HST Pathways

Managing financial estimates for 100s of patients each month is hard work – especially with constant changes in coverage and insurance details. With HST Clariti, you can simplify the process! ✅ Get a comprehensive view of all your cases in one place ✅ Automate insurance checks across four clearinghouses ✅ Stay up to date with benefits refreshed right up to the day of service

ICYMI: Here's what's going on This Week in Surgery Centers.  📢 The Ambulatory Surgery Center Association has officially submitted comments in response to the CMS 2025 proposed payment rule for ASCs and HOPDs. ASCA advocated for the continued use of the hospital market basket to update ASC rates, shared its feedback on new procedures to be added to the ASC-CPL (focusing on cardiac and spine codes), and opposed the three new measures CMS is looking to add to the ASC Quality Reporting Program. The final rule comes out by 11/2. [Source: ASC Focus] 🔄 Signed into law by Governor Gavin Newsom, California's new Data Exchange Framework (DxF) will ensure that every provider—whether at a doctor's office, social services agency, or emergency room—can access essential information about their patient. The hope is that this framework enables secure, real-time information and helps to overcome outdated, paper-based systems and siloed medical records. [Source: Healthcare Dive] 🤖 According to a report by Bain & Company and KLAS Research, 75% of U.S. healthcare providers and payers have increased their IT spending over the past year, with a strong focus on cybersecurity and AI. On the AI front, about 15% of providers now have an AI strategy, up from just 5% last year. Much of this investment is aimed at clinical workflow optimization, with tools to reduce administrative tasks, generate clinical note drafts, and streamline revenue cycle management. [Source: MedCity News] 👁️ Aaron James of Arkansas lost most of his face in a high-voltage accident at work. The 46-year-old received the world's first whole human eye transplant, and this week, a study revealed that while James cannot yet see through the donor eye, it has maintained normal pressure and blood flow and retained its size. Dr. Dedania, NYU Langone Health, said, "The outcomes we're seeing after this procedure are quite incredible." [Source: Positive News] Check out the full stories on Apple Podcasts, Spotify, or YouTube!  #HealthcareNews #ThisWeekinSurgeryCenters #TWISC 

📣 Now Available: HST's 2024 State of the Industry Report! 📣    We live in an era where data-driven decision-making is crucial for a surgery center's long-term success. That's why we're thrilled to share this free report, packed with valuable benchmarking data from 590 ASCs across 47 states.   Download the report today to access: • 130+ KPIs • 50 Chapters • 35+ Charts • 12 Year-over-year Comparisons • 5 Emerging Trends Click the link in the first comment to give it a read. 👀

🎙 Mike Ferguson, President of Horizon Solutions, joins us to conclude our three-part series on Evaluating Ownership Options for ASCs.  As an ASC expert, Mike sheds light on one of the more complex ownership models—when physician owners, a third-party management group, and hospital partners are all involved. Does the saying 'two's company, three's a crowd' apply here, or is it possible that all three could work harmoniously together? Here are some highlights from our discussion! ✅ Ownership Dynamics: Physician, hospital, and management group partnerships offer different benefits. While physician/management group partnerships allow for greater physician control, hospital involvement can provide access to better resources but often comes with hospitals seeking majority ownership (up to 51%). ✅ Referral Patterns & Financial Impact: Physician-hospital partnerships tend to face fewer referral challenges, and the 1/3 rule must be followed closely.  ✅ Shared Decision-Making: In a multi-ownership model, decisions are made by a governing board composed of physicians, a management group representative, and a hospital representative. Operating agreements outline the rules and ensure decision power is distributed among the stakeholders. ✅ Leveraging Resources: Both hospitals and management groups bring valuable vendor contracts and expertise to reduce ASC costs, making these partnerships more resource-efficient. Listen to the full episode for more details!  #SurgeryCenters #TWISC #ASC 

Here are three ideas for Custom GPTs that your surgery center can set up today. 💭 What is a Custom GPT? A Custom GPT is like having a highly knowledgeable assistant that you can train to help you with specific tasks or questions based on your information. You can upload documents, data, and rules and ask questions based on that information alone. They are easy to set up and only take a few minutes. 1️⃣ Scenario 1 – Your Policies & Procedures Upload your policies and procedures and use AI as an on-demand assistant for your team. Staff can ask questions about anything without having to flip through pages manually. You could ask: • What is the protocol for sterilizing instruments after a cardiology procedure?   • What is our process for reporting a patient safety incident?   • What’s the policy for storing patient records after discharge? 2️⃣ Scenario 2 – Data Analysis & Trend Predictions Upload historical data every 60 days (or whichever cadence works for you), and ask it to analyze key metrics, spot potential patterns, and set up alerts for data anomalies. After you upload all your data, you could ask: • What are the three most common reasons for case cancellations in the last quarter? • Which payors have the longest payment delays? • Which surgeons consistently have the shortest case times for knee replacements? 3️⃣ Scenario 3 – Patient Satisfaction Survey Results Like the above example, you can upload patient survey data, and AI can help you get ahead of any downward trends that might not be obvious. You could ask: • What are the top three most common complaints from patients this quarter?   • If you were the admin, which area would you focus on improving next?   • Has there been an improvement in wait time satisfaction scores since we implemented the new scheduling system in June?  And with all three of these scenarios, these Custom GPTs could be helpful when a surveyor drops by unexpectedly, or you're in a board meeting, and a physician asks a nuanced data question. All questions could be answered immediately and accurately. Note: To build Custom GPTs, you will need the paid version of #ChatGPT, which is $20/month.

