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Improving the Patient Experience: Gramercy’s Patient-First Culture & New York’s ASC Momentum
26 Plays4 hours ago
Jeffrey Flynn, Administrator and Chief Operating Officer at Gramercy Surgery Center and President of the New York State Association of Ambulatory Surgery Centers, joins the show to share how Gramercy keeps care personal at scale — training every team member as a patient advocate, keeping families informed, and even empowering nurses to call a case when something feels off. He also gives us insight into what the NYSAASC has been up to and previews what’s ahead for New York ASCs as we approach next month's state conference in Albany.
In our news recap, we’ll cover why anesthesia providers are choosing ASCs, CMS’s proposed 2.6% payment update and additions to the ASC-Covered Procedures List fueling industry growth, ASCA’s July 60-Second Survey on EHR adoption, and a nationwide study in New Zealand using AI to speed stroke imaging.
In or near New York? Join us at the NYSAASC Conference in Albany, NY, at the Desmond Hotel, October 6-8, 2025.
Resources mentioned:
Why anesthesia providers are drawn to ASCs
The policy shifts driving the ASC boom
ASCA Survey Shows Continued Growth of EHR Usage by ASCs
National rapid stroke imaging AI study underway in New Zealand
Brought to you by HST Pathways.
Recommended
Transcript
Introduction and Episode Overview
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.
Patient Experience and Care Strategies
00:00:24
Speaker
Hi everyone, here's what you can expect on today's episode. I am joined by Jeffrey Flynn, Chief Operating Officer at Gramercy Surgery Center and President of the New York State Association of Ambulatory Surgery Centers.
00:00:36
Speaker
As part of our series on improving patient experience here on the podcast, Jeff gives us an inside look at how Gramercy delivers superior patient care at scale. With strategies like treating every team member to be a patient advocate and even empowering nurses to call a case if something feels off, Jeff shares some incredible insights into what it means to create a patient-first culture.
00:00:59
Speaker
We also get into what's changing on the ASC scene in New York with the state conference coming up in October in Albany. From expanding access to care, to more cardiac procedures moving outpatient, to securing a seat on the Public Health Council, our listeners will get the inside scoop on some of the biggest news coming out of the state before you hear it in New York.
00:01:18
Speaker
Then in our industry news segment, we're going to talk about why anesthesia providers are increasingly choosing ASCs over the hospital setting, what CMS's proposed 2.6% payment update and expanded list of covered procedures mean for industry growth, ASCA's latest EHR adoption stats from their July 62nd survey, and a nationwide New Zealand study using AI to speed up stroke imaging.
00:01:43
Speaker
I hope you enjoy the episode, and here's what's going on this week in Surgery Centers.
Role and Impact of ASCs in New York
00:01:56
Speaker
Hi, Josh. Welcome to the Freakim Surgery Centers. Thanks so much for joining us. Can you introduce yourself to the audience and tell us a little bit about your role Gramercy and with the New York State Association as a well?
00:02:08
Speaker
Sure. Thank you, Alex, for having me My name is Jeff Flynn. I'm Chief Operating Officer of the Gramercy Surgery Centers, which are located in Manhattan and Queens in New York. And I'm also President of the New York State Association of Ambulatory Surgery Centers.
00:02:21
Speaker
yeah Fantastic. I wanted to have you on because there's a lot of exciting stuff happening in New York, which we're going to get into. it out We're also talking patient experience right now on the podcast. And I know that you have some really incredible stuff that you've been doing at Grammar's Day. So I wanted to ask you a few questions about that.
00:02:38
Speaker
Let's talk a little bit about growth at Gramercy. I understand that you've grown a ton the last few years. So how have you made that the patient experience has remained personal, efficient, and centered on some work?
00:02:53
Speaker
That's a good point, because I think that's where a lot of centers, if they experience a tremendous growth, that's where things start to lag. think one of the things is, and I've always made it a point to make sure that the patient experience, really training our staff to begin with, that the patient experience is utmost at the top of the list.
00:03:13
Speaker
And one of the things is, is if a patient doesn't have a good experience, I will call the patient directly myself, no matter what it is. I'm sorry it wasn't the experience you wanted. Please tell me about the experience, because I think that in all complaints, there's some validity along the lines, but also teaching your staff that they're coming in for surgery, their anxiety.
00:03:32
Speaker
And it's very important to do that. It's interesting because I just looked back on this because yesterday was my 23rd anniversary at Ramercy. Awesome. Congratulations. I started the company with the founder of the company, Katie Chang. And from day one, we wanted it to be about patient experience. We wanted it access of care for doctors who needed to get into the ORs. There was a shortage of ORs in New York, so that's where we started out.
