Become a Creator today!Start creating today - Share your story with the world!
Start for free
00:00:00
00:00:01
Highlight Reel – 20 Tips to Improve Your Surgery Center
102 Plays6 days ago
This week marks our 100th episode of This Week in Surgery Centers!
We are beyond grateful to everyone who has tuned in and to our 80+ guests who have come on the show over the last two years. Our episodes have accumulated tens of thousands of listens, and it has been our privilege to share such important information and expert advice with the industry.
Now, let’s celebrate! At the end of every discussion, we always ask our guests, “What is one thing our listeners can do this week to improve their surgery centers?” For today’s 100th episode, we took the last 20 answers we received from our guests and turned them into a 25-minute highlight reel.
A HUGE thank you to everyone who has supported This Week in Surgery Centers. We hope you enjoy this roundup, and here’s to the next 100 episodes!
Recommended
Transcript
Introduction and 100th Episode Celebration
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.
00:00:27
Speaker
Hi, everyone. Here's what you can expect on today's episode. This is a very special week because this is our 100th episode of This Week in Surgery Centers. Now, if you're watching on YouTube or on video, I'm using this really cool Google reaction. There's confetti everywhere.
00:00:45
Speaker
We launched this podcast back in October of 2022, so a little over two years ago. And while I was so excited to do it, I really wasn't sure how it would be received by the industry or if people would listen in or if this format was the best option to help provide free education to ASE leaders. But now I can humbly say that we had no reason to worry, and it's really all thanks to our wonderful listeners.
00:01:12
Speaker
Whether you tune in every week or just based on the topic or guest, I have so much gratitude for any time that you have spent with us. And speaking of gratitude, we have had roughly 80 different guests come on over the last two years. And I am just beyond grateful for the time they dedicate to sharing their expertise with all of us. It's just been so much fun learning from everyone and getting to know their unique points of view. um And I really just have had a blast running the podcast with all of you.
Special Episode Highlights: Guest Advice
00:01:41
Speaker
Alright, so what are we doing to celebrate? As you hopefully know by now, at the end of every discussion, we always ask our guests, what is one thing our listeners can do this week to improve their surgery centers? So for today's 100th episode, I took the last 20 answers we received from our guests.
00:01:58
Speaker
and turn them into this week's recap episode. So there'll be no full guest interview, no news or data segments, anything like that, but instead just a 25 minute highlight reel of all the great advice our most recent guests have shared. So without further ado, I hope everyone enjoys the episode and for the 100th time, here's what's going on this week in Surgery Centers.
Personalizing Patient Experience
00:02:24
Speaker
Oh, one thing this week, you told me this was coming. Okay, this is a personal one for me. One thing that I've done in every facility I've ever owned is I personally hate what I call the cattle call, which is someone opens a door and they call out a name. Erica?
00:02:46
Speaker
and they bring you into the back. I think a great thing that you can do in your ASC is create a process out front where the receptionist grabs the name of the person, writes down where they're sitting. And so when the nurse comes out to get the patient, they see the note, they walk over to the patient and they say, hi, are you Erica?
00:03:09
Speaker
I'm Michael. I'm going to be your nurse. Come with me. I think that sets up your experience and the patient's experience to be phenomenal because it's personal. It's not the cattle call. That's my personal advice that somebody can do today.
00:03:24
Speaker
I think that's great. And I think it's those little personal touches, as you mentioned, that you'll see on the satisfaction reports. Absolutely. Just making them feel comfortable and at home. So that is great advice. Yeah. I guess we've been talking about workflows and that sort of thing, best in practice, design,
Streamlining Workflows for Efficiency
00:03:43
Speaker
et cetera. I guess the thing I'd encourage physicians and surgery centered administrators to to do is carefully examine all existing workflows. Staff, patients, identify potential bottlenecks that exist in daily movement throughout the facility. Might be placement of equipment, storage equipment, might be location of supply storage.
00:04:07
Speaker
might be lack of adequate signage. So wayfinding might be a challenge, but conduct a thorough assessment and document any bottlenecks, anything that pops up as a potential bottleneck. And what that'll do is it'll create an opportunity for immediate improvement. You'll kind of come away with, ideally you'll come away with a short list of things that look, they could be accumulating to workflow inefficiencies. So if we just address these items,
00:04:34
Speaker
It's a very simple, simple sort of task that can be assigned to administrators to to go through and yeah just create a more efficient and organized environment, reduce stress for staff, minimize delays. Really at the end of the day, we're looking to improve that overall overall patient experience. So it should contribute to that. So that is one thing that.
