Becker's ASC Review

24 Thought Leadership SCA's plans for 2020: CEO Caitlin Zulla on key investments, partnerships and more By Laura Dyrda C aitlin Zulla became CEO of Surgi- cal Care Affiliates in December aer spending nearly five years as the com- pany's CFO and chief administrative officer. She is a respected leader within the company and champion of SCA's diversity, inclusion and belonging program, which includes teammate resource groups. She also has a strong background in revenue cycle manage- ment and risk-based contracting, with a track record of launching successful bundled payment initiatives as well as leading through acquisitions. As CEO, she is responsible for the company's more than 230 surgical facilities, 9,000 teammates and 8,000 physicians that perform around 1 million proce- dures each year. Here, Ms. Zulla discusses her new role and where she sees SCA invest- ing in the future. Note: Responses were edited for style and content. Question: What is your vision for the future of Surgical Care Affiliates? Caitlin Zulla: First and foremost, it's all about achieving the quadruple aim of delivering high-quality, low-cost solutions for patients, and sup- porting physician and specialist partners. It's an exciting moment with healthcare being so present in the upcoming presidential election as candidates discuss how to fix a broken healthcare system. We need to make sure everyone has access to high-quality care, but the costs have to be adjusted. What we do in the ASC space is such a meaningful part of the solution to address this challenge. e second thing I'm thinking about is how to partner with specialists in ways that are additive to the traditional ASC. We want to find ways to diversify offerings beyond the ASC, which includes SCA's specialty practice division called Optum Specialty Practice, which is all about providing practice management support, value-based care solutions and network participation. rough partnering with SCA's OSP divi- sion, physicians have access to capital, which can help them expand and recruit physicians early in their career to join their practice. On the specialty diversification side, we are also investing in cardiovas- cular specialty centers including office based labs and thinking through overall ancillary and anesthesia needs. Q: In your former role as CFO of Surgical Care Affiliates, you were a big advocate for culture and employee re- source groups. Now as CEO, what will you do to support company culture? CZ: e reason I joined SCA was our incredible culture. We are focused on supporting that culture, and I'm incredibly passionate about diversity, inclusion and belonging. When we are diverse, we are stronger. We just added our sixth Team Resource Group, which is focused on creating a stigma-free environment in our support of mental well-being of our teammates and their family members. We want SCA and this TRG to be a safe place where they can talk about their struggles and anxieties. Our focus in 2020 is around mental health companywide. Q: That is fantastic. Shifting gears here slightly, I know SCA has entered into some value-based contracts. Will that con- tinue in 2020? How do you view value-based care? CZ: We are incredibly strong advocates for value-based care. Now, more than 64 percent of our facilities are in some form of value-based arrangement, and we expect that number to increase quickly. On Jan. 1, we launched a statewide total knee bundle with a major payer, which is that payer's first prospective bundle, for 14 of our facilities. We see value- based care as an incredible way to align high-quality, low-cost care. For patients, value-based care means simpler billing. Providers have account- ability for the episode of care, and for payers, it creates savings because they are paying for quality. And for our teammates and partners, these contracts fuel growth, which means we can continue to recruit surgeons and invest there. We are firm believers in value-based care and we are seeing those structures grow across the board. We are also doing shared savings agree- ments where we commit to lowering the cost of care for affiliated physicians. Q: When it comes to physician recruiting, what trends are you seeing? Are you seeing any uptick in specialists inter- ested in the private practice or ASC model? CZ: We actually have an SCA physician development institute, which is a training program that prepares early-career physicians to partici- pate in today's Medicare environment and outside of hospitals. We recognize that physicians are trained in medicine, not the intricacies of private practice and managed care. Physicians are also training in hos- pitals instead of ASCs, so they are more familiar with that setting. So through the institute, we engage with physicians that are just complet- ing their residencies and educate them about private practice. We have done more than 30 workshops and educated more than 700 residents, some of whom now work within OptumCare or other ASCs. Q: What do you want to do more of in 2020 and what do you plan to change? CZ: We need to do more within clinical quality. We are definitely upping investments of our clinical services team. We are doing that really in three primary areas. e first is establishing a medical executive board, which is a national body of clinical thought leaders from across the SCA network, including physicians from all specialties. e group is focused on providing expert advice and supporting patient-safety initiatives. at was a huge effort in 2019, and it will amplify in 2020. We have patient quality teams and regional quality leaders that promote and execute best practices for quality on a daily basis. e third and final way we augment our investment in clinical quality is putting on a clini- cal leadership session to focus on nurturing the culture of patient safety and investing in clinical leaders so we can continue progress on our vision to make SCA the safest place for surgery. Q: What challenges do you see? CZ: e biggest challenge, as we start to diversify our business beyond ASCs, has been what will that take from our team and business, and how can we communicate that to our surgeons and proceduralists. We closed two significant investments at the end of last year, includ- ing a group of specialists that don't yet work with SCA ASCs. One is a cardiovascular group, and the other focuses on orthopedics.

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