00:03:58
Speaker
And just along the way, each time we always kept in mind, even as we've grown, have a second site in Queens, It was really concerning to make sure that when the patient left the place, we want that patient to say, I had a wonderful experience.
00:04:13
Speaker
What we see is, and it's the chaos of hospitals and larger places, ah is either we really see a lot of problems in the sense of there's 10 or 15 people talking to a patient from start to finish. if you go to an outpatient surgery at a hospital, you talk to so many different people.
00:04:30
Speaker
When a patient comes back and names the nurse that helped, I had one nurse who admitted me. was another nurse in the OR who handed me off to another nurse. When you mention those three names, because they've introduced themselves, they're there for them. They're the patient advocate.
00:04:46
Speaker
You know you've done a successful job because you really did make an impact on the patient, and it's really teaching your staff that that impact is crucial. One of the bigger issues I've noticed, and I know that HST does this, other companies do it too, specifically is patient communication. One of the best parts about the anxiety and the experience is that the loved one waiting for the patient knows exactly where the patient is throughout time.
00:05:09
Speaker
They're in pre-op, they're in the procedure, they're in post-op. And that's one of the big issues that go forward. I also insist that the doctors speak to the patient's family. That's a strict rule that we have that it's You're not going to just send a nurse out to say that you're going to go out and say you're going to spend two minutes to just tell the that everything's okay, the procedure went well.
00:05:29
Speaker
And that makes them feel heard. Because the doctor finds out when he goes to the office, the patient comes into the office and says, oh, you went out and spoke to my wife, my husband, whoever it is. And it just is a better experience for the postoperative period, too.
00:05:42
Speaker
You've also mentioned before that the pharmacy serves a pretty diverse patient population in New York. How do you adapt your care model to meet potentially different cultural, linguistic, socioeconomic needs?
Facility Standards and Patient Comfort
00:05:56
Speaker
You know, the bottom line is, I think, especially if somebody's going into a surgery, you're about to be in a very vulnerable position. You're going to be under anesthesia. First and foremost, I think you have to have a diverse staff. If you walk in and see somebody that looks like you, there just is a level of anxiety. It's softened immediately as you walk in. If there's eye contact with the patient and everything right off the bat,
00:06:16
Speaker
We have several multi-languages, obviously specifically in Queens, but also in Manhattan. We do have a number of staff that speak several different languages, as well as the fact we do have the backups for the rare ones we don't have.
00:06:28
Speaker
I really do think it's important to have the patient information also. so translated into their language is key factors too. We're in not downtown Flushing, but the north side of Flushing. But if you walk into Flushing and you just have English and Spanish, you've just messed up the population.
00:06:43
Speaker
need to have it in Mandarin. You need to have it in Korean. And it's just having that other information for them. They feel like but it's been thought of. And that's a better experience for the patient also.
00:06:54
Speaker
We talked little bit about this, but surgery is stressful. What other steps do you try to get Gramercy to try to reduce anxiety for patients? You know, one of the so most simple things, which is really one of the things, is making sure the facility is absolutely spotless.
00:07:10
Speaker
sure your facility's clean because I have to tell you, if you walk in and you walk into a dirty bathroom, as I hope the OR is clean. It's just one of those things that you know that that's going to run through their mind. Having a culture in place that, you know, if there's a piece of paper on the floor, if I'm walking through Grammarist, I immediately pick it up.
00:07:26
Speaker
And I want everybody else to feel that they need to pick it up or that they will intervene in a situation and not just wait for something. I often do like spot checks and kind of walk through. If you walk into the doctor's lounge and The garbage is filled at 10 in the morning. You know, that's only going to get worse. Make sure they take it out. We have our maintenance staff on walkie-talkies, but it's also crucial that they understand they're responsible for delivering a very big part of the patient experience because a clean facility is going to ease the patient's mind.
00:07:57
Speaker
I have an excellent front desk staff in Miami Manhattan Center, and I do a lot of development too, so I'm not always there. And I do remember it was a hospital administrator who reached out to me and said that he had a very good friend that he was having surgery the next day. I said, oh, I'll go and say hello to him. And that particular hospital administrator was being the patients at school when they left.
00:08:20
Speaker
So I walked over to meet the patient and we had a new person behind the front desk, which was like, I was waiting for the patient to just finish with the front desk before I said hello. And without a step, the new employee smiled at me and asked for me for my insurance card and my ID and that they would be happy to take care of me. And it was just, it was perfect. I remember they were horrified. I was like, absolutely not.
00:08:41
Speaker
That was, that's exactly what I want. You're not waiting for somebody to ah address you. You're walking and somebody says hello to you right away with a smile. That's a real crucial aspect of it. One doctor and sent me something on Saturday about Friday. He said the person at the front desk was absolutely wonderful to my staff member. She said she came in. It was early in the morning. It was 630, disheveled, you know, just getting up for surgery, not having eaten and everything else. And he walked her right to her seat, let her handle just the paperwork from the chair or taking the tablet over. They really enjoyed that. And it's important that you point that out to your staff that you're hearing that back so that they're getting positive feedback and not just, hey, there was a complaint here.
