Advocating for ASCs

In this episode of the Advancing Surgical Care Podcast, ASCA Chief Executive Officer Bill Prentice talks with Todd Currier, ASCA Board treasurer and administrator of Bend Surgery Center in Bend, Oregon, about the importance of having ASC owners and physicians involved in ASCA’s federal ASC advocacy efforts. They also discuss ways every ASC could benefit from Currier’s model for owner engagement and participation. Today, 90 percent of the physicians practicing at Bend Surgery Center contribute to ASCAPAC, the only political action committee devoted exclusively to advancing the issues that matter most to ASCs of every specialty throughout the US.

Transcript

Narrator 0:02

Welcome to the Advancing Surgical Care Podcast, brought to you by ASCA, the Ambulatory Surgery Center Association. ASCA represents the interests of outpatient surgery centers of every specialty and provides advocacy and resources to assist them in providing safe, high-quality, cost-effective patient care. As with all of ASCA's communications, please check to make sure you are listening to or viewing our most up-to-date podcasts and announcements.

Bill Prentice 0:27

Hello, and welcome to the Advancing Surgical Care Podcast. My name is Bill Prentice. I'm the Chief Executive Officer of the Ambulatory Surgery Center Association, or ASCA, and host of this episode. My guest today is Todd Currier. Todd is the Administrator of the Bend Surgery Center in Bend, Oregon, and serves on the ASCA Board of Directors. In his capacity as a board member, Todd also currently serves in leadership as ASCA's Treasurer. For the past 20 years, Todd has held both management and advisory positions in the surgery center community, as well as being an active member and leader of multiple state surgery center associations. Today, the thing that I am most eager to talk with Todd about, though, is ASCA's Advocacy, Government Affairs, and ASCAPAC, ASCA's Political Action Committee. Todd, welcome to the podcast.

Todd Currier 1:15

Thank you, Bill. Excited to be here.

Bill Prentice 1:18

So Todd, as everyone listening to this podcast knows, surgery centers are both heavily regulated at the state and federal level and impacted upon both positively and negatively by laws that are enacted by Congress and state legislatures. Yet for many administrators and physician owners, not all, but many, there's a real reluctance to become actively involved in direct political advocacy on behalf of surgery centers. despite the fact that there is no substitute for them speaking with or providing direct support to their elected officials. Can you comment on your experiences and why it's so important for both administrators and physician owners to play a role in advocating for the ASC community? Sure.

Todd Currier 2:01

I think the reluctance comes from the fact that physicians utilize their ASCs as an extension of their regular practice. Thus, for the most part, they treat it as a secondary component. leaving it to be ran by the administrator. But times are changing and their involvement is more important than ever for them to be engaged and involved. Sitting on the sidelines just will not bode well for the future of ASCs. They need to become active in engaging our political leaders and becoming involved.

Bill Prentice 2:31

What I think folks fail to realize is we're just a very small piece of the healthcare ecosystem. Obviously, for those of us in this community, it's critically important that the surgery center model not just survive and thrive. And I think that because we are relatively small in size relative to the hospitals or the entire physician community, We need more people to be involved in order to have a critical mass to be successful. And so, Todd, like this fall, the entire Congress, a third of the Senate, and all but six state legislatures will be standing for reelection. At the federal level, ASCA is actively engaged in raising funds for our political action committee, ASCAPAC, so that we can provide contributions to members of Congress who have demonstrated their support for the ASC model. Contributing to a member of Congress, and Todd, you know this well, It does not ensure that they're going to vote your way. But if you're providing political support to a member of Congress or a candidate, they're at least going to listen to you. And listening is really the only thing that we need because, you know, I think on the facts, we have such a good story to tell. So contributing to the PAC is a direct investment in our future, the ASC community's future. But it's often a struggle for ASCs to even raise small dollar contributions from ASC owners. I know you've had a refreshingly different experience and that you've been very successful in helping us raise money for ASCAPAC. Can you share with us what you've been able to accomplish and what the secret to that success was?

