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2025 Highlights: 30 Guests on One Thing You Can Do This Week
54 Plays4 days ago
If you only had time to do one thing this week to improve your surgery center, what should it be?
To kick off the countdown to year-end, This Week in Surgery Centers pulls together a year’s worth of conversations into one rapid-fire episode, featuring input from 30 past guests on the closing question of every interview: what is one thing ASC leaders can do this week to improve their surgery centers? You’ll hear practical, do-it-this-week ideas from ASC administrators, nursing leaders, business office experts, consultants, and physicians on:
- Supporting and recognizing your staff in meaningful ways
- Cleaning up payer profiles, item masters, and days to bill to strengthen margins
- Tightening credentialing, monitoring, disaster plans, and IT/infosec policies
- Improving communication with patients, caregivers, schedulers, and surgeons
- Getting your financials and partnerships ready for the next phase of growth
This episode gives you simple, concrete starting points to make 2026 a stronger year for your center — one small improvement, week by week.
Brought to you by HST Pathways.
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Transcript
Podcast Introduction: Format and Highlights
00:00:00
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, 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.
Guest Insights: Improving Surgery Centers
00:00:24
Speaker
Hi, everyone, and welcome back to This Week in Surgery Centers. I'm really excited about today's episode because it's a special one. It deviates from our typical format. And instead of a guest conversation today, you're going to hear from 30 guests that we've had on the podcast throughout the course of 2025.
00:00:40
Speaker
I pulled together a highlight reel of some of the best responses to that final question we ask our guests. And that question is, what is one thing ASC leaders can do this week to improve their surgery centers? As you know, it's been a big transition year. I took over the podcast along with Grant Duncan. And so you're going to see four different hosts throughout these clips, which is pretty cool. So buckle up.
00:01:01
Speaker
It's going to be a fun one. I also want to let you know that this is not our final episode for the year. We are getting very close to the end of the calendar year. just a few
Future Episodes and Content Teasers
00:01:09
Speaker
weeks away. And we'll be talking to Kara Newberry from ASCA about the CMS final rule that we've all been waiting for that came out on the 21st. And then we'll have one final episode after that. So be sure to check back for updates. But this is our highlight reel. Without further ado, enjoy.
00:01:25
Speaker
All right, Becky, last
Leadership and Staff Engagement Strategies
00:01:27
Speaker
question. What is one thing our listeners can do this week to improve their surgery centers? What I would say is one thing you can do is try to carve out time this week. And the reason I say carve out is because I know as an administrator, your week is already prepared.
00:01:45
Speaker
So I'm saying if you can try to just carve out maybe an hour of time, might be a lot of time to commit to this, to just do some rounds, go around, talk with your staff.
00:01:55
Speaker
Talk with your surgeons. Talk with your patient. And with the question saying, was there anything you think we can improve upon? Because I think if you did that, you would also have a plethora of information that could help you as you're looking forward to what you need to do for your QAPI studies for the next year.
00:02:15
Speaker
I think empowering team participation. i think that as administrators and with as busy as everything seems to be these days with staffing and surgeries picking up and things like that, really considering empowering your team and delegating oh things evenly along the way. it does twofold. It helps ah your administrator not be so overburdened as to doing all of it on his or her own, but it also empowers the team to buy in more. So really targeting the team to help with different things that interest them, infection control or quality or risk or safety.
00:02:54
Speaker
So I'm really saying empowering the team to participate will really help your ASC in its improvements and then also help just in an overall teamwork aspect of everything.
Design and Innovation in Surgery Centers
00:03:06
Speaker
I think to really challenge the status quo of what you've seen in surgery centers, there's not a one-size-fits-all approach. And I think if you're designing a surgery center, it can be a once-in-a-lifetime chance to really put your mark on your practice and do things the way that you want.
00:03:22
Speaker
Of course, within the stipulations of the building code and all those different things, but there's so much innovation and creativity that goes on in ASCs these days. challenge yourself, challenge your design team, and hopefully you have a design team that that is up to that challenge and really work hard and and develop that new model of practice that you're excited about and make your dream a reality.