00:09:22
Speaker
You really have to encourage your staff to be like that. How do you describe the culture of Gramercy when you are onboarding somebody new? This is not sort of like your culture, values as you talk about it with staff. Tell me a little about that.
00:09:35
Speaker
Very much so. And, you know, I view Gramercy kind of like as a family. I somewhat have we expanded that to New York State's ambulatory community, too, is that, you know, we know each other and we're here to support each other.
00:09:48
Speaker
And one of the things is, you know, if there's an issue, let's talk about it. Let's get it out there. I'll support you in whatever the case may be because you're there supporting my center. You're there actually right there. You're the one who's going to make sure the patient experience is
Team Culture and Quality Care
00:10:02
Speaker
good.
00:10:02
Speaker
But you're also going to tell me if something's a little awry. At Gramercy, when an anesthesiologist calls to cancel a case and or a surgeon calls to cancel a case, I've done something different. I think it's protecting the center and protecting the patient. The nurse is there to be the patient's advocate.
00:10:18
Speaker
A circulating nurse can call a case at Gramercy. Now, if something's just wrong... If it's like, you know, I think this patient really did eat, and i I'm telling you right now, they're saying they didn't, but I, whatever the case may be, that's the case. It was funny, it was somebody walked in, and they had a water bottle, and they were drinking from the water bottle. And it was like, yeah, you're not going to have surgery. I wasn't drinking from the water bottle. It was like, it's on our camera. I'm sorry. But I went and handled that with the patient. I didn't put it them in that situation.
00:10:47
Speaker
But they have to realize, and the staff really has to feel that they're going to be supported, and that everybody on that team is so crucial to get everything done. So we don't put people in particular categories at Gramercy. It's all one big group because everybody's part is crucial to deliver the product, superior patient care.
00:11:07
Speaker
Absolutely. How does Gramercy ensure continuity of care once your patients leave? It's making sure that we've set up everything and they do have the doctor's information. They have everything set up.
00:11:19
Speaker
And also we do a follow-up call. And one of the things we've done with that is with our pre-op and post-op calls, we actually have New York state licensed nurses, but they're not on site because they're able to call the patient off hours. The patients that work the day before, they miss the call, they're calling back up. So these nurses are able to call like at six o'clock or seven o'clock. How was your experience yesterday at Gramercy? And we do follow up very carefully.
00:11:42
Speaker
If there's any complaints on anything, the patient will be hearing directly from me. I will drop everything and make sure the patient hears because I want to know what exactly occurred that made it happen. had a wonderful experience. One of my maintenance people saw woman working cataract surgery walking in with a cane.
00:12:00
Speaker
He saw that she was a bit unsteady, introduced himself. as one of the employees of Gramercy and proceeded to assist her in the room. And she she just was absolutely stunned. She said, oh, well he saw me yeah outside and he immediately helped me right in here. And it was just a nice experience to hear that he realized that that was part of our whole experience. And even though ah patient care isn't his issue, making sure the patient was safe and brought in was. I like the fact that they all felt that way to jump in in that need.
00:12:30
Speaker
And his comment to me is, well, I have a mother and I would want to know she was treated well. that was he just dismissed it as he walked away, but it was was wonderful to hear that that was actually happening. And As I see afterwards, we also contact the doctor if there is some issue that the patient was dissatisfied with or if the issue is is that up they're unsure of something. I mean, you give them their discharge instructions.
00:12:52
Speaker
You give the escort the instructions because patient coming out of anesthesia, you know, very often, well, nobody told me what the discharge instructions are, but you're holding them in balance. That's just a common thing. But I mean, just to get as many points out as to what their immediate post-op chair will be,
00:13:08
Speaker
And to know that we know that a follow-up post-operative appointment has been made. So we keep to that, too. Well, that's incredible, Jeff. Thank you so much for sharing what you're doing in Grammarcy. But you have another role, and that is at the New York State Association of Ambulatory Surgery Centers.
00:13:26
Speaker
And I understand there's a ton of exciting stuff going on in New York right now that is going to be talked about at your upcoming conference in October as we ramp up to that event. I wanted to kind of get a preview of what people are going to learn. So tell me a little bit about your role there and the kind of advocacy work that you've been doing lately.
Advocacy and Policy Efforts in ASCs
00:13:44
Speaker
Well, you know, it's interesting. it went back several years ago, back in 2017, downstate surgery centers just didn't feel like we were participating. And you the state association at the time, want to say it was 30 surgery centers in it.