00:04:53
Speaker
you all can take away and and hopefully improve without too much burden on your team. You said you were going to mention this, so I thought about it. i'm like i think I wonder if people always mention the thing they probably do the least or they wish they did more, I should say. I you know i mentioned ah just mentioned that this takes up so much of my time and I feel like we had a really good center and a really great culture.
00:05:13
Speaker
And maybe for me, it's just, I feel like I'm not as in touch with everybody as I used to be because I don't, I'm not up and about moving as much. And so my one thing I'd say now is again, get out there and and meet with the staff and see how they're doing, see what their issues are, see what, what's bothering them. We just had a staff meeting this morning and we had really good turnout and really good conversations. So I think the FaceTime is really key if you're in my spot as an administrator, it shows you you, you really care, stop. It's not just a breeze through, it's a stopping, seeing what people are doing. If you're clinical.
00:05:43
Speaker
maybe spend some more time in the business office. that If you're business oriented, spend some time in the clinical staff, see what they're doing, see it, learn. and I think it's important. And the face time for the docs is also the surgeons that are there. It also shows how much you really care. So building that time, if you can, I think that you can do that right now. Right. So that doesn't take much. Just get up and get moving around. So that's my one tidbit.
Innovative Procedures and Physician Burnout
00:06:02
Speaker
Eric, I think that the the main thing they can do is to really think outside the box, right? As physicians sometimes, and I've been guilty of this time and time again, my my wife even tells me that sometimes I think too much inside the box. You really have to think outside the box. What is it that I could do differently? Could I bring a new procedure ah to my menu of services?
00:06:28
Speaker
Again, I keep referencing the laser blepharoplasty because that's my gig, but there could be something different that maybe you could bring to the table and learn something that can be learned postgraduate, if you will, which is how I learned many ah of my other procedures that I've done over the years, such as facelifts, liposuction, endoscopic brow lifts. I learned those all postgraduate. The blepharoplasty I learned during my residency, but But think outside the box as a physician, consider learning a new procedure, get some continuing medical medical education credit while you're at it, and then consider bringing it to your surgery center. Discuss it maybe with the surgery center administrator, see how it can be a win for both of you to, again, bring patient satisfaction and enjoyment, bring
00:07:21
Speaker
financial revenue to both the practice, the surgeon, as well as the surgery center, and in in help decrease some of the stress and burnout that some physicians experience by doing the same thing over and over. Just think outside the box and let your imagination just take you wherever it wants. That's my advice.
Challenging Established Practices
00:07:48
Speaker
Great question. And with the ever-changing landscape,
00:07:51
Speaker
of the ambulatory space, you have to be really sharp on operational efficiencies. So that would be my recommendation is to always be thinking about optimizing operational efficiencies. You'll see that in labor when you can cross train or stagger staff. And then also, like we talked about earlier, leveraging technology can save both time and resources. Honestly, I think just opening your worldview, willing to think outside of the box on established, often practiced status quo. There's my least favorite saying when I seek to understand a process and I'll ask, can you tell me why you're doing it this way? I'd like to understand, give me the history behind it. Tell me the why.
00:08:43
Speaker
And of course the response typically is, this is the way we've always done everything. This is the way we always do it. And I, that just, that really is not the answer that ah my favorite answer, frankly. So I guess what I'm saying is be willing to challenge the established status quo because they've always done it that way. Doesn't necessarily mean they should continue to do things that way.
00:09:09
Speaker
not saying in their way isn't effective, but there may be a better way to operate more more on a lean scale where you can save some resources here and you can pick up synergy here by doing something different. It's just never too late to learn and adopt something new. And and I find when I talk to other leaders in the ASC space,
00:09:34
Speaker
It's wonderful to hear what they're doing because you get an idea and you're like, oh, I've been trying to solve for that. And somebody has already solved for it. So you should be willing to be open to these new processes or policies or procedures for a better way of improving your clinical operations and your ASC.
Financial Insights: Case Costing
00:09:52
Speaker
I'm always open to learn something new. I thrive on that. And I'd like to always be in a process of a mindset of continual improvement. But the other way to Besides thinking outside the status quo is to listen to your teammates and their feedback. Their suggestions are always welcome and they're much appreciated. I've had multiple examples over my career where people come and bring me cost saving ideas and time saving ideas. And I'm just so grateful for it. I like to recognize and reward that feedback as well, because it's so helpful.