00:03:43
Speaker
Take credit for the improvements that you make because you make them every day. You do something, you tweak a process, you make something better for a patient.
00:03:53
Speaker
Take credit for it, whether it's a study or not, but celebrate and communicate that to staff. It makes them feel good about the work they're doing and about the surgery center.
00:04:05
Speaker
What's one thing our listeners can to do this week to improve their surgery centers? I think you can go, i think this week you can probably go in and print out your current insurance payer profile list. So this is every insurance that you have loaded into your software system, right?
00:04:24
Speaker
Print that out. and go through it and organize it to make sure that you have a good naming convention, meaning you want to make sure that you know that the front desk is always naming the payer of the same way.
00:04:36
Speaker
You're, you know, productizing the payer, meaning that you're distinguishing between HMO, PPO, Medicare Advantage, because I see a lot of issue with that, right? You know, we have a situation where, you know, i pulled one last week and we may I may have had, you know, 200 different insurance profiles and in this system.
00:04:52
Speaker
Half of them were active, half of them were double. And, you know, the other thing is you're not properly understanding the frequency of insurance product type. What if you're sending an offer from a payer and they're offering you different rates for HMO or PPO? How are you understanding that frequency difference? Right. So I think what I would do is print out that insurance list of all of your active insurances.
00:05:15
Speaker
and go through and organize it, clean it up. And and that's also a recommended annual practice as well, ah because I think that front desk is really so important to not only operation of the ASC RCM, but considering managed care contracting, you know, our data is only as good as what's in the system. So, you know, that management at that front end is key to make sure that that I can look at your data on the back and properly understand different things. So hope that was helpful.
Financial and Operational Advice for ASCs
00:05:43
Speaker
I'll say this, I'll speak more to kind of those centers that are independent that may be looking at a strategic partner or potentially selling some ownership. would say first, decide what you want out of a partnership.
00:05:54
Speaker
Do you want help? yeah yeah is Is your center currently being managed by physicians and those physicians just want to be physicians and they don't want to manage the business anymore? So do you want a strategic partner to help with managing the day-to-day operations? Do you want help with managed care contracting? you want help with staffing or billing and collection? So I'd say first and foremost, decide what you want to get out of a partnership before you start going down the path of getting a partner.
00:06:24
Speaker
Now, secondly, I would say most important, you get your house in order. So get your financials cleaned up, get a really good grasp on the economics of the center. Look at your cap table. Does your cap table need to be cleaned up? Do you have a bunch of positions that have ownership that have retired or have relocated or may be violating one third from a violation perspective?
00:06:44
Speaker
Clean up your cap table. Basically, get all your financials together and and really be able to tell your story or the story of your center to potential suitors. Ultimately, a concentrated effort on maintaining a low claim submission timeframe, your days to bill, and analyzing those claim adjudication bottlenecks with claim rejections and peer adjudication lags. It'll give you a solid starting point to identify potential areas for improvement, where if everything is going great, celebrate the success of your staff.
00:07:16
Speaker
Fantastic. I like the celebration piece. And if we double click on days to bill, you have one or two tips for centers on how to bill faster? On how to bill faster, your documentation being in line as quickly as possible.
00:07:31
Speaker
Ultimately, you want to be looking at your middays to be at two to three from the data surface. Documentation's done, coding's done, charge entry's done by day three. I think an actionable step that an ASC could take as a project is go in and audit their top 10 unpaid claims over the last 90 days.
00:07:51
Speaker
Try to identify some common trends across those top 10. And I bet you're going to find a very core foundational issue, whether it be authorizations that were missed.
00:08:03
Speaker
Or is it a certain payer that's just constantly asking for medical records? Or is it a certain payer that's not paying on time? Or just is it coding errors? Just really drill down and see why they're not paid. Because i guarantee you'll find a core foundational issue that can be addressed on the front end that can fix that problem.
00:08:27
Speaker
What is one thing our listeners can do this week to improve their surgery centers? That's a tough one. I have two answers. I don't know. I'll turn it aside. Okay. I'll take two.
00:08:38
Speaker
Okay. I will say, while 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 because you cannot guarantee that there would not be an emergency, right?
00:08:54
Speaker
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?