00:13:58
Speaker
And they would hold the meetings upstate consistently. They held it in Cooperstown. And for people around the country who don't realize, Cooperstown is 80 miles off the nearest highway. In that part of New York, it's just really remote to get to.
00:14:12
Speaker
And then we saw that there was a board of fun life, but that there was one seat for Westchester South. And we made up 84% of the surgery centers.
00:14:23
Speaker
And so we we challenged it by holding a downstate ambulatory surgery center meeting. We did invite the president at the time to come, and he did come. The one factor though that happened was that I approached him about, you're announcing it's in Cooperstown again. He said, well, that's kind of the direct center of the state. And I said, not by any means is it the direct center of the state. So I asked him take a chance and let the people who ran the Downstate Conference, let us chair the conference.
00:14:49
Speaker
And he agreed to, and I said, but we also need to reform the organization. And we started talking with different people around the state. One of them, and he's now on the ASCA board, and he's my predecessor, John Van Valkenburgh from Upstate Orthopedic Ambulatory Surgery Center in Syracuse. And he was feeling the same thing, that there really wasn't a connection. It really was like they'd show at a conference, but nothing really got done.
00:15:11
Speaker
We ran the conference where it was only surgery center members that were there as attendees. There were exhibitors there to go through. And at that one, we changed to a board of 15. And i was elected to that board. went in, and i remember ah the first thing I knew that needed to happen is that John would take over as president because it was very important that it was upstate. This wasn't an upstate, downstate thing. It was a group of people who wanted to work together.
00:15:36
Speaker
And then... We got a new lobbyist who really had a strong relationship from the Department of Health, had a strong relationship with the governor's office. And she took a chance on us, too, at the time. She had just started her company, Lisa Altieri, who is now our executive director, in addition to being a lobbyist.
00:15:54
Speaker
And what happened is she kept telling us, what are your priorities? And everybody would say, you know, nothing. It was like that. Then we got very organized. We ran a conference upstate, downstate. We were really working well together.
00:16:10
Speaker
And it was then we said we should look at some priorities. What do we want to do as an organization so we're not just a conference? And there's a lot in New York State that even the Department of Health didn't really know to utilize us in certain things. And then when COVID happened, we decided to do a daily phone call separating fact from fiction because that's what was happening in March of 2020. People were just seeing anything.
00:16:31
Speaker
Absolutely. And then the Department of Health suddenly realized that, well, they might be a resource for us. And they actually started joining the call. So it was like we suddenly got recognition that we were there. Initially, we weren't even thought of because we applied to be able to be open as an essential service. And I remember the response we got back from the application was, you are deemed an essential service. Like it was almost don't bother us again. And they really didn't put s surgery centers down in that list. So we had some work to do to educate people.
00:17:01
Speaker
then one of the things we did was get our legislatures into centers, get people into centers. And we really started and strived to do that. And Governor Huckle, when she was Lieutenant Governor, she actually came and visited Gramercy Surgery Center in Queens here.
00:17:14
Speaker
And she found out what a surgery center was. She was understanding that our founder ah passed away in 2020, Katie Chang. This was actually the first woman-owned surgery center in the state of New York.
00:17:25
Speaker
Wow. And she was actually friendly with the lieutenant governor at the time. And so she was able to talk a little bit more about it as the transition happened. And then she became the governor. There was more opportunity to to work with everybody. And what did we want to do?
00:17:39
Speaker
The Public Health Council, there's a feeling that they have a negative view of surgery centers. You know, we cherry pick cases. We don't take Medicaid cases. It angers me when I hear that because like, for instance, in New York City alone, back in 2022, they asked us, oh, well, you're not doing colonoscopies. We did 22,000 colonoscopies on Medicaid patients. We have a center in the Bronx that is 80% Medicaid, where there would be no way for those 7,000 patients to be treated anywhere annually.
00:18:08
Speaker
Mid-Bronx Surgery Center. Actually, it's in the district of the Senate Health Committee chair, and he actually came to it. He is very pro-ASC. We've gotten him through about eight surgery centers in the state, and he's also one has encouraged his other members to see it. So we've had a number here in Queens and in Manhattan, the same thing.
00:18:26
Speaker
Speaker Hastings has actually come to Gramercy Manhattan and also Eastside Endoscopy, which is one of the SCA centers. We're located in the same building. So It's one of those things we can show the multi-specialty and the GI specialty all in one building. but But in addition to that, we wanted a seat on the Public Health Council. It actually passed both houses unanimously and the governor signed it into a place, finally giving us as independent surgery centers a seat on that board so we could actually dispel some of the issues that we hear about consistently. And one of the big things is we can be a tool to assist in providing access of care.
00:19:02
Speaker
So we're not looking at it just from a standpoint. We're private, joint venture, we're with hospitals, but we can actually be part of that experience to get access of care to people. And we started to get people to listen to that.
