. And you're currently at Skyway Surgery Centers, correct? Yes. Tell us a little bit about Skyway in terms of
Speaker: what type of facility you are in specialty areas and things like that. Sure. Yeah. Skyway is a four O R one procedure room multi -specialty facility. We perform around 600 cases a month and we see predominantly ortho ophthalmology and GI cases. Great. And does Skyway have any affiliations either with management companies or ownership groups or anything?
Speaker: Yes, yes, we are part of Surgery Partners. Fantastic. And I appreciate that background. And one of the things, Marie, we're excited to talk to you about today. At HST, we're big fans of the ASCA Forum. We check in there for time to time. It's been a good source of learning and knowledge sharing for our company over the years. And one of the posts that we noticed
Speaker: recently was a post that you made around KPI files and KPI sharing. And we thought that'd be a great topic. We're always talking about KPIs and data at HST with our customers. Yeah. And thought it'd be a great topic for a podcast. A couple of the KPI categories that you posted about, and you were so kind of nice to share your file on, was around billion collections. Yes.
Speaker: When you think about KPIs overall across Skyway Surgery Center, are those typically the categories that you're focused on, as the billing and collection said? I mean, just with my background in business, yes. But the business has so much more to it, right? Patient satisfactions, surgeon utilization. There's so much you can focus on.
Speaker: But of course, the business is my main focus, as should any administrator. Absolutely. Revenue in, right? How much money are we making? So can you share what KPIs are in general and why you think they're so important and helpful? Sure. KPI is an acronym for Key Performance Indicators. Key Performance Indicators measures your facilities
Speaker: performance that you can use to quantify levels of success. It gives you that visual representation of key areas of focus. I use it to watch historical trends and to see if my organization is meeting its goals. Normally, you can use this when one chart or a graph or a piece of data does not provide enough information to decide.
Speaker: KPIs are important because you can't manage what you don't measure. I think it was Peter Drucker that said it best. That's great. How long have you been tracking KPIs at Skyway? I've been tracking KPIs from the beginning. I've quickly learned the benefits and feedback a KPI can give to determine which one to track is individualized. The need at Skyway was more financially,
Speaker: related, I needed to be able to track how we were doing with upfront collections, aging, billing timeliness, credit balance levels and things of that nature. Got it. Okay. And so the focus on the financial side with billing and collections. And so you've got your key KPIs, which you track. Do you change those on a regular basis or do they tend to stay pretty consistent month over month, quarter over quarter?
Speaker: Yeah, more than likely, I find I will add to my KPIs rather than stopping a measurement altogether. The indicators that I choose to follow are important to me and there is no finish line. It's a monthly comparison of a performance that I can follow and then learn from. Fantastic. And the data side of it is something that our customers ask us a lot in terms of, hey, how do we get the right metrics in the right way that we want to see it?
Speaker: What do you guys use for the data collection? HST. I have several reports I run in HST. For example, if I want to follow how well registration is doing, collecting the amounts due at time of surgery, I will run a report under HST scheduling reports called SC1000 Admission Billing Schedule. This report clearly shows the amount estimated
Speaker: the patient will owe at the time of service, which has been given to the patient ahead of time and the amount collected. Each month I track their progress or decline. Once I've collected this data, I entered an Excel spreadsheet that I've created and I'll follow the changes and variables. Once I started to track the numbers, I implemented benchmarking levels to help motivate change. Fantastic.
Speaker: Marie, if you had to choose five KPIs that every ASC should be focused on, what five would you choose? There's so many. I would say you should definitely follow your financial numbers. This is so important for administrators to track. When you keep a close eye on this, you'll know sooner rather than later if numbers start to shift. I would also track supply costs or
Speaker: operational costs, track those numbers either by case or against revenue volume. Again, if you notice a shift, what happened? Where did the shift come from? How do we fix it? What are your options? In the long run, this is going to help those financial numbers. And then the employee expenses, labor expense per gross revenue or average labor cost per case, however you want to follow and track it.
Speaker: It doesn't even have to be a ratio. You can just follow the numbers. Surgeon utilization using who's using or not using their block and why or why is their volume shrinking. Those are questions you can answer by following those numbers. Lastly, patient satisfaction. What's the trend? Do you see a decline in satisfaction scores and why?
Speaker: Love it. Very, very encompassing there in terms of the different categories of operations. So appreciate it. So final question for you, Marie, and we do this every week with our guests. What is one thing listeners can do this week to improve their surgery centers? I say, empower your employees with information. These tracings are just not for you and the board. Allow your employees to see the changes that are happening.
Speaker: Set a benchmark and create a goal for them. And lastly, reward them for a job well done because their success is your success. Love it. All right. That's a wrap. That's a wrap. Okay. Thank you so much. As always, it has been a busy week in healthcare, so let's jump right in.