00:09:10
Speaker
Understanding at the end of the day, the right agency partner is here to help you. 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.
00:09:24
Speaker
You don't need to hire someone for four weeks and incur all that cost. 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.
00:09:36
Speaker
So again, you know, be prepared and really rely on your agency. 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.
00:09:52
Speaker
thought about this one a lot. This is the hardest leadership skill that people will develop and learn to tell the truth.
Leadership Integrity and Outsourcing Strategies
00:10:01
Speaker
this is This is one of the hardest things you'll do when you see somebody who you've checked out on or you think is checked out on.
00:10:09
Speaker
But to really hold yourself accountable as a leader, to be in integrity with that person is below the bar. And I'm no longer telling them.
00:10:21
Speaker
I'm no longer giving them feedback. I am walking a wide berth around them and it essentially endorsing their bad behavior. Everybody in the organization deserves deserves to know where they stand and give them that feedback to help them be better and give them the dignity and empower them to respond to that.
00:10:44
Speaker
It's not your job to help them get there necessarily. You can help them, but it's you don't need to force them to do the right thing. You can treat them as adults, give them the feedback, positive and negative.
00:10:58
Speaker
But make sure you're telling the truth, whatever that truth is, whether they're doing well, they're not doing well, they could be better. And make sure you're in integrity and and don't endorse non-confrontation.
00:11:10
Speaker
Don't and endorse or encourage that bad behavior. So I'm going to come at this more from a business standpoint, because that's the side that I'm on in that I think a lot of people i hear are afraid to spend money to make money, whether it be hiring the right provider for more money.
00:11:26
Speaker
You really need to think about it like this, that you need to outsource things that you cannot do yourself or that cost you too much of your time. And if you are an ASC, whether you're a de novo ASC or you've been around forever, you can't get too stuck in your own ways that you're afraid to spend money on things that will ultimately lead to ah ROI, but it might take time. And that really boils down to recruiting in a whole sense and big picture is that you're never going to make back.
00:11:55
Speaker
what you pay somebody, maybe even in the first couple of years when you're thinking about, you know, surgeons. But eventually you will. And you have to have that long-term mindset rather than just the upfront cost of things.
Safety and Compliance in Surgery Centers
00:12:10
Speaker
Well, I think being intentional, that's another area I see ASCs struggle with is disaster preparedness. And so it's all connected because a fire in an ASC would be a disaster.
00:12:22
Speaker
But polishing off those disaster plans, or your fire response plan, I think is pretty unique in an ASC. So you've got a fire drill and you've got a fire exit drill.
00:12:35
Speaker
And so when we talk about a fire response plan for an ASC, The responses are going to be different for those two types of fires. If you've got a fire in your waiting room, that race acronym I talked about is the perfect application for how you respond to that.
00:12:50
Speaker
But race doesn't make as much sense in the OR. look up another good resource for this is with AORN. They talk a lot about fires in operating rooms and that triangle of you've got the the source of ignition, the oxygen and the fuel and how each person in that environment controls their part of it.
00:13:13
Speaker
So make sure that your fire response plan really addresses both instead of just an all-encompassing plan. What is one thing our listeners can do this week to improve their surgery centers?
00:13:25
Speaker
Okay, well, I will go first. I actually was at book club last night and I asked the girls in my book club. I said, okay, who's had surgery? Who's had day surgery? And i brought up an idea of something that anybody could do this week is go in the waiting room, talk to the caregiver, talk to spies caregivers that are waiting for their loved one to come out of surgery and ask them two specific questions.
00:13:48
Speaker
What went well from a communication standpoint? What did you feel went really well? And what were the most frustrating things? You can talk to five people and you could clearly quickly identify there may be some opportunities to make some really quick changes that could aid in doing what you're doing. So celebrate those wins and then change the communication, how it's communicated or what's communicated to really improve that experience for that.
00:14:15
Speaker
I'm going to go the other way. I'm going to go very anti-technology here today. You know, usually I talk about patient communication and patient satisfaction, but you know, survey season is upon us. It seems like lots of places are getting surveyed through the summer and fall.
00:14:31
Speaker
Go in your ASC, grab your camera on a clipboard, go look at every single certificate you have on every single wall. Make sure they all are current.