00:19:14
Speaker
There's 22 cardiac codes that are actually approved in 2020 to be done in ambulatory surgery centers that CMS approves. Immediately, New York State said, no, you couldn't do that. And several states have the same situation.
00:19:26
Speaker
But over time, a number of states have actually changed that. And there are 26 states now that are currently doing cardiac. Well, we got that in front of the governor because we've met with her several times. There were studies out, not a lot of information, but studies out that it also didn't hurt the hospitals in the states that it was being done in because their cath labs were clogged already.
00:19:45
Speaker
So what happened is the diagnostic ones and lower acuity ones were able to shift into certain centers, but those were replaced by higher acuity. So you're actually... getting access of care to the patients.
00:19:57
Speaker
In Brooklyn, we're estimating 14% to 15% of the people who actually have cardiac issues to begin with are not getting treatment at all. It's because there isn't access of care. It's an emergency room. It's a clinic. There just isn't people going out in that care. In addition to the fact the cost-efficiency...
00:20:15
Speaker
we could save the Medicaid system a significant amount of money if we're doing more of those procedures and higher acuity procedures in the ASC setting. So there needed to be discussion about that. And finally, the governor is in favor of this. And the health department actually has proposed this to go forward and has given a date that they would like to see regulations by December to be implemented at some point next year. So that's a really big thing that's going to happen to open up Access of Care in New York. So we're very excited about that.
00:20:43
Speaker
But we're also excited in looking around the state so that each place has a pinpoint to, we can start a cardiac program here, we can start one here. And in many cases, we're working with hospital systems to do that.
00:20:55
Speaker
But in addition, what we'd like to see was there to be more of a discussion about Medicaid to begin with. Right. The hospitals get paid a higher rate than we do, but in addition to the fact they're allowed to bill the codes where they get paid for the implants and they get paid for the supplies.
00:21:10
Speaker
We're not all allowed to do that in the ASC setting. If we could just do that in the ASC setting, and this is a discussion we're having now with the state leaders, and this fall is the budget season where the governor will present a budget in January, they're actually allowing us to participate in that conversation of what could change.
00:21:27
Speaker
Because a lot of times the implant is more than what the reimbursement is. So you're underwater to begin with, you can't afford to do that case. But if the implant was paid for, there's so many more cases we could do.
00:21:39
Speaker
And they're paying for it in a hospital hospital setting already. And that's where most of those cases are getting done. Another issue of access is the length of time it takes somebody to get when they're waiting on a hospital list versus an ASC list.
00:21:50
Speaker
And so that's where we really do feel we can transfer healthcare. care And it's working with the government leaders. They're excited that when we're filming today, and it's actually happening on Monday, is Governor Hockel is going to visit probably our most technologically advanced new center that opened. It has integrated some AI into their sterilization processes.
00:22:09
Speaker
It's implemented programs into the patient trackings, which is also there. It's a beautiful center, too. And she is from Buffalo, incidentally. So we're showing her in her own hometown that we don't have to just show her New York City surgery centers. We want to show her across the state.
00:22:24
Speaker
And she's been very helpful to us. so She made the comment at a reception we had. that the ASCs of New York are part of her solution to deliver health care to the 20 million people in New York.
00:22:35
Speaker
That's a crucial point. And she said it's a patient experience, it's a cost of care. And obviously, she's very concerned about what will happen in the Medicaid budget in the upcoming years to come. We only have 182 surgery centers in the state of New York, and we're 46 per capita in the nation because of that. If we're going to start saying, oh, you're my competitor, that's not where it goes. There's so much business. There's so much access ah care issues that need to be done.
00:23:01
Speaker
We should be colleagues. We should be supporting each other. In certain instances, we should be policing each other. The state treasurer actually is CERB Cytodoscopy, and that's in the concourse of the building where Gramercy Surgery Center is on the 10th floor. We constantly borrow stuff from each other or pop in to visit each other, or it's just different things. But also, if anybody calls up and says, I'm out of this and I need this, of course, if we have it, we're going to share it with you. I mean, and share it back. It's building that type of community with each other. And I do think that It started with our calls during COVID because we were kind of concerned about it.
00:23:35
Speaker
What was going to happen? And then all of a sudden we realized we're all in the same boat. We're only doing essential procedures. But it was exciting when we finally got through and realized now it's time that we can really learn from each other, but also support each other.
00:23:49
Speaker
We've had six surgery centers that have been hacked. And it's wonderful that if you're one of those centers that you can talk to somebody else who's in the same position you are. here You're going to have to send out a notice. But just having that support with each other and be able to have those conversations with each other, that's out there, that that's happening.
