Transcription:
I’ll Take One To Go! Increasing Ambulatory Strategy In Key Procedures And Services

Intro: The following SHSMD podcast is a production of DoctorPodcasting.com.

Bill Klaproth: This is a special podcast produced onsite at the SHSMD Connections 2021 Annual Conference in San Antonio as we talk with keynote speakers and session leaders direct from the show floor. Now, a conversation with Ross Swanson, Chief Operating Officer at Corazon, Inc., about his session, I'll Take One To Go, Increasing Ambulatory Strategy Versus Key Procedures and Services.

Ross, thank you so much for your time. We appreciate it. Thank you for stopping by. So can you give us a brief overview of your session?

Ross Swanson: Sure. Thank you for having me. The session that me and my co-presenter are going to be presenting is about ambulatory services in what I'll call key service lines and how the acute care environment with these procedures, they're actually being moved to the ambulatory environment. And we're actually going to cover just a couple of topic areas in that.

The first one is really around the industry trends and why facilities and health systems or hospitals have to consider procedures they're going to move into the ambulatory environment. The second portion that we're really going to cover is around how to successfully execute that? What processes does it take to move your services that are traditionally in the acute care setting today into the ambulatory world.

And then finally, we're going to finish up with promotion of outcomes and making sure that the care that's being rendered in the new environmental space is either equivalent to or either exceeds what you see in the acute care hospital or health system environment.

Bill Klaproth: Right. So as you articulated, why are these services having to move? Why is this happening in the industry?

Ross Swanson: Yeah. That's a great question. There's several things that are the impetus for this. I'm actually going to start with the patient first. There's a lot of patient requests for I call it easier access to care. And if you think about, you know, put yourself in the shoes of a patient that needs to have a complex service done that can now be handled in these new environments, when it comes to things like smaller facilities to work through, even all the way down to how you park your car and move into the environment. So there's a lot of patient requests. There's a consumerism aspect to it.

Many entities like CMS and others are actually responding to the consumerism by making more applicable payment methods for procedures that were once only reimbursed in the acute care side that are now being reimbursed into these ambulatory care settings. So you kind of have a double pronged approach. You have the patient environment, that's really pushing this factor. And then you've got the federal and the payment system and even commercial third party payers are also pushing for this because they also know that the care that's rendered there is done in a much more operationally efficient manner. There's a much lower cost of care in these settings. And then you couple that with the last piece that I talked about before, in terms of talking about outcomes, there's already been demonstrations that show that patients that are receiving more complex care in these environments are having outcomes that are either equal to or exceed what they were experiencing in the acute care. So it's really driving the continued movement of that.

Bill Klaproth: So, this is like an evolution of services, consumerism and easier access.

Ross Swanson: Absolutely. I think evolution is a great word, because if you think about it, patients have been receiving treatment in ambulatory centers for years. And if you think about non-complex orthopedic procedures, people don't even blink an eye at it. And now, I think a few years down the line from now, when you think about complex cardiovascular procedures or neurology, I just don't even think people are going to think twice about it because we're moving in that direction now. There's a demonstrated safety and efficacy and that's what's really going to be promoted.

Bill Klaproth: So in the session also, you talk about a successful approach to moving these key services that were traditionally provided in the acute care setting. Can you give us an example of that?

Ross Swanson: Sure. The one thing we're going to talk about in a lot of detail is like a five-step approach in terms of the planning when you think of key services today and moving them into the environment. And it starts with really a high level assessment of, number one, what's really permitted in your market. There's still regulatory constraints in certain states when it comes to what's allowed to occur in something like an ambulatory surgery center and sometimes even a hospital outpatient department. So you have to really look at your current local market first and say, "What are the restrictions or barriers that can be up against me in terms of what procedures I'm considering to move?" There's also a piece of the actual market itself in terms of how many patients are available within a given service. And does it make sense to make this move if you don't have enough volume or just not enough market catchment to do that?

The other thing that we would also recommend is what's happened already in that marketplace today related to movement of procedures that were once acute care based into the ambulatory world. So looking at what the competitors are doing and perhaps even if you are a hospital or health system thinking about what your physicians would be aligned with the service are asking for.

Oftentimes, if you have a group of physicians that are loosely aligned or even perhaps even in pure contradictory terms with the organization, it might not be the best route for you to take. And actually when you put those pieces together, one of the final things we'll talk about tomorrow is it actually culminates in a financial analysis and you say, "What does the business case look like?" Because the patient case is already there. It's been made. It's "How can we afford to do this? What's it going to look like to the bottom line when we look at the specific procedures?"

Bill Klaproth: So financially, this is a smart move to make as well, this evolution, but it sounds like for the patient, the outcomes are there as well. Can you talk about that?

Ross Swanson: Sure. Yeah, the easy one is the patient, of course. The financial one's a bit of a convoluted perspective. It really does depend because the payment for these procedures does not equal the same reimbursement that a hospital would get. However, these facilities on the outpatient side need to be much more incredibly operationally efficient to garner a bottom line. And a lot of them do it. And we're not saying that it's a negative financial picture. You just have to be very cautious. You need to be very careful and you need to be extremely coordinated with how patients move through that system.

So for example, when you talk about operating room procedures, which is one of the key aspects of an ambulatory surgery center, they absolutely have to be able to do the same procedures that you may see over at the hospital in a shorter period of time with less resources and they accomplish that. Most of the centers in the US that do these today are accomplishing those goals and still seeing positive returns, even with decreased reimbursement. That is the key. The reimbursement is less. They will not get paid as much as they would on the hospital side.

Bill Klaproth: Right. Well, thank you for bringing this education to us at SHSMD Connections. We appreciate it. As we wrap up, anything else you want to add, Ross?

Ross Swanson: There's a mantra that I would tell everybody here.

Bill Klaproth: Give us the mantra. We're ready.

Ross Swanson: The mantra is prepare for the move to ambulatory, even if it's outside of your comfort zone and perhaps even outside of your belief system in terms of where you think things should be happening, because the bus has already left the station.

Bill Klaproth: It's coming. Prepare for it.

Ross Swanson: It's coming. Yeah. You can't bring this train back in the station. It's out.

Bill Klaproth: Right. Well again, thank you for bringing this education to us. It really is a great topic. So thank you again and great to meet you. Thank you for stopping by our podcast booth today. We appreciate it.

Ross Swanson: Yeah, thank you. Appreciate it as well.

Bill Klaproth: And sign up for the SHSMD Connections Virtual Conference, October 19th through the 21st 2021, which will feature two days of new sessions plus recordings from the in-person event. Go to shsmd.org/education/annualconference to learn more and to get registered. And please join us at next year's conference, SHSMD Connections 2022, September 11th through the 14th at Gaylord National Resort and Convention Center in National Harbor, Maryland, outside of Washington, DC. And if you found this podcast helpful, please share it on your social channels. And to access our full podcast library for other topics of interest to you, visit shsmd.org/podcasts. I'm Bill Klaproth. As always, thanks for listening.