00:14:45
Speaker
You would be surprised how many boiler certificates, AAAHC or Quad ASF or Medicare license is not up to date. You have the right one probably sitting in your desk. ba fileo it's scan It's in your EHR.
00:15:01
Speaker
It's in your quality software, but it's not on the wall. Just take the time, check everyone, take pictures of the one center and replace them. It just saves you a little bit of headache with the next survey where the patient that's bored and walking around or the caregiver that notices the place is not licensed.
00:15:23
Speaker
It's worth the five, 10 minutes to do the walk around. You know, if you have the capability, print out or export that item master and clean it.
Ownership, Benchmarking, and Advocacy
00:15:32
Speaker
You know, that can definitely be done this week.
00:15:36
Speaker
I think just taking the time to focus on that and, you know, maybe you can't get through every item in one fell swoop, but working through it, you know, updating the names, looking at the unit of measures, looking at how they're categorized and looking at the prices, I think will go a mile to just, you know, improve what you have as a foundation.
00:15:58
Speaker
I would say um collaborate and benchmark. You know, if you go into the best case scenario, set a goal for you to be able to show your docs their case costing against each other.
00:16:11
Speaker
and then really important to measure yourself against the industry. What else is going on in the industry for your cost per case data? And then also compared to revenue. So that's really the biggest thing is what is that supply ratio?
00:16:26
Speaker
look like for you, your ANC, compared to other ANCs in the same space. You know, we publish for a long time benchmarking data on cost, supply costs, supply ratios.
00:16:38
Speaker
You really have to figure out where your facility is compared to your peers, right? So having that benchmarking data is just so important. And that's the first thing the docs are going to ask, you know. So this is where we are. Where are we compared to others? And if you don't understand where you are what's acceptable for a cost per piece in the industry may not work for you because of your payer contracts.
00:17:02
Speaker
You could be upside down when someone else is getting three times the rate. So you need to understand where you need to like cut costs and really spend that time and energy into getting that great contract, looking at your GPOs and making sure you're not overpaying.
00:17:19
Speaker
What is one thing our listeners can do this week to improve their surgery centers? So I think probably the but one thing that I would, that keeps our surgery center and continues to be is successful starting as it has been was the complete buy-in from the physicians. So all of the physicians have ownership in the surgery center.
00:17:44
Speaker
So they're all hooked for the money. And so that makes them all very adept at trying to make it work. Even if they're not happy with a software or instrument or whatnot, everybody's in the same boat on trying to make it profitable and start getting back to even. And so it's a it's got everybody focused on one mission. And so that that has been one of the biggest advantages I think our practice, our surgery center has over most is just the complete buy in from all of the physicians because they're all investors.
00:18:19
Speaker
Love your nurses that take care of you. bring in something to your surgery center after you had surgery and and you don't remember what happened, just know that they took really good care of you. So go say thank you to the nurses and the team that took care of you.
00:18:37
Speaker
And I would say, ain't gonna like my answer. I would say to do a random audit on your credentialing file.
00:18:46
Speaker
Amen, sister. Okay, I'll double that one. And do a random audit on your monitoring program. And I know that seems crazy. And I know it's like, what? Who wants to do extra work?
00:18:56
Speaker
But when you're really looking at it from an auditor perspective and from wanting to ensure that your compliance is up to date and that you're on point, that is the best thing that you could do for your surgery center is to ensure that there are no credentialing issues and that if anybody comes in there to look over your items, that's that they see that you take care of this department as well as you're taking care of the surgery and that all the things that are done in the ah OR?
00:19:21
Speaker
So I would recommend, and I know this is a pain in the butt, but make sure you've updated your IT t policies and procedures. It's one of those things that's pretty pretty much on the back burner of everyone's list.
00:19:37
Speaker
And I know a lot of times the administrators just cruise through them once a year to make sure, and hey, I've touched my policies. But this year is a big year. The OCR and CMS are updating HIPAA high tech, and there's going to be a whole new set of things that are going to be required. Now, technically speaking, they're already in the law, but because of the way it was written and the way the final rule was produced in 2018,
00:20:06
Speaker
There has been a lot of failures and from an audit perspective, from OCR's viewpoint. So they were going back to circle back around. The changes were introduced.