00:10:29
Speaker
So those are just a few of the suggestions, but just don't accept the status quo as, well, the only way we've done it and it's the best way that you may learn that there's actually ah another way, or you could amend your ways and add something to the process to make it more streamlined. So that's my advice. Yeah. It's a great question. I love that you guys do this. I think giving appreciation to staff, I'm going to go with that one. I think.
00:10:56
Speaker
just understanding that it's such a, it can be stressful environment inside the OR and just physicians, leaders being able to recognize staff and and praise them for their efforts and just their the work that they do for patient care, like it's bigger than just a job. And I think if we treat our people well, I think we we see that return um on the other side. I think the most important thing is to start case costing now, even if it's a simple way, even if it's a simple thing, but not a sophisticated model. You can get more sophisticated, you can have
00:11:31
Speaker
Huge spreadsheets that determine everything, but just start, even if it's just simple case costing. So you know what each case is costing you, what you're being reimbursed for those cases. And if it's profitable or not, it's not profitable. Then you really have to look into if you should do the case or not. And that's, I think the number one thing. And if somebody is not sure how to start it in a simple case costing program.
00:11:54
Speaker
I'd be happy to shoot them an email and give them a couple of ideas. I'm not going to give you some huge long thing, but ah you need to do something and I can give you a couple of ideas. I'd be happy to help. How about if I give you three quick answers? Billing and coding is the first one. Billing and coding is the lifeline of ah of an ASC, making sure that the billing and coding and really the revenue cycle management, I'll tie both of those together. So I'll just give you two answers.
00:12:20
Speaker
The billing and coding and revenue cycle management part of that of any ASE is the lifeline, the lifeblood of that ASE. Making sure their billing and coding is being done accurately and that they're not getting an exorbitant amount of denials.
00:12:35
Speaker
And if they are getting denials, making sure that they're being promptly followed up on, so that those denials can be flipped if possible. But what I see typically, a one-man ASE or two-man ASE that may have a million dollars in denials, that's a gut punch to that ASE. You have a million dollars sitting out there and you still have payroll and whatnot.
00:12:58
Speaker
We do get a lot of calls from physicians, maybe not wanting to partner with us as far as investors, but wanting some help on Mr. Billman and Colton and the revenue cycle management to better understand why their business is struggling. And then the second part of that answer, I would say payer contracts. They're difficult to get a handle on, having somebody in the ASC with that kind of expertise and making sure that those payer contracts are paying what should be the fair market value of those contracts. So you've got to constantly have somebody negotiating with them. That's a key part of our business here at Horizon Solutions. And we constantly stay on top of these big payers to make sure the payer contracts are set up in a fashion to where everybody can win. So without without proper billing and code and revenue cycle management, without the proper payer contracts, you're really putting that you're really putting your AOC address.
00:13:53
Speaker
So obviously I come from the revenue cycle side. So one of the things that I consistently see that that we always watch is to have the surgery center really work with their physician groups on the scheduling process, making sure what CPT codes that they state their scheduling at the surgery center is actually the procedure that they end up performing. Because if the authorization is done on what they scheduled, which just happens to be a CPT code attached to the procedure. And it's not just right. It's the difference between you getting paid and getting denied because one digit off yeah could be just one digit off. So my suggestion is to spend just a little time with each of those surgery clinics and make sure that information is valid and it will decrease so many denial issues on the backend. Fantastic. I love
AI in Patient Communication and Admin Tasks
00:14:50
Speaker
that. And what one follow up for you, if I can.
00:14:53
Speaker
What have you found is the best time or place in the patient life cycle to to double check that CPT code at time of scheduling? So the best time to check that is prior to the patient actually having the surgery it for obvious reasons. But if we find that the patient actually has a different surgery, if you're doing that within 24 hours of the actual surgery being performed and validating or making adjustments to it, that is the best time to at least adjust an authorization if you have that option. If you do need to adjust, time is of the essence on that. Yeah, but obviously if you work on the back end with it, you can look at your data for a timeframe, you can see trends.
00:15:38
Speaker
you can go back to your surgery center and say, hey, I need you to work with this clinic group. I'm noticing this CPT code versus this one. And then let's work with them. And it may just be updating the scheduling format. But for them, the office then can at least call the auth on the correct CPT code at that point.
