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Highlight Reel – What is one thing you can do to improve your Surgery Center?
132 Plays1 year ago
🎙️Over the last three months, we have had seven amazing ASC leaders on our podcast.
At the end of every discussion, we always ask them, "What is one thing our listeners can do this week to improve their surgery centers?" We took all seven of their answers and turned them into this week's episode. Topics range from interoperability to finding a strategic partner to profitability and so much more. We hope everyone enjoys this round-up of things you can do this week to improve your surgery centers!
A huge thank you to our featured guests:
➡️ Joan Dentler
➡️ Michael Powers
➡️ Angela Mattioda
➡️ Matt Kraemer
➡️ Maura Cash
➡️ Blake Peart
➡️ Erik Sunset
Brought to you by HST Pathways.
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Transcript
Podcast Format Introduction
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.
Format Changes Highlighting Leadership Advice
00:00:27
Speaker
Hi, everyone. For today's episode, we are going to change it up a bit from our usual format and agenda. There will be no guest interview and no news, but instead a highlight reel of all the great advice our most recent guests have shared. Over the last three months, we have had nine amazing ASC leaders on our podcast.
00:00:46
Speaker
And at the end of every discussion, we always ask them, what is one thing our listeners can do this week to improve? So we took all nine of their answers and turned them into this week's recap episode. Topics range from interoperability to finding a strategic partner to profitability and so much more.
00:01:06
Speaker
This is one of my favorite episodes that we do every quarter. So I hope you all enjoy what we have for you today.
Inviting External Reviews for Improvement
00:01:13
Speaker
And here's a roundup of things you can do this week to improve your surgery center. Um, you know, one thing, cause we do work with a lot of existing centers that are, like I said, maybe thinking about getting acquired in a joint venture is I would always say it's sort of like when you have somebody come into your house, um,
00:01:37
Speaker
And, you know, they see the dirt in the crevices or they see, hey, if you move that chair to that other side of the room, this room would look a lot better. We often say, you know, invite somebody in. And when I say somebody, somebody who knows healthcare, somebody who knows surgery centers.
00:01:53
Speaker
and have them sort of look at your operations from top to bottom and see if they have any suggestions. And because sometimes they pick stuff up that the people that are there day in and day out don't notice. And I'm not talking about just physical things, even just operations. You can watch and say, why are people, you know, looks like you're doing double work right there. So that's something that I would say is maybe find another administrator, ASE administrator in the area or
00:02:21
Speaker
you know, somebody, maybe somebody from the hospital who maybe knows things and just say, we just walk through and just give us, you know, see if you see anything you think we would should change. Um, and don't be threatened by that is what I would say, because most of the time you can pick up at least one or two pretty easy to implement ideas from those activities. Yeah, that's, that's, that's good advice. I think,
00:02:47
Speaker
oftentimes we start doing things a certain way and running any kind of business or process, right? And that just becomes the way we do it. We don't necessarily go in from that mindset of, okay, let me understand this all with a fresh set of eyes and what could you tweak or improve. And so, right. I think there's, you know, I think people in the ASC industry in general need to remember that first ASC opened back in 1960. A lot of people working in ASCs weren't even born back then. And so, um,
00:03:14
Speaker
I think that the longer an ASC has been open, the more likely you're going to see that where people just, well, this is the way we've always done it. You know, I don't know why we do it this way, but this is the way they trained me to do it when I started 10 years ago and we've always done it this way. And most of those are probably great things and don't change them. But usually you can find one or two time saving or money saving ideas when you, when you have a fresh pair of eyes, look at operations for you.
Strategies for Financial Success
00:03:45
Speaker
Uh, for me is, um, number one is for us, the, the focus is it's hard to find staff staffing shortages is a big deal. So ensuring that you're competitive on compensation for one K matching, um,
00:04:08
Speaker
You know, things that you can do, you can do small things. Just last week, we brought in a coffee truck and paid for everybody to get a coffee or a hot chocolate or whatever, just to sort of celebrate some of the things that we've accomplished. I think from an administrator side to a surgery center side, obviously, if you want to be extremely successful, work in your OR schedule.
