We are continuing our three-part series about QAPI studies. Last week, we heard from Becky Ziegler-Otis, who shared some fantastic insights into how you can generate new ideas. And today, I had the chance to talk with Tina DiMarino. Tina is the CEO of Custom Surgical Consultants, a Board member of the Maryland ASC Association, and an AAAHC Surveyor. So Tina will give up the inside scoop on what specific aspects of QAPI studies surveyors typically focus on during an inspection.

After my conversation with Tina, we’ll switch to our Data & Insights segment. In September, HST released our annual State of the Industry report, which analyzed client data from 590 surgery centers. Today, I’ll share the cardiology trends we saw from 2023 to 2024, specifically around OR duration, revenue per case, and revenue per OR minute.

Resources Mentioned: HST’s State of the Industry Report

Brought to you by HST Pathways.

We’re kicking off a new three-part series on QAPI Studies!

Becky Ziegler-Otis joins us this week to share practical tips for generating new study ideas. Becky is the Assistant Executive Director at the ASC Quality Collaboration, an ASC consultant, and a member of the ASCA Education Committee. Having run an ASC for many years, she knows QAPI inside and out and will show you how to find fresh ideas through internal and external benchmarking.

Coming up next:

• February 18: Tina DiMarino gives an inside look at what surveyors are really looking for.
• February 25: Kathy Wilson walks us through the 10-step process she used to run a successful study that reduced case cancellations at a GI center.

Resources Mentioned:

• Take the ASC Quality & Safety Assessment
• HST’s State of the Industry Report
• Why ASCs Should Brace for Consolidation in 2025
• The battleground states for colonoscopy laws
• Shamika Ossey Champions Resilience and Compassion During LA County Fires

Brought to you by HST Pathways.

Scott Allen is the SVP of Managed Care at nimble, and he’s on today’s show to help us wrap up our Payor Contract series. We have already covered 6 Tips for Effective Management and Leveraging Data for Negotiations, and we’ll finish up the series by doing a deep dive into Chargemaster Essentials. Scott walks us through common issues, making sure your chargemaster is up to date, and how to maintain it effectively.

In our news recap, we’ll cover a kickback lawsuit in New York, potential AI bias, the role of automation in RCM, and, of course, end the news segment with a positive story about a nurse who saved a patient’s life who was having a stroke.

Also – we’re offering a $50 gift card to the first 30 listeners who complete our Podcast Survey! It only takes a few minutes of your time, and you’ll be able to share your feedback and ideas. Start the survey here: https://www.cognitoforms.com/hstpathways1/podcastsurvey

Resources Mentioned:

• The View co-host Sunny Hostin's surgeon husband Emmanuel accused of insurance fraud in bombshell lawsuit
• Hospital evaluation of AI predictive tools for bias is inconsistent, study finds
• How to Make True RCM Automation Work for You: Three Tools Every Organization Needs in Their Toolkit
• Meet Carlee Minyard: The ER Nurse Who Set a Stroke Care Record and Transformed a Life in Just 17 Minutes

Brought to you by HST Pathways.

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!

Rita Reyes-Williamson is the Senior Director of Managed Care at Surgery Partners, and she joins us today for part 2 of our payor contract series to talk about Leveraging Data for Negotiations. Rita has great tips and ideas for what data you should bring to your payor negotiations, such as physician case volume data, case migration from inpatient to outpatient, how you’ll improve access to care for their memberships, and so many more creative ideas for how you can gain leverage and get the best rates possible.

After my conversation with Rita, we’ll switch to our Data & Insights segment. Today I’ll share with you case volume trends per specialty from 2023 to 2024 and then tips for how you can increase your case volume if you’re looking to do so.

Plus - we’re offering a $50 gift card to the first 30 listeners who complete our Podcast Survey! It only takes a few minutes of your time, and you’ll be able to share your feedback and ideas. Start the survey here: https://www.cognitoforms.com/hstpathways1/podcastsurvey

Access HST’s State of the Industry Report: https://www.hstpathways.com/resources/surgery-center-industry-report/

Brought to you by HST Pathways.

We’re starting 2025 with an exciting three-part series on Payor Contracts! In this episode, Kristin Pegram, Contracts and Compliance Manager at Mann Eye Institute shares six essential tips for effective contract management. Kristin brings invaluable firsthand experience to help you navigate contract challenges.

In our news recap, we’ll cover why ASCs closed in 2024, projected headwinds and tailwinds for 2025, SCA Health’s latest acquisition, and, of course, end the news segment with a positive story from Baxter, the manufacturing facility in North Carolina that was hit hard by Hurricane Helene.