00:15:58
Speaker
Okay. My advice for surgery center leaders who are listening would be to pay attention to your surgery center's brand and marketing efforts. Most ASCs kind of skip this because you know, you're going to get business from your physician. So what does it matter if you have strong marketing?
00:16:14
Speaker
but it really does make a difference. And it's more than just your logo, your colors, your fonts. Those things matter, but it also mostly includes how you translate your mission and your core values into real life. So it includes you know what makes your surgery center different than the surgery center up the street. It includes your website, your social media presence. How do you engage and support your local community? um What is your internal culture like?
00:16:41
Speaker
and so many more elements. you know It also includes your your lobby. What is their first impression when they walk into your surgery center? It includes your scrubs, your the paintings on the walls. your you know Your overall aesthetic will impact the patient experience and their perception of you. So it's totally worth your time to take a look at these things. It impacts patient, physician, and staff satisfaction. So ultimately, your bottom line. Make sure you're always have the latest news on information such as patient collections, listen to podcasts like this one, read articles, make sure that you always are staying on top of everything. I know it's a lot of information and it's the saying goes, how do you eat an elephant? You just one bite at a time. So yeah, that's my biggest takeaway from that. Yeah, I think that's great advice. I'm always a huge advocate of the state associations, ASCA, all these
00:17:38
Speaker
communities, everyone is dealing, whatever issues you're struggling with, someone else is struggling as well or has already gotten through it. So building that community is huge. So my biggest thing that I talk all the time at the surgery center and they're sick of me saying is the power of conversations and the power of conversations. Every single conversation you have, whether it's at your surgery center or home has the ability to either enhance a relationship or diminish it a little bit at a time.
00:18:06
Speaker
So if you're not having critical conversations, that's just as critical. If you're having them, the tone, the inflection, how you're listening, all of those things are super important because you can destroy or enhance that relationship a little bit at a time. So that would be my one thing is concentrate on your part of conversations and start elevating them in your surgery center.
00:18:29
Speaker
Great advice. It's rather ironic. You said that Susie, because, and and we did not talk before this all about this question. So Erica, you threw that one on me. I knew you were going to ask the question, but Susan, and I did not talk about it. I actually, I did a different approach. AI is huge right now and everything. Right. So I actually went into online and and AI and I asked the question, give me an improvement idea, an ambulatory ambulatory surgery center could implement this week.
00:18:58
Speaker
And it came up with enhance patient communication. There you go. And when you take a step back, it's everything that we do at the surgery center. What it really comes down to is patient care. And it's a reminder of how important it it is to have those communications with the patients, make sure they understand what's going on and really provide great patient care. Because if we can do that's one of the best things that can lead to success in the surgery center.
00:19:25
Speaker
And I'm going to tag off real quick off of that AI, because we are all over this at the surgery center AI, and we're using it in really funky ways. But one of the things that we're doing is when we don't have the emotional intelligence to not diminish a relationship. When we're wanting to communicate something, we're going into AI and going, can you please make this professional clean for us?
00:19:48
Speaker
I love it it. It closes the gap of the bandwidth for us to get in a better headspace to actually try to solve and partner with our physicians or whoever it is to do that. That's a great question.
Optimizing Labor Costs with Staff Planning
00:20:01
Speaker
The one thing that always pops out to me, and again, accounting financial analyst going way back, the one thing that always pops out to me when I look at somebody's financial statements, ASD's financial statements, the labor line,
00:20:15
Speaker
is almost always, is it's one of the two largest expense line items for every DSC that I've ever seen. And how do we control, get a better handle around our labor costs? And one of the things that they I learned over the years, and again, I'm not super into operations, but operations and finance talk to each other a lot. And one of the things that I thought it's super simple, it works.
00:20:45
Speaker
is just on a weekly basis do simple staff planning. And what I mean by that is take your schedule of cases for, we get to Friday, take your schedule of cases that you have on the books for the following week and compare that to your staffing schedule for the following week, day by day. And when you just line those two up,
00:21:12
Speaker
Okay, Monday case volume schedule versus Monday staff schedule. Friday, next Friday case volume schedule versus staffing schedule. You'll be able to see what days are we light on cases. Do we need to to bring in a full clinical team for that day? to Do we think about potentially canceling the the the one or two cases that they are moving into Thursday?