00:24:06
Speaker
And it's also learning the fact the health department's not your enemy. And trying to teach each of our centers around the state, the health department, and you should be able call them and get a guided resource from them.
00:24:17
Speaker
um Can I do this? Can I do this? I'm not sure what the situation is. There's so many people are willing to help. And that's one of the things I'd like to see happen. And I've been going to the establishment meetings of our public health council because we want to meet the elder of who's applied and who just got approved for a surgery center.
00:24:35
Speaker
Because I tell them that's when you should join our organization, not after you've built. you're going to have thousands of years of experience of different people you can reach out to. So you don't make the same mistakes. Opening up a surgery center in the state of New York, we've all done it by the seat of our pants. So, I mean, I jokingly tell people, I do drink the ASC Kool-Aid 100%.
00:24:55
Speaker
But it's not just for my own centers. I want to see the access of care grow. We're in a certain window of opportunity of a number of things happening in year where with our FIPC-SEE, with cardiac, and with this bigger Medicaid discussion that we have really made known that they do know who our organization is. We were the ones who consistently lobbied the governor, the health department to make this happen. And it's not to take credit for it, to be honest with you, it's really to give better patient care and better patient access out there. I do want to share one story with you about the access of care, which is important across the state to hear.
00:25:31
Speaker
There is a cardiac group in New York, and it's called the Soaring Medical Group. I actually do believe that Dr. Puma, who runs it, has actually been on this podcast. He had two patients that came in, called in.
00:25:45
Speaker
One was a patient who didn't speak English, who called into the helpline. They told him, show up at 8 o'clock tomorrow morning. One was a VIP patient that got through, show up at 8 o'clock in the morning. They had doctors positioned in all cath labs every single day of the week. Two doctors in each one, wherever they are. Both patients had clots. So both patients were going to have to be stunted.
00:26:05
Speaker
Both patients go to Presbyterian, Westchester. The VIP patient goes there. The patient goes there who was a Medicaid patient. Both of them got done that day and left. But they left corrected. They didn't just put them on a blood thinner and figure out what was happening. They looked at it. They saw the clot. They went in. They fixed the problem.
00:26:22
Speaker
And both patients were home by 5 p.m. that night. Had that Medicaid patient gone into an emergency room and not sought out the soaring group to begin with, he wouldn't have got care
Technological Challenges and Opportunities
00:26:32
Speaker
like that. He would have been put on a blood thinner, sent home. And I'll tell you the punchline in this story is I was the VIP patient.
00:26:40
Speaker
I saw the care the other patient got. The patient got the same care I got. Those are the people that I'm proudest to work with. That they took those two patients and they put them both in that care. They didn't even admit them through the emergency room.
00:26:53
Speaker
Because they had access to the thing, they admitted them directly into the Catholic. I remember telling the governor this story is that that's the type of care she wants New Yorkers to get. And it's nothing against any any of the emergency rooms in New York, but they're dealing with trauma. They're dealing with a number of things, limited resources.
00:27:10
Speaker
They're diagnosing them. Well, we're going to refer to this doctor or that Dr. P. And that's where we could be part of the solution. And I think in New York State, we have to work together to be part of that solution.
00:27:23
Speaker
That's why I've been trying to get a number of the owners very actively involved. And we'll have more owners at this conference than have ever been before, because now they are very interested in knowing that that conversation is going to happen. But engaging expectations, we have to be smart about those conversations.
00:27:38
Speaker
We need to show where we can save the state money, but can afford to do these cases. And it's so important for this conference coming up, 90% of the people at this conference, it's going to be the only conference they go to all year. So we're a tight-knit community, but people live in their own silos because, you know, you're not looking for something new unless it breaks. For somebody, a doctor asking for something new or a service, your day is filled.
00:28:03
Speaker
This conference is an opportunity for exhibitors to really start relationships, but also understand what products that are out there. This is what you should be using. This is something that might be an alternative to you.
00:28:14
Speaker
One of the biggest concerns I have, and New York did not make this easy, is we initially were exempt if your software systems did not go with the Rios, the healthcare care exchange program. But we saw that was going to be a problem back in 2021.
00:28:32
Speaker
And we got roasted by a deputy commissioner who just was saying, I can't, but because 40% of our centers are still on paper. We knew that something was going to come to this. yeah Last May, the Public Health Council took the exemption away. The way New York State made it difficult, they divided the state into five regions and they picked a different company for each region. So for any of our software vendors that we use, you suddenly had to work with five different companies with the Rios to go through. And some weren't very cooperative. Some were.
00:29:02
Speaker
Now they've just changed as of September 30th, we all have to sign new agreements, but we can pick any company of the five we want. And I'm encouraging people to pick the ones that have worked with HST, has worked with CIS, has worked with probation. There's going to be a penalty at some point next year where we're going to lose part of our Medicaid money if we are not participating healthcare exchange. But one of the things is, is getting that information out to people to say that this is true, this is coming. We also have a threat with the Graving Families Act up again in New York.