Do you want $50? We’re offering a $50 gift card to the first 30 listeners who complete our Podcast Survey! It only takes a few minutes of your time, and you’ll be able to share your feedback and ideas. Start the survey here: https://www.cognitoforms.com/hstpathways1/podcastsurvey

Resources Mentioned:

• Why ASCs closed in 2024
• New Year, New Trends
• SCA Health Acquires OrthoAlliance, Expanding Orthopedic Footprint
• Baxter Expects Pre-Hurricane Levels of Production in Early 2025

Brought to you by HST Pathways.

We had the chance to sit down with Kara Newbury, ASCA’s Chief Advocacy Officer, to discuss what ASCs can expect in 2025. CMS officially published its 2025 Final Payment Rule, so we covered Medicare reimbursement rates, changes to the ASC Covered Procedure List, updates to the ASC Quality Reporting Program, and some other topics that every ASC should be aware of.

After my conversation with Kara, we’ll switch to our Data & Insights segment. In September, HST released our annual State of the Industry report, which analyzed client data from 590 surgery centers. Today, I’ll share with you the numbers we were able to put together regarding OR efficiency and patient throughput. We’ll look at OR Start Time, OR Duration, OR Turnover, and Recovery times.

Also, this week’s episode will be our last one in 2024. There will not be any new episodes on December 24th or December 31st, but we will hit the ground running on Tuesday, January 7th, with a brand new series on payor contracts. If you need content to hold you over, please see the list of educational resources below.

So, with that, we hope you all enjoy the holiday season with your loved ones, and we will see you after the New Year.

Resources:

• Connect with Maia Kunkel from ASCA for help scheduling a facility tour
• HST’s State of the Industry Report
• ASC Data & Benchmarking Video Playlist
• Content Bundles by Topic (board meetings, OR utilization, EMRs, etc.)

Brought to you by HST Pathways.

Mel Gunawardena is the Co-founder and Managing partner at SYNERGEN Health, and he is here to share with us a few things that every RCM expert needs to know. In this episode, Mel shares essential insights every RCM expert needs to know, including best practices for ASCs, how technology is revolutionizing the process, and the key considerations for keeping RCM in-house versus outsourcing.

In our news recap, we’ll cover a new surgical tech training center, what to watch out for in your payer contracts, a new controversial decision by Anthem, and, of course, end the news segment with a positive story about a new, game changing therapy for people with asthma or COPD.

Articles Mentioned:

Plaza College unveils $1 million surgical tech training center in Forest Hills

Watch Out for Payer Contract Proposal Red Flags

Anthem Blue Cross Blue Shield Won’t Pay for the Complete Duration of Anesthesia for Patients’ Surgical Procedures [Editor’s Note: since this episode was published, Anthem has decided to reverse this policy.]

Doctors hail an asthma ‘breakthrough’

HST’s State of the Industry Report

Brought to you by HST Pathways.

This week, our host, Nick Latz, sits down with Joan Dentler, Founder of Avanza Healthcare Strategies, to explore the insights from their 6th Annual Hospital Leadership ASC Survey. Together, they break down the survey results, uncovering key trends in ASC ownership, the growing interest from hospitals and health systems, the equity dynamics, and the role of third-party management companies. And the best part is that all these insights are backed by the data Joan and her team have aggregated and analyzed, so the takeaways are equal part interesting and meaningful.

After Nick’s conversation with Joan, we’ll switch to our Data & Insights segment. HST released our annual State of the Industry report in September, which analyzed client data from 590 surgery centers. Today I’ll share with you the numbers we were able to put together regarding Pre-Authorization Rates and Insurance Verification Rates, and we’ll look at how that compared to 2023.

Resources Mentioned:

• HST’s State of the Industry Report
• Avanza’s 6th annual Hospital Leadership ASC Survey will not be publicly available until January 2025. Please check their website for any updates: https://avanzastrategies.com.

Brought to you by HST Pathways.

We’ve explored many topics related to opening an ASC, but today’s episode dives into something very specific and exciting. Three experts from Align Health join us to discuss what it takes to open an ASC with a cardiovascular focus.

Cardiovascular is one of the hottest specialties right now, with reimbursement per case ranking second only to orthopedics. But with great opportunity comes unique challenges—feasibility, construction, staffing, technology, and so much more.

In our news recap, we’ll cover ASCA’s latest survey regarding access to anesthesia, how health systems are publicly ranking AI models, the critical role of ASCs during national emergencies, and, of course, end the news segment with a positive story about a nurse who went above and beyond to help a family in need.

Resources Mentioned:

• ASCA Survey Shows Improvement in Access to Anesthesia Services
• Health systems band together to test and publicly rank top AI models
• The Critical Role of ASCs During National Emergencies
• Celebrating Compassion: Heather Braden Helps Family in Time of Need

Brought to you by HST Pathways.