00:20:19
Speaker
They were put out for request for comments. That process, I think, ended March 7th, March seventeenth sometime in March. And they're reviewing all of the comments now. So we expect sometime before the end of the year that they're going to make all of the changes official. You can go out to the CMS and see our website and it will actually list them. It's pretty legal needs, a lot of text.
00:20:43
Speaker
But your policies and procedures are going to have to be updated. I would say wait until those come out and make sure that you get them done in a timely fashion. But one of the requirements that we know is going to make it is they're going to absolutely require you to have your data documented in a basically a Visio chart.
00:21:01
Speaker
So where does your data reside everywhere in your environment? You know, respect the patient data, essentially. So your policies and procedures, those documents, diagrams, make sure those are completed.
00:21:13
Speaker
You'll have 180 days once the rule goes final, but I would say don't wait. I would say as soon as the rule's final, get working on that because you don't want to get caught at the end of that time period.
00:21:25
Speaker
Start measuring where you are against where you should
Goal Setting and Networking for ASC Success
00:21:29
Speaker
be. Learn what your numbers are and learn where you need to go because if you don't have a goal and you don't know where you are, then it's going to be a frustrating thing.
00:21:39
Speaker
That's the most important thing I believe that our listeners can do. Start measuring where you are comparing to where you want to go and start taking incremental steps. I may have said this in a previous appearance, but I think get involved in local advocacy.
00:21:54
Speaker
ASCA is really nationally focused, but I think we've seen a big increase in stuff happening at the state level, at the local level that affects ASEs. You know, that's reimbursement issues, prior authorization, EHRs, you name it. We're seeing a lot more issues pop up at the state level.
00:22:10
Speaker
And I think one of the best things you can do to make sure that these things aren't burdensome, that your state governments are understanding about your place and their healthcare delivery system, is to get involved, whether that's your state association, maybe hosting a facility tour from one of your state, your local officials coming to the fly-in.
00:22:29
Speaker
These things really make a big difference. And I think we're trying to keep track of this federal stuff, but a lot of the times we need help from the grassroots level to combat some of these issues that are happening at the state level. So it really can't be overstated. if you have a state association, you have a local organization, please get involved because these things make a huge difference.
00:22:49
Speaker
I would say pull out your boarding criteria. That's a quick thing. Just look at it and say, are you outdated? is there things, there's reasons that you can maybe say, instead of not bringing this case, find a reason why to bring a case. You know, if your BMI cutoff is artificially low, and can you provide the support to allow cases that are, you know heavier patients? If you're doing total joints,
00:23:12
Speaker
morbidly obese patients tend to be the ones that are young and well-insured. So to kick those cases out of your center, just surely on that criteria, you're really losing a lot for the center.
00:23:24
Speaker
My answer is to grab some baked goods and visit every single physician office that provides cases to your center and sit down with their schedulers, even for 15 or 20 minutes.
00:23:37
Speaker
ah Bring them some swag, whatever you have to do. But definitely they are the ones. That's a ticket to bringing cases to your center. So I highly advise that you sit down periodically with them but and ensure that they want to bring cases and they understand which ones can come.
00:23:54
Speaker
I will tell you go through your own center as a patient. And if you do it, and maybe just doing it virtually, but go through, look at the whole chair in your center itself. And if you can walk out of there saying, I'm really proud of what I just saw, then you're doing a great job.
00:24:09
Speaker
But more importantly, if you find a lapse in it, Don't get angry at that lapse. It's a point of education. It's a chance for learning. and It's something that we haven't encouraged a particular person to know that.
00:24:21
Speaker
That would be the one thing I would tell you to do in that situation to improve your center. But the other aspect is because we are a big community, join your state associations because the networking, and it's not just the officers, it's the networking of the people you meet at these different conferences. You want to be able to call somebody who lives your life.