00:04:36
Speaker
knowing what your most profitable cases are, maximizing that, knowing your fastest positions, giving them two rooms to flip back and forth, working the OR schedule and such that you're doing cases that make you the most money, that you don't have gaps, and that you're doing as many cases that you can per day. I think that's foundational. Number two,
00:05:01
Speaker
is we work and we rework every three years, every contract that we have to get fee increases. So I think staying on top of that and again, you got to know your business. And if you don't know what your most profitable and your most common cases are, then you have to very closely watch the contracts you negotiate because they sort of want to stay budget neutral.
00:05:31
Speaker
But what you want is you want the cases that you do the most of to make the highest profit off of. So having that data and knowing your business. And then lastly is everything that you can to control your expenses. So, I mean, you know, the bottom line is you got to have happy employees. Happy employees will make happy physicians and happy patients. And then if you want to be profitable,
00:06:01
Speaker
is knowing your business, working your OR schedule, increasing your revenues, and decreasing your expenses. I mean, it's basically what I call your very basics in football of just blocking and tackling really well every day in and out. And I think staying connected through your associations, through your state or the national associations, having other administrators or other individuals that you network with and talk with,
00:06:30
Speaker
I find very invaluable.
Importance of Upfront Payments
00:06:34
Speaker
Well, I would say keeping it related to this specific topic, I would say to have strong policies around collecting upfront, having the ability to give the patients options, whether or not it be funding or payment plans.
00:06:55
Speaker
of financial hardship, whatever those policies may be. But do your patients a favor, give them a professional and as close as accurate estimation upfront, collect that estimation. And that just helps the patient. I know if I'm going in to have surgery, I want to know how much I'm going to be out of it. And I expect to pay that upfront.
00:07:25
Speaker
and should be the same across the board for other centers. Just focus on patient satisfaction and providing them what they need so that they can pay up front and then that will help reduce revenue leakage on the back end. Yeah, it makes total sense. So give them an accurate estimate up front and then collect it by, what's the best practice? Should centers be asking their patients to pay by data service?
00:07:53
Speaker
pay by or at data service, you know, at the time of service is okay. If they don't pay, then at least have that pre-service financial call to tell the patient what they owe and what is the expectation, you know, provide them with a link to pay online through credit card.
00:08:17
Speaker
Is the patient saying they'll bring a check with them on the date of service? Did you set up a payment plan? And if you do set up a payment plan, set up an auto payment plan. Don't just make a note to say for the RCM team on the back end to set up a payment plan depending on whatever the balance is on the back ends. Get those payment plans set up upfront.
00:08:43
Speaker
Yep. And that seems like good practice and common sense, but there's still a lot of centers that don't do that. They don't require their patients to even pay at data service. Do you have a sense of why? What are the common objections? The most common reason for centers that I have experience with, it's their demographics.
00:09:08
Speaker
It always comes down to demographics. It's the types of patients. It could be Medicaid patients or an older demographic, more strained financially demographic that they tend to be a little bit more forgiving. The other reason would be not having those policies, not reviewing it, not KPIs,
00:09:36
Speaker
key performance metrics aren't just for on the back end, our collections and volume and charges and AR. It also should include your upfront collections. You know, those types of KPIs are really critical too, so they should include those. So sometimes it's just kind of a lack of visibility.
Efficiency Through Case Analysis
00:09:59
Speaker
you know, kind of focus on other things within the surgery center, you know, not getting feedback.
00:10:08
Speaker
from the team doing the RCM could be also a reason that they don't realize that there is more urgency to improving those processes up front. The easy thing to say is just start looking at these things. Start digging into these details and start performing your own root cause analysis.
00:10:29
Speaker
Um, you know, we started off by just starting to create a spreadsheet. I mean, it was 1 simple spreadsheet where we started to look at. Case types by provider by times the cost of supplies used in those cases, and then based on our general contract averages, what we would expect to see from a reimbursement perspective.
00:10:50
Speaker
And then as we started to build that list out, started to notice some trends. And that might have been a trend by case or by a vendor or by a contracted payer or provider, and then have some conversations around that. This case becomes viable where it might not be viable today. It might become viable if we're able to reduce the case time by 10 minutes. And what are the things that we're doing as part of our preoperative setup or our closing process or our room turnover time
00:11:20
Speaker
in order to shave off 10 minutes. And if you shave off 10 minutes and you save $100 or $1,000, now all of a sudden a potential loss on a case is a gain. And now you can recruit more and more of those cases. Not to mention the byproduct typically when you're faster and more efficient is a much happier surgeon, happier patient, it's less anesthesia, it's faster recoveries and better outcomes.