Speaker: Our first story comes from Becker's ASC and it's definitely an exciting one. Four lawmakers have reintroduced legislation that would eliminate penalties that charge Medicare beneficiaries higher co -pays for care outside of hospitals. The four lawmakers are Senator Bill Cassidy of Louisiana, Senator Richard Blumenthal of Connecticut,
Speaker: Representative Brad Winstrup of Ohio and Representative John Larson, also of Connecticut, and the bill is called the Outpatient Surgery Quality and Access Act. The goal of the bill is to close the reimbursement gap between hospital outpatient departments and ASCs, and co -pay penalties for Medicare beneficiaries, address barriers to affordable and quality care, and increase transparency about CMS's procedure coverage at ASCs
Speaker: which I know has been a longstanding question and issue. Senator Blumenthal shared that patients shouldn't be charged more for procedure just because it was performed by an outpatient provider.
Speaker: The current restrictions on ASCs are an unnecessary burden, limiting seniors access to care and driving up healthcare costs. I think we can all agree with that. And honestly, as a Connecticut resident, I am proud of how Senator Blumenthal is advocating for surgery centers. And also the bill is endorsed by ASCA, which always helps. So we'll keep a close eye on how it progresses and we'll make sure to share some timely updates.
Speaker: The next story is kind of wild, but the United States Department of Health and Human Services has paused surprise billing arbitration after Texas court decision. So to understand what this means, you need to first understand the independent dispute resolution process. So as we know, surprise medical bills have been banned in America since 2022, since the No Surprises Act went into effect.
Speaker: Despite the law, though, one in five Americans still report receiving surprise bills, and obviously we all know compliance with the No Surprises Act has been completely hit or miss. There's been so many questions. So part of the No Surprises Act allows patients to file payment disputes through CMS's website.
Speaker: And in 2022, they opened up the portal for five and a half months, so from April 15th to September 30th as kind of a trial. And about 90 ,000 disputes were submitted in that timeframe. And for perspective, the number of disputes they received in that five -month window surpassed the number that they anticipated receiving in a full year.
Speaker: And since 2022, the Texas Medical Association has been extremely vocal and has had multiple lawsuits filed with the latest one being in September, alleging that the arbitration process set up in the final no surprises rule favored payers over providers. And a few weeks ago, a Texas judge ruled in favor of the Texas Medical Association.
Speaker: So what does this mean? I'm going to read to you what healthcare dive shared as a briefing of what's happening next as they kind of summed it up perfectly. So there's three bullet points here.
Speaker: The first is that CMS has asked parties involved in surprise billing disputes to put payment determinations on hold. So everything's kind of on pause. The government is currently in the process of evaluating and updating independent dispute resolution guidance systems and documents to make them consistent with the judge's decision.
Speaker: And then the last part here, along with pausing new determinations, arbiters should recall any determinations made after February 6, 2023. So that's the latest. How this will continue to play out is still a bit of a mystery, but we will certainly be staying on top of this story. Here's another fascinating story from MedCity News.
Speaker: Allureon Technologies has commercialized a gastric balloon in the form of a capsule. Unlike traditional gastric balloons that are surgically implanted, this device is meant to be swallowed by the patient under the guidance of a clinician, of course. The balloon then inflates in the stomach and is checked by an x -ray to verify its placement. And they say that this whole outpatient procedure only takes about 15 minutes.
Speaker: But it doesn't end there. Allureon has software that helps physicians collect data and monitor the patient. And then the patient is able to download an app that will help them adjust and develop new food habits. The last step is after about four months, a valve opens and allows the balloon to empty and pass out of the body with waste.
Speaker: Um, kind of crazy. So the product has been trialed on over a hundred thousand patients and is available in Canada, Mexico, India, Australia, and Brazil, but it hasn't been able to get the FDA clearance in the U S, um, that it needs. It didn't pass their first attempt. Um, and I believe they're going for a second round. Um, but overall I would love to hear what you think of this technology. I feel like in theory, it could be a real game changer. Um,
Speaker: And not only in providing and how the procedure is performed, but also in helping educate people on healthy diet habits and portion control. But of course, would also come with its fair share of health risks. So if you follow HSC Pathways on LinkedIn, check us out and leave a comment on this episode. I would love to hear your thoughts on what you think about this new procedure.
Speaker: And to end our new segment on a positive note, in 2011, Colin Cabela and Taylor Givens were both recovering from heart transplants at ANOVA Fairfax Hospital in Virginia. During that recovery period, they had crossed paths a few times, but it was really on the five -year anniversary of their heart transplants when they were reunited at the hospital that they decided to go get dinner together.
Speaker: Since then, they've been married for four years and have really leaned on each other as a recover and continue to live their lives. So they were able to turn a really scary life altering moment into a beautiful love story.
Speaker: 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 to subscribe or leave a review on whichever platform you're listening from. I hope you have a great day and we'll see you again next week.
