Restarting Our Wounded Medical Facilities

Healthcare was always an industry that was supposed to be recession proof.   If someone’s foot hurt during a recession, they would still go in and have their foot looked at – pain is a strong motivator!    Today, however, the healthcare industry is terrible shape.   Surgeons are out of work.   Doctors, yes doctors, have been furloughed.   Our specialty as an M&A firm has been physical therapists, podiatrists and gastroenterologists – they haven’t been able to see patients and their practices are hurting.

Our quest to get a pulse on what is really going on in the medical industry led us to one of the top experts.   This episode features Angela Stewart, who is one of the top editors with Beckers Hospital Review.  Beckers reports on numerous medical segments daily and is THE source of up to date information with anything medical.

Angela covers what is currently going on in today's environment with hospitals as well as private practices.  Her insight is not only necessary for administrators and owners, but also something for all people to keep in mind.   We're ALL impacted by the medical industry.

This is an episode you won't want to miss.

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www.beckershospitalreview.com

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Transcript

spk_0:   0:06
Welcome to the Tech report Podcast where we help businesses survive, thrive and create value.

spk_1:   0:16
Welcome everybody to the Tech report the podcast that it's all about helping businesses survive, thrive and create value, especially, and are trying environment today. So I'm your host, Brad Stoller. You know, I recall not too long ago when I had what felt was like a nasty cold about to happen. Yeah, and it just really couldn't. It was just a disaster about the happen. I had a critical meeting that was coming up in just a few days. The last thing I wanted was to have a nasty sneezing and coughing spell. Well, I'm trying to present to a board of directors. So the physician's assistant that I went to did a masterful job and recommended a certain antibiotic to take now before my cold really took hold was kind of a preventative thing of more than anything but worked out great and I was able to not miss a beat. I I was just so extremely pleased with how the quality of that medical tension I received and I was very thankful that I was able to make the trip and I had a really good presentation. It all worked out great. A lot can happen in a week. So a few days later, the Corona virus was starting to rear its ugly head in the US My wife was not feeling well at the time, and she tried to get in to see her primary care physician. So the doctor's office, you know, is kind of strangers. They seem to be really, extremely confused. So they set up an appointment to ever come in. And then someone from the office called back the next day and canceled the appointment. My wife was really frantic, as she wasn't sure if she had symptoms of the Corona virus. I mean, we're all kind of wondering what all those symptoms really are. Or she's just getting a bad cold and nobody seem to be able to help with her situation at all. So she was told not to come into the office and just merely stay home. What? We don't know what to do. So finally, her doctor face timed with her A couple days later, Um, if their doctors office was just simply closed and as she put it, we were informed not to go to the emergency room, but to stay home and self quarantine for 14 days, would it? Our world changed in just a matter of a couple of days. So today's podcast is all about health care. The health care was always an industry that was supposed to be recession proof. So somebody's foot hurt during the recession. You know what they would still go in and have their foot looked at. Pain is an extremely strong motivator. Well, today, however, the health care industry, you're in terrible shape, and I don't mean that they're not doing a good job. But it's just it's chaotic. Surgeons are out of work. Doctors. Yes, doctors have been furloughed on our specialty, isn't as an M and a firm has been with physical therapist. But I Atriss gastroenterologist, and they haven't been able to see patients and their practices really hurting right now. So today's guest is the perfect person for this topic, as she is an editor with Becker's Hospital Review. If there's anyone who really has a pulse on what's going on the health care industry, it's our guest. Angela Stewart. Angie, welcome to the Tech report Podcast.

spk_0:   3:43
Thanks for having me. I'm happy to do it.

spk_1:   3:45
Well, great. Well, anti. Before we dive too deep, just tell us a little bit about Becker's hospital review. You know, maybe the history of how you guys get started and how you're helping physicians, medical practices and hospitals. Just give us an overview of what Becker's is all about.

spk_0:   4:02
Yeah, absolutely so, actually, to clarify Becker's hospital review is just one of the many lines we have under the Becker's healthcare brand. So our founder and publisher, Scott Becker's, started the company probably about three decades ago, roughly, and he is a partner at McGuire Woods. So he's been representing hospitals, health systems, healthcare companies, surgery centers and just so many other facilities and practices for years. And he's brought up an incredible network and understanding of the industry. So with that kind of knowledge base, he started a newsletter that he put out himself, and from there we've grown to include a lot of niche coverage tailored to leaders and hospitals. A SC is specialty practices. For instance, we have an emergency emerging women's leadership line pharmacies supply chain. So basically what we're doing at Becker's Healthcare is working to put out coverage that helps healthcare stakeholders of all kinds run their business better, more cost, effectively, safely and improve in whatever ways they need to.

spk_1:   5:11
Well, that's awesome, because I know there's so much. I don't think there's ever been a time where, so money doctors and administrators, they just somebody just don't know what's going to be going on. And everybody wants to know, Hey, what should we be doing? And nobody's really seems to have a good answer for it. And they're really trend of backers, aren't they? Because you guys have a I think you guys have the best pulse of what's going on the industry out there right now. So, um, before we dive too much deeper, I want to know, tell us a little bit about your role of backers. You know how you got started and and that should be exciting. What is a typical day? If there is such a thing for you right now, what's a typical look like they look like on your world today?

spk_0:   5:53
Yeah, we used to have some semblance of a normal day

spk_1:   5:56
way. All did

spk_0:   5:59
small but mighty team at Becker's. So where we're putting out a high volume of articles on a daily basis. So usually that's how my my morning starts. It's just, um, covering a bunch of beats that I was very unfamiliar with when I started out. Backers. I don't have ah, health care background. I have a journalism, um, training background. So I was with The Chicago Sun Times in Crain's Chicago business. Um, before I started at before I started Becker's so kind of dove in headfirst into all these this healthcare jargon and terminology. Um, and now I'm I'm cranking out several articles before noon every day before jumping into some sponsored content and lists and, um, Webinars for Becker's. So are our journalists are editorial team. Everyone is pretty much a jack of all trades. Um, and we're all covering, uh, we like to use the term like white on rice or all covering our beats like white on rice. Um, we have a lot of specialty coverage that really helped.

spk_1:   7:12
Exactly. So. So I know you guys have certain things I know you're in charge of, like, spine, and you have another division that you're also in charge of the editing four. So tell us a little bit about what you're responsible for. It is kind of curious.

spk_0:   7:25
Yeah. So basically the easiest way to say it is I cover the ambulatory surgery center space in all specialties and functions that apply in nasties. So the specific specialties would be a gastroenterology, orthopedics, a little bit of ophthalmology, spine and cardiology, or really up and coming and have a, you know, larger presence in a SCS than ever before. So those air, some areas we cover, then we look at some of the business functions so coding billing collections the most important part, and then quality another most important cart and benchmarking. So those are my specific areas. We I mean, like I said, anything related to a SC's, though it it pretty much falls under my domain.

spk_1:   8:19
Yeah, exactly. So that's good to know. So, uh, and I know there's been a lot of questions on coding, especially telemedicine that's been popping up here on all that. So you get have a great source of quick, quick ways for people to find information. Um, wonderful. So you guys are doing an awesome job, and that's kind of what I wanted it to talk to you guys today. So the magical question on every decisions and administrators mind is, what's the future? Hold with our medical practice or facility. So based on your research and your findings and and ah, the number of articles you guys crank out, I think you guys are like the arm you doom or before people get up in the morning that most people do all day, I get it. So how do you respond when people ask you this?

spk_0:   9:05
Well, it's a great question, and usually I'm the one asking it. That's right. Big effort to ask the actual people working in these facilities what they're seeing and the leaders in their field. What, um, you know, people who have been in health care for decades and decades and have all the training. We asked them to tell us what they're seeing. So, uh, just claim her. All my knowledge is just I'm a vessel of knowledge From what physicians were saying on the front lines, Um, and it differs from speciality to speciality and from market to market, especially with how Corona viruses impacting different regions much, much differently. Um, what I've been seeing, one of the most salient points is that consolidation isn't going away. It was already a huge trend in healthcare. Um, Healthcare's always had a lot of uncertainties as to how it would get costs under control and, um, ensure quality, the best outcomes every single time. And really moving to a free for first, uh, brahma versa. It's world to value base care. But all those moving parts I've just been seeing consistently consolidation. And it's something I don't think is gonna be minimized by the pandemic. I think it's going to be exacerbated. Um, especially with how this is wreaked havoc, like you've mentioned on on practice finances with elective surgery bands. So it was difficult for independent practices and centers to compete with these large health systems that had equally large negotiating power. And this way, um, and now independent groups have this double whammy with Corona virus where they already had a just advantage in some ways. So with this pandemic, joining ah hospital or health system might be even more attractive and in some cases, the only way to survive exactly loss in revenue. Um, and then another, Another key reason for consolidation that was there before, and I suspect will continue to be here after, um if we have Ah, I think posts Croteau virus world. It's kind of a myth. I think we're just in a Corona virus world now. Um, but insurers we're already seeing that a SCS and outpatient centers were excellent value, high quality, lower costs in hospital settings with, ah lower infection risk. So they were sending patients for more procedures to outpatient settings and hospitals and health systems. We're seeing this and still are seeing this, and obviously they want to buy up that surgery center or whatever. That's getting that revenue so that they don't lose out on that revenue opportunity. Um, as you mentioned, and as as I just touched on with finances in really bad shape Right now, everyone's going to be looking for how they can capture more of that revenue. So that's why I think,

spk_1:   12:14
yes, my, that's that's good stuff there. So, you know, I know we've been hearing a lot about in fact, before we started the call, you you're in Chicago. And as of today, you know, the news wasn't really good for Chicago is far as opening back up, but But we have been hearing that elective surgeries. They're gonna be restarting, but supplies air still an issue. So what are you seeing and hearing about the PPE supplies and water facilities doing to make sure they have enough supplies to actually do surgeries and see patients?

spk_0:   12:47
Yeah, that's a great question. So for starters, facilities by most if not all industry organizations have been instructed not to reopen unless they have adequate supplies. Inadequate levels of those supplies. So that would mean their community as a whole should have enough to handle the surge in Corona virus stations. Right? Or they should start taking those those considered elective patients. I did air quotes there because the longer you in elective case untreated, the less elective it becomes, right? Exactly. Yes. So there isn't there is a necessity and getting these procedures back up and running. But senators have been cautioned not to do it unless the community as a whole is in a stable place with supplies. A Zara's going forward from there. I think there will still be supply difficulties, even if the community, as the whole seems pretty stable. So every facility that's reopening everyone that I've seen uncovered has protocols in place that have emerged because of the pandemic. So those protocols air going toe likely include maybe changing gowns and gloves more often than they would have in the past. It's definitely going to include more rigorous sterilization processes, which also takes personal protective equipment and a decent amount at that. So I think, yeah, what we're seeing in the spaces, there's going to be a bit of, ah, dance centers. We're gonna have to do with how toe balance case volumes with current levels of supplies, then watching for any drug shortages that might emerge, especially with the supply chain being so interconnected globally matter how the situation unfolds in other countries as well. Um, so that's what we're looking for moving forward. It's gonna be It's going to be different. I think that's safe to say for