00:24:41
Speaker
and get advice from that person, get a different perspective. but And I've been so fortunate to have that opportunity because of the state association. It's often I have conversations with people and it was like, I never thought of it that way. i remember sitting down with a board member and the board member said to me, we're not the charm job we once were. We're doing higher acuity procedures. This isn't that we're just doing a simple seven to three. We walk out the door, don't think of it till the next day. Those are the surgery centers of the 90s. So in understanding that your nurses, your nursing directors and stuff have to go through much more, the job's more stressful than it was 25 years ago.
00:25:17
Speaker
And it's important that we as the operators of surgery centers understand that and really understand what your staff is facing, but more importantly, what is your patient facing? i remember when that person said that to me, I was just so stunned. It's not the easy job that it once was. You're doing joint replacements. We're doing laparoscopic sleeves, laparoscopic general surgeries. We need to recognize that. And that was really eye-opening when that person said that to me. She was absolutely right.
00:25:43
Speaker
I think this is easy for me. It's a team effort. It's not just me. It's not just Connor, the vendor. He becomes part of our team And the thing is that you have to listen to your team.
00:25:57
Speaker
And if there's an issue or a problem, we can work it out as a team. i am not an administrator that's ever punitive. If you have a problem or you've made a mistake,
00:26:11
Speaker
Come tell me, we'll fix it together. We'll figure out a way for it not to happen again. i love that. And what about you, Connor? um I think kind of two general kind of points. One would be to like incentivize people on the ground to engage in technology adoption. Because again, i think that there can be a challenge as an outsider where a vendor coming in because like if people are very busy and like what they're being said,
00:26:36
Speaker
promoted and incentivized to do is the day-to-day. It can be kind of difficult. It takes a while to figure out how to make this work well for them. And as Benita says, like our job is is to make life easier. But if there's people that are not incentivized to engage with us, then it's really hard to get to a position of doing that. And understanding that there is a little bit of upfront you know support needed in the early days to just get the point where it adds value in the medium to long term.
00:26:56
Speaker
I think going beyond that, i we're extending that is that viewing vendors less as a kind of transactional thing. And I think this is a really nice thing within the ASE business. It seems like it's much more collegial than some other places we've experienced where you're kind of working together towards a shared objective and a shared goal. It's not just a case of like, you know, you do this and we'll do this and it stays that way. We've benefited, I think, mutually by being able to you know, learn what the actual pain points are and similarly get the opportunity to work closer with them to customize and build bespoke systems. And that's a mindset. If you expect to work out of the box immediately, that's a much harder expectation to live up to
00:27:31
Speaker
Being a part of an association, being able to go to Becker's and ASCA and OR manager and, you know, the AAA stuff and joint commission, network and don't stop, network. The more you reach out to your colleagues,
00:27:45
Speaker
the more you're not going to feel like you're on an island by yourself, because some of us do. It is a very ah specialized role that we take on. But I would say network, whether it is to subscribe to podcasts, because they're all amazing, including this one, or be able to go to the conferences or be a part of your state leaderships or be part of the ASCA stuff.
00:28:03
Speaker
stop networking is key. It's really going to open your doors to being able to have these really great conversations that we're having together. You know, the way I do things might do an aha moment to someone or me listening to one of your other product answers and be like, oh, maybe I could take that perspective as well. and It might help me out.
00:28:19
Speaker
I just feel like networking is key right now in our space, particularly for ASCs, but just healthcare in general. so that would be my one thing I'd say to you. oh Check the quality of your cost data and where there are gaps or things that don't look right.
00:28:34
Speaker
Put in a plan to get good cost data hygiene because it'll pay dividends all over the place. Whether it's when you're trying to negotiate better pricing, whether you're trying to forecast your cases, whatever whatever it may be, improving the quality of your cost data will just serve all sorts of purposes.
00:28:52
Speaker
If you could give people advice on one thing they can do this week to improve their surgery centers, what tip would you give everybody out there? One thing. On your busiest day this week, you got if your busy day is 20 cases or your busy day is 50 cases, on your busiest day this week, go around, I call it patting butts and kissing babies. quote cheer Cheerlead your folks.
00:29:16
Speaker
Tell you recognize how hard they're working. You value them and then buy lunch for your center. busiest day of the week, and just see how far it gets, just see what it does for you. It'll do wonders.