00:29:32
Speaker
We're very thankful that she has vetoed twice, and we're hoping she vetoes it a third time because she actually understands that it's really affecting the cost of doing business. And the other factor is, in New York State, we train almost 20% all the surgeons in the nation here, yet 90% of them leave New York.
00:29:52
Speaker
And it's how do we attract people to stay in New York? And that's another big question the governor's addressing so that there are people to treat patients here in New York. Anesthesia is another big one. And so we have such a threat with the shortage of anesthesia now and how it's going up.
00:30:05
Speaker
Do we change anesthesia in New York to allow nurse anesthetists to work independently? Will that improve access of care? But anesthesia really across the board, I think in the country, is the number one threat to ASCs right now is the coverage of it.
00:30:19
Speaker
Three years ago, we were not paying for anesthesia, you know, and now with the fact of the shortage of them, the salary hikes that have occurred there, both with nurse anesthetists and with anesthesiologists, that's really been a situation we need to talk about. And that's another community thing.
00:30:34
Speaker
And as I said this time, we're really excited that this is really going to turn out to be probably our best attended conference, but also with a number of owners attending, administrators, DONs attending. This Week in Surgery Centers is going to be there too.
00:30:48
Speaker
So we're very excited about that. And our state health commissioner, Dr. McDonald, is going to be the keynote speaker. And it's interesting, this year he's going to be talking about how the ASCs can team up with the health department and him to provide more access of care.
00:31:04
Speaker
We need another 75 surgery centers in the state of New York to properly give care to everybody. So how do we make that happen? how do we And the way we make it happen is if we're cultivating and supporting each other.
00:31:16
Speaker
I consistently talk with different people who talk about wanting to open a surgery center, and I'm always open to that conversation. It's not a secret sauce by any means. It's just your determination. Do you want to do it? And do you have the wherewithal to do it?
00:31:28
Speaker
But it's also, you don't want to see somebody fail. You want to see everything go well. A black mark is a black mark on all of us, just because we're not known as much in the industry. And that's where we need to really promote ourselves.
00:31:41
Speaker
Because in the past years, we've been bad advocates. And it's, you know, are excited. Not only is the governor visiting on Monday, North Towns, State Senator Jackson is visiting a center in the Bronx on Monday. And The more we can get out there to educate people about that, our legislators about it, and the more they see us as they're battling this budget and what will happen with Medicaid, we really can be that
ASC Conferences and Networking
00:32:03
Speaker
solution. Fantastic. I mean, there is a ton of stuff going on. So I would encourage anybody who is in New York or in the region who maybe doesn't have their own state conference or association to definitely join us. Remind me of dates.
00:32:17
Speaker
location. In Albany, the capital, which is easy access airport, trains go straight there. It's at the Desmond, October 6th to 8th. And actually, it's interesting you say that. Vermont only has two surgery centers, and that we've told them to join us until they have more to make their own association. So we've welcomed them. And some of the ones in Western Massachusetts join us also.
00:32:39
Speaker
Oh, that's fantastic. So I'm personally very excited to attend, and I encourage anybody listening who's interested in hearing these updates, learning more about to build a strong relationship between your association, your centers, and your legislative team that is there to help you. It's a partnership, so you're doing a phenomenal job, and I'm really excited to hear more. I have one final know question for you. It's something that we do with our guests every week, but if you were to give our listeners one piece of advice,
00:33:07
Speaker
that they could use, go out and approve their surgery centers this week, what would be? I will tell you, go through your own it 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.
00:33:28
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.
00:33:40
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, and I have to say this from the state association standpoint,
00:33:52
Speaker
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 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.
00:34:11
Speaker
But i I really hope that people feel the need to jump out and do that. It's often I have conversations with people and it was like, I never thought of it that way. um remember sitting down with a board member and the board member said to me, we're not the charm job we once were.
00:34:26
Speaker
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 ninety s 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. And it's important that we as the operators of surgery centers understand that and really understand what your staff facing, but more importantly, what is your patient facing?
00:34:53
Speaker
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.
00:35:09
Speaker
Amazing. Thank you for spending time with us. Lots of exciting stuff going on. So thanks again, Jeff. I appreciate it. Thank you, Alex. And we look forward to seeing you in October.
00:35:27
Speaker
As always, it's been a busy week in healthcare, so let's jump into some of the latest news and headlines.
Trends and Future of ASCs
00:35:33
Speaker
A recent headline from Becker's spotlights a growing trend. Anesthesia providers are increasingly drawn to the ambulatory surgery centers, and it's not just about money.