Selling a minority share of your ASC can be very overwhelming. Many physician owners will question whether it’s the right move, the right amount, and the right partner before the process begins. Minority interest is typically when physicians retain majority control, and 20-35% is sold. Jeff Peo, Managing Partner at Lifeline Vascular Care, breaks down the pros and cons of selling a minority share, the typical ownership split, how it impacts physician autonomy, the financial advantages, and more. 3️⃣ Advantages of a Minority Model: • Physicians receive management support without losing total control.  • Facilities gain access to the management company’s experience and resources.  • Partners assist in scaling the business and increasing profitability. 3️⃣ Challenges of a Minority Model:  • The facility may lose some operational flexibility.  • Physicians must share a portion of the profits with the investor.  • Differences in vision or strategy can cause friction. ⭐ A bonus is the double-sale opportunity: physicians might sell a minority stake, grow their business, then sell a majority stake later for a higher valuation. Click the link in the comments to access Lifeline's breakdown of the two-phase sales model. Listen to the full episode for more details! #SurgeryCenters #TWISC #ASC 

ICYMI: Here's what's going on This Week in Surgery Centers. 📊 Healthcare leaders are closely monitoring eight trends: mounting financial pressures, physician and nursing shortages, rising influence of payers, regulatory and policy changes, surge in M&A activity, non-traditional competitors, technology and digital transformation, and workforce recruitment and retention. [Source: HealthLeaders] 🤝🏻 ChristianaCare and Atlas Healthcare Partners announced a new joint venture to expand a network of ASCs in Delaware and the mid-Atlantic region. This partnership reflects a growing trend toward outpatient care, as alliances like this will be crucial in meeting patient and payer demand. [Source: ChristianaCare] 💡 According to a Mercer study, we can anticipate a shortage of over 100,000 critical healthcare workers by the end of this decade, with NY, NJ, and TN projected to be hit the hardest. But, on a positive note, CA, PA, and TX may see a surplus of workers. If you’re concerned, contact staffing agencies, focus on employee benefits, offer flexible scheduling, and promote career growth opportunities. [Source: Healthcare Dive] 🥇15-year-old Heman Bekele has been named TIME Magazine's "Kid of the Year" for his groundbreaking work in skin cancer treatment. Growing up in Ethiopia, he witnessed the harsh effects of the sun on outdoor laborers and was struck by the high cost of cancer treatment. Determined to make a difference, Heman created a soap infused with Imiquimod to make treatment more affordable and accessible, particularly for those in developing regions. The soap is currently in trials. [Source: Positive.News] Check out the full stories on Apple Podcasts, Spotify, or YouTube!  #HealthcareNews #ThisWeekinSurgeryCenters #TWISC 

Last week at CASA, Blake Nelson hosted a session on "How to Prepare for and Navigate Board-Level Conversations." We were honored to be joined by Benita Tapia, the Admin/DON at 90210 Surgery Medical Center LLC, and Dr. David Shapiro, an anesthesiologist and ASCA board member (amongst many other accolades!) for the second half of the session, to answer audience questions.   Here are just a few of the topics we covered: ⭐ Establishing a repeatable agenda ⭐ Utilizing time savers like a consent agenda ⭐ Sharing key metrics such as days to bill, collection rates, and denials ⭐ Determining the frequency, length, format, and timing of meetings ⭐ Implementing tips to make meetings engaging and data-driven   We also had an excellent time, as always, speaking to everyone who came by the booth. Thank you, California Ambulatory Surgery Association, for another great show!

🎙️ Has your ASC ever considered partnering with an MSO?    An MSO (Management Service Organization) provides all types of support to its ASC clients. James Calligan, President of Phoenix Gynecology Consultants, hopped on this week's podcast episode to discuss what an MSO is, the perks of partnering with one, and how to evaluate one before jumping in.    🔑 Advantages: MSOs offer flexibility that allows ASCs to maintain independence while outsourcing key functions like RCM, HR, clinical oversight, and even marketing. It's a game-changer for centers that need support but want to stay nimble.    💡 Staffing Solutions: James highlighted that MSOs ensure consistent staffing, helping build trust and efficiency in the OR—especially important during today's staffing shortages. No more relying on unfamiliar per diem staff.    ⚙️ Customizable Services: MSOs provide tailored options, whether handling entire operations or offering a la carte services like marketing, accreditation prep, or HR support. ASCs can pick and choose based on their unique needs.    📊 Technology & Vendor Support: Whether managing vendors or assisting with the tech buying process, MSOs help ASCs choose the right partners and guide them through implementation.     Are you interested in other ownership structures? Today kicks off our new three-part series about "Evaluating Ownership Options." Two more episodes will air on 9/17 and 9/24! Listen to the full episode for more detailed insights. #SurgeryCenters #ASC #MSO #TWISC 

🎙 In our new three-part podcast series, "Evaluating Ownership Options," we explore the key ownership models available to surgery centers. We’ll cover what it’s like to partner with a Management Services Organization (MSO), the pros and cons of selling a minority stake, and how to navigate the complexities of centers with dual ownership by both a management group and a hospital. 👉 September 10th: James Calligan, Phoenix Gynecology Consultants 👉 September 17th: Jeff Peo, Lifeline Vascular Care 👉 September 24th: Mike Ferguson, Horizon Solutions Subscribe to "This Week in Surgery Centers" on YouTube or your favorite podcast platform so you don’t miss an episode.