Realistic Policy Development
00:11:49
Speaker
Well, if I'm sticking this topic, I would have to say to have policies and procedures that are not just for surveys and are not just an exercise on paper. You don't want to set yourself up and your team up for failure. So sitting down with your team and listening to them, having that heart to heart, and not just about EHR policies. If they say to you, this policy, this procedure is not what we're doing. We can't do this.
00:12:19
Speaker
the time to boost, the resources to do this. We don't have the environment to do this in. Change your policies. Make sure that your policies are, yes, same for the patient, absolutely geared towards positive outcomes, but also they need to be able to be followed by the staff that are expected to deliver care to the patients and or
00:12:47
Speaker
bills to the patient and or medical records for those patients. They have to be able to follow those policies. And if you can have a heart to heart with your staff that says, hey, you guys look at these 10 policies and tell me if we're not really doing any of this stuff, because if you're not really doing it, then it's really not a policy and procedure. That's what I would recommend to everybody because
00:13:15
Speaker
We are all about keeping our staff happy, keeping them in their jobs that they're doing. And what can better let these people know that they're valued than hearing them and listening to them and making the changes that make their job easier?
Team Happiness and Partnerships
00:13:34
Speaker
Well, I think, you know, first of all, as a former, you know, clinician myself and
00:13:41
Speaker
I think it's always do no harm. Make sure you're always working to provide the best services for your patient. You're monitoring compliance risk. You're addressing wrongs. You're addressing all the things that need to be done. Protect your staff, your great staff that you may have. Professional nurses, techs are worth their weight in gold, as we all know right now.
00:14:11
Speaker
you know, take care of your staff, keep them there. Working a bunch of contract people in it, not that we've all done it, but it's not the same thing as having people who you know you rely on depends on it. I think that's a two factor. So if you're taking care of your patients, you're doing everything right, you're forming everything safe, I do truly believe a lot of the revenue and things will come. And it's just keeping and mitigating that process and understanding it. Don't, you know, get what you need to get,
00:14:41
Speaker
Um, by what you need to then enhance your business. And if you find yourself in a position where as a position that I, I have a harder time getting the OR than I did before. Then again, start thinking about how you can change that. And sometimes it can be some internal processes and sometimes it can be what we started our topic about is.
00:15:03
Speaker
Maybe I need to find a partner to take some of these operational and HR components and some of the things that I find myself being entangled in every day off the table so I can spend more time doing what I went to 15, 20 years of school to do and focus on that. And I think that to me is just a factor of quality of life and it also helps
00:15:27
Speaker
mitigate, like I said, a lot of the pressures that everybody has to go through when you're running these surgery centers that are very complicated. And there's a lot of process to get them right. Have someone else take some of that burden off of you. And I, you know, and look, a happier, a happier surgeon is a happier center. So, you know, I think sometimes that sometimes has combinations.
Technology for Process Improvement
00:15:48
Speaker
So we've talked about ways technology can improve your surgery center and what I would do.
00:15:54
Speaker
My recommendation to your listeners would be to list out the processes that you're managing manually, something that you would call the old way, something that isn't technology enabled.
00:16:05
Speaker
Let's be clear, not everything has to be technology enabled to be good, but you end up with a process that you can control and manage much better with technology. So now that we've got that caveat out of the way, list all of your processes you're handling the old way, rank them in the order of the most painful to the least painful. That could be time, that could be cost, that could just be frustration with what it is that you're doing now.
00:16:29
Speaker
And this may be somewhat self-serving for both of us even, Erica, but it's to start shopping. Once you've identified the key areas or the number one issue that's causing you pain at your ASC, get a cost benefit analysis together and start talking to vendors. And the reason for that is that most often than not, anything that you can purchase off the shelf that's commercially available will do better for you than something that's brewed from home. You end up with much better support.
00:16:56
Speaker
You end up with a community of like-minded users to help you through that process. And then as you rinse and repeat through that list of identifying processes where it's strictly manual or it's the old way and being able to replace them with technology, take that to your board and say, Hey, I think I'm onto something here. We can save X amount of time per week, or we'll have this much less waste if we look at technology.