Todd Currier 4:00

Well, I agree that we must take action now and provide support where needed. It's imperative that it takes every one of us to step up and become involved, not only with our engagement of political leaders, but also financially to show our support in that manner. What we have done here is We have over 40 physician partners at our center, and I have about 90% of them contributing $200 annually to the ASCA PAC. I started by asking a select few of my physician owners to become physician champions in this regard. And most of these people I approached with single-page data sheet explaining what ASCA does for us on an annual basis and what they've done for us in the past and what they're doing for us in the future. And getting those physicians involved and becoming champions, I actually had them write a letter to where they all signed to the rest of the partnership, seeking their support to also contribute $200 annually. Furthermore, we actually provide monthly distributions from our surgery center. So I offered the opportunity to take monthly deductions from that distribution. So we're doing $16.67 per month. equals 200 a year and so it's a very small component very small chunk of taken out of their distribution on a monthly basis and that we can provide support to ask a pack in that manner that helps with the advocacy that we need up on the hill

Bill Prentice 5:30

So Todd, that's the the really brilliant thing about this approach is that once you have the physician owners agreeing for this deduction you take it from there. And it's obviously, it's a very small amount of money pulled out of, in your case, a monthly distribution. It could be a quarterly distribution or annual distribution. It still would be a really small bit of money for them, but hugely important when we collect it and have the ability to use that. So I think that's a great model and something that I hope listeners will be able to replicate in order to get their physician owners to support the only political action committee that is supporting their surgery center. So that's amazing. And as you know, we have legislation pending in the House and Senate that would, among other things, significantly improve Medicare reimbursement for ASCs, as well as the process for adding more procedures to the ASC covered procedures list. Things that we know our physician owners would love to see. And so to get this legislation over the finish line, however, We need more allies in Congress. And again, it's these political action dollars that allow us to develop the relationships with the members of Congress that we need so that they will hear us and listen to us and then be able to use their own best judgment about how to vote on issues. But I think, again, as you and I know, we have that opportunity to make them understand the value of the surgery center model and what we're doing for the Medicare program, for Medicaid programs around the country. for reducing healthcare costs overall, we have a great chance of success. And so that's the positive side. But similarly, I think the physician owners need to know we have several very real threats that pop up from time to time in the form of legislation and regulation that, for example, could restrict facility fees or require ASCs to file cost reports or have to provide all sorts of different data that would be really burdensome for them to provide. Is it your sense that physician owners are fully aware of both the opportunities and threats that we face as a really heavily regulated healthcare provider community? If they aren't fully aware, what should we be doing?

Todd Currier 7:41

I think for the most part, they are not fully aware, Bill. And I'll take ownership of that. I know in my past, as far as how I related items to the board, to the rest of the physician partners, is more focused on our singular surgery center. And what we've taken approach now is I let them know what's happening at ASCA. I let them know what's happening with our state society and the importance of both of those associations and how we can make an impact on that. I think the biggest part is making them realize, you hit it on the second it goes, that it's not only the offensive nature of things that ASCA is doing on our behalf, it's the defensive measures that we continue to battle that may be and is on the most part unseen.

Bill Prentice 8:29

Yeah, I think that's right. As an example, something that ASCA does to try and kind of like get directly to the physician owners is we actually produce a physician brief that comes out periodically that is aimed directly at the physician owner. And it's very, as its name implies, it's brief, short bullet points about the things that we're working on on their behalf. And so anything we can do to try and motivate the physician owners, just pay a little bit more attention to the surgery center issues, I think is going to be beneficial to us. Anything you want to respond to that?

Todd Currier 9:04

I guess I've used that physician brief also as a major and something to send out to the physicians individually. And... I think it also gets back to the, if I can ask for $200 on an annual basis, I can almost guarantee you or do guarantee you that we get that back from our center. Each one of you get that back in the form of a distribution by the impact ASCA's had on our Medicare reimbursements, being tied in with the hospital market basket versus CPIU and looking at the, it costs us more than $200 annually per physician if we had to do a cost report. You know, these are things that are directly affecting them, directly affects their distribution.

Bill Prentice 9:45

Any other advice that you'd like to provide to your colleagues about how to set something like this up?

Todd Currier 9:50

I believe first and foremost that we need to understand that ASCA is the voice for ASCs. As you mentioned, Bill, we are the ones out there fighting. ASCA is the ones out there on the front lines when we talk to the legislatures and Congress and working on our behalf, working on every center's behalf. We have over 2,500 ASCA members. And if each one of those centers does a small part, it helps contribute to our ASCA pack and it helps contribute to the whole. As you mentioned, we are a small player in a big pond and it does take action though. And we can sit aside and let things happen to us, or we can be motivated and proactive and help that narrative up on the hill.

Bill Prentice 10:36

Todd, I want to thank you for volunteering your time and expertise as a member of the ASCA Board of Directors, serving as our treasurer, and for actually being on this podcast with me today. You're a tremendous advocate for the ASC community, and I thank you for that. And we really appreciate you sharing your time and knowledge with us.

Todd Currier 10:54

Thank you, Bill.

Bill Prentice 10:55

Before concluding, I would also like to acknowledge our podcast sponsor, AMSURG, a leading ASC management company with more than 250 ASC partners in 34 states. To learn more about them, visit amsurg.com.