Issue link: https://beckershealthcare.uberflip.com/i/1500722
10 THOUGHT LEADERSHIP we had to step back, look at our waiting room, look at our open space to make sure that we weren't having everybody kind of on top of each other. We looked at how we have a lot more people working from home in our coding and billing departments and our support services than we ever have. at made an impact on some of our designs and we were fortunate enough that we were in a place in the construction process that we were able to make those changes and get pretty aggressive about our air handling designs and our waiting rooms and common areas. Q: Did you see an uptick in patients after you reopened your surgery centers? CT: e pandemic didn't mean cancer was cured or sore knees got any better. So we saw a pretty big uptick right aer that because of that pent-up demand. Unfortunately, when it comes to some of those cancer patients, boy, they were sicker by the time they got to us though. ey put off screenings, they put off other treatments. Q: Have you seen any changes in patient volume among other providers? e surgeries and office visits are getting as normal as you can expect. People are coming back from using telemedicine, too. We jumped on telemedicine right away and now that people can come back and see their physician, we have not seen the telemedicine side of the pandemic stick. I don't know if that's just Western Colorado, but we are back to basically where we were as far as telemedicine versus in- office visits. We've got a very high senior population. You know, so a lot of them didn't really want to come and see their doctor and not do it over a screen or an iPad. So we have seen that go back to normal and I don't know if that's the same everywhere else in the country, but telemedicine is not kind of stuck as we thought it might have. Q: How do you think being one of three independent hospital systems in Colorado has helped your management success? CT: I'm the second-most tenured CEO now in the state of Colorado; I'm in my 15th year of tenure. I think we're just a lot more nimble. As a small organization, I report to a 12-member board of directors. It's made up of seven bankers and lawyers from town and the other five members of medical staff, so we're really agile. When the pandemic happened, we were able to pivot quickly and move into telemedicine or move where we needed to go. Ten years ago, we were approached by five local oncologists who said they wanted to join Community Hospital, and we had a cancer center 100 days later. I think that's just the result of being nimble and having a low hierarchy of command, that when something presents itself we can get it done. But feel pretty positive on that front that there's a place for the independent hospital in the future of healthcare. Q: Do you think you would ever go back to leading a larger health system? CT: From a professional standpoint, my job is so much more rewarding running an independent hospital than just being a branch manager at a system hospital. I have a lot more autonomy to do things. at's why I'm still here, it's just so rewarding to be able to have an idea, see it to fruition and not have to ask permission. I can make decisions in the best interest of the community, not the system. at's what I tell when we recruit new physicians. We are very proud to be an independent hospital, but who knows where healthcare is gonna go? I can't promise you we will be independent forever, but we're going to fight like hell to stay independent as long as we can. n Payers still pushing procedures to the ASC setting -- here's why By Patsy Newitt C ost savings and convenience are pushing procedures to the ASC setting, according to five leaders who spoke with Becker's ASC Review. Question: Do you see payers pushing procedures to the ASC setting or away from the ASC setting? Editor's note: These responses were edited lightly for brevity and clarity. Paula Autry. CEO of Leadership DNAmics: I see payers pushing procedures to ACS settings when it is as effective as inpatient settings. In addition, providing procedures on an outpatient and/or short-term hospital stay basis encourages patients to recover in a home or rehab setting, allowing them to be with family and/or an environment focused on recovery to reasonable self sufficiency. Stephanie Conquest. Administrator of Vanderbilt Surgery Center Cool Springs (Franklin, Tenn.): I see payers pushing procedures to the ASC setting due to the value and quality care ASCs offer. Craig Sarine. Former CEO of University Surgical Associates (Chattanooga, Tenn.): In our practice, we have definitely experienced efforts by insurers to push cases to ASCs. However, in our market, the majority of ASCs are single-specialty facilities (orthopedic, gastroenterology, ophthalmology) — although that is in the process of changing. As such, we have very limited options, which the payers generally accept and clear the cases for hospital- based facilities. Definitely the push is toward ASCs, though, rather than the reverse. Marietha Silvers, RN. Administrator of the Surgery Center of Cleveland (Tenn.): Commercial will be pushing more to the ASC in an effort to reduce costs, but not necessarily at a benefit to the ASCs if declining reimbursements are not addressed. Matthew Solis. Director of Downtown Surgery Center (Orlando, Fla.): I still see payers moving cases to ASCs. They are saving money by sending them to our facilities. It would be nice for CMS to follow suit with the procedures they moved back onto the hospital-only list. n