00:35:42
Speaker
Many say ASCs offer better work-life balance, less red tape, and a close-knit culture compared to hospitals. In fact, some hospitals have even tried to mimic ASC scheduling to keep their staff happy, but so far, the ASC environment still comes out on top.
00:35:57
Speaker
Autonomy is another big perk. Anesthesiologists and CRNAs who are frustrated with hospital bureaucracy value the freedom that ASCs provide, including the option of flexible 1099 or W-2 pay structures.
00:36:09
Speaker
There's also the chance to shape patient care more directly. ASCs give anesthesia providers an active role in designing efficient workflows, improving post-op pain management, and boosting overall outcomes.
00:36:21
Speaker
And leadership opportunities abound. Anesthesiologists often become medical directors, influencing everything from EHR strategies to supply chain and revenue cycle processes. Simply put, ASCs offer anesthesia providers the chance to practice at the top of their license and have more control over both their schedules and their careers.
00:36:40
Speaker
For the ASC industry, the message is clear. Attracting anesthesia talent isn't just about pay. It's about autonomy, culture, and leadership. ASCs already have the efficiency advantage. Now they can double down on being the workplace of choice for anesthesia providers who are ready to lead and not just follow.
00:36:57
Speaker
And while we're talking industry trends, another recent Becker's article unpacks some of the big policy moves that are fueling the ASC boom. As you know, in fact, we discussed it right here on the podcast, back on July 15th, CMS proposed a 2.6% payment bump for 2026 and rolled out a plan to shift hundreds of procedures off the inpatient-only list.
00:37:19
Speaker
We're talking about 285 musculoskeletal services over three years, plus another 276 procedures that could be added to the ASC list as the criteria becomes advisory instead of mandatory.
00:37:31
Speaker
All told, that's more than 500 new procedures potentially headed to ASCs. State-level deregulation is also fueling expansion. The rollback of Certificate of Need laws is removing barriers to entry and expansion for ASCs, making it easier to build and operate new centers.
00:37:48
Speaker
For ASC leaders, the growing scope of ASC-covered care and looser state regulations means it's time to gear up. In short, ASCs are poised to become the go-to setting for more complex procedures as long as leaders seize the policy momentum to scale up fast.
00:38:03
Speaker
In other news, ASCA recently released the results of their July 62nd survey, showing that 76% of ambulatory surgery centers now use electronic health records, a record high since ASCA began tracking 2021. That's up from and four years. The survey included 280 ASCs across 42 states, offering broad snapshot of adoption trends.
00:38:22
Speaker
marking a thirty six percent jump and just four years the survey included two hundred and eighty ases across forty two states offering a broad snapshot of adoption trends EHR use is strongest amongst physician-owned centers where adoption reaches 82% compared to 72% for joint ventures and 71% for hospital-affiliated ASCs.
00:38:44
Speaker
Among users, 76% would recommend their system to others, citing better data gathering as the top benefit at 87%, followed closely by improved efficiency at 85%.
00:38:56
Speaker
Of the centers still using paper records, 68% say they'll stay that way until forced to change with cost cited as the main barrier to switching. The message here is clear.
00:39:07
Speaker
Digital adoption is accelerating and EHRs are delivering on efficiency and data access. As AFCs look to scale and streamline operations, EHR integration is moving from nice-to-have to must-have for staying competitive in a data-driven healthcare care environment.
Innovations in Healthcare
00:39:23
Speaker
Our final story is a real feel-good one coming out of New Zealand, where cutting-edge technology is teaming up with healthcare to save lives. A new nationwide study is testing whether AI can help doctors diagnose and treat strokes faster, and the potential impact is huge.
00:39:39
Speaker
We're talking hundreds more patients getting timely care each year and closing critical health gaps in rural and underserved communities. A partnership between NICO Lab, Health New Zealand, and the University of Otago is rolling out Stroke Viewer, an AI tool designed to speed up stroke imaging reads across as many as 36 hospitals.
00:39:58
Speaker
This national study will compare treatment times before and after ai implementation to measure its impact. Early estimates suggest that faster AI-assisted scans could enable treatment for 850 more stroke patients annually, potentially saving $5 million dollars in healthcare care costs and up to $40 million in societal benefits each year.
00:40:18
Speaker
The study also focuses on equity, ensuring that rural and Maori populations who are often underserved in stroke care, see real improvements. Researchers hope that this will become one of the largest evaluations of AI in acute stroke care and a model for integrating AI into emergency services worldwide.
Conclusion and Listener Engagement
00:40:34
Speaker
And that officially wraps up this week's podcast. Thank you, as always, for spending a few minutes of your week with us. If you enjoyed our episode today, please consider leaving us a rating or review on your favorite podcast platform, and be sure to join us next time on This Week in Surgery Centers. so We'll see you soon.