00:21:39
Speaker
and not not even have the clinical staff come in on Friday. If we're going to be done by noon, can we send folks home early? ah We're going to be super, super busy on Tuesday. Maybe we need to bring additional teams in that day. But that simple process of mirroring up and matching up your surgery schedule for the following week to your staff schedule for the following week, day by day,
00:22:07
Speaker
That simple comparison on a Friday, the Friday proceeding that week makes a huge difference in your labor efficiency. And it could really turn into a lot of ah dollar savings on your labor line item. When you take that weekly process and extend it out a month, three months, six months, a year, and you could really see how that one simple thing can yield to significant cost savings long term.
00:22:38
Speaker
Yeah, I think a lot of surgery centers, in fact, most that we evaluate do not have a ah line of sight into their accounting, tying their accounting to revenue, to volume, to really their patient accounting system. And we're talking about budgeting properly, estimating revenue properly, accruing, so that you can really see your expenses and revenue in the period and you can understand your business and how it reacts to the different levers that you pull.
00:23:04
Speaker
And so only then if you've got all that tied together, can you truly know if you're being efficient and optimizing your
Industry Updates and Cost Structures
00:23:10
Speaker
ROI. The thing that I would just say is we just had an election. It's changing as we speak. We just got a proposed name of the head of CMS. I think if there's one thing that will probably come to fruition between a ah drive for lowering costs and a ah friendly Senate to this is going to be site neutrality.
00:23:33
Speaker
And so I would say the one thing that everybody should be doing is really paying attention to the news, because I think that, and getting ready for the fact that hospitals and ASCs will no longer have this big variance between how much they charge for outpatient surgery. And that can be both good and bad for both hospitals and ASCs. It's going to change the landscape a lot. So I think just really staying abreast of that, because I think It's been put in many bills and that haven't passed up to this point. So we're assuming it's probably going to be one of the first things in January. So it's not this week, but I would say in the coming weeks, get ready. It's coming. Yeah. so
00:24:17
Speaker
If there's one thing that to be done, I would make sure that they're tracking and trending and reporting the most important KPIs for the RSM operations. And we believe in the statement that you cannot manage what you don't measure, right? So it's really important that you're tracking your data. So as I mentioned earlier, some of the KPIs are days sales outstanding, the DSO, total they are on over 90 days. it's It's a good benchmark to look at.
00:24:41
Speaker
paid claim percentage, bad debt percentages, collection percentage of net revenue, and then denial trending, right? As a percentage as well as trending, you've got to be able to trend it to understand what the root causes are. And then finally profitability per case. It's it really important that you are tracking and trending that information. And I would say by measuring, you can really determine the root causes and focus on the areas that you may be having challenges. And then based on that, you can really transform your RCM operations.
00:25:09
Speaker
I would actually recommend that you contact Maya Kunkel on our staff. I'm sure she's going to be happy if she gets bombarded with people, but and try to schedule a facility tour with the start of a new session of Congress. There's a lot of new members and really just making sure that the elected officials that we have elected know who we are because if they don't know who we are then they could potentially act against our best interests. It can be an in-person tour, it can be a virtual tour we have, you can come to our fly in the fall, but please I do encourage everybody in whatever way that you can to get involved and really that's a great way to help your ASE succeed.
00:25:52
Speaker
If you're not already doing this, I think it's always a good idea to go through all of your contracts and make sure you have all the right copies. Even after doing this for five years and gosh, all of the contracts that we have, I'm still surprised that some of the smaller ones that maybe we don't have a lot of volume with, it comes up randomly as a conversation or a question because something happens. And I'm like, wow, I just realized I don't have maybe the original copy.
00:26:21
Speaker
or I have the original copy, but I don't have the all the amendments that have been made. So if there's one thing that I would suggest that you could start today, it would be to make sure you have all of the copies of all of your contracts, even the smaller ones, and be mindful that sometimes amendments are made maybe from someone who was in the position before you, or just a change was made by the payer themselves. It should not happen without the providers being notified, but I think that would be the best thing to do is to just make sure you have copies of everything that that you could possibly need. So you feel secure in being able to answer some of those random questions because they all happen and being able to know contractually what you are allowed and what they are obligated to provide. I would say double check to make sure that you understand what your costs are per case. And so that involves the cost of implants because that's something that we can get paid back on.
00:27:22
Speaker
Just making sure that your surgery center staff are capturing implant costs properly is going to be really critical to negotiating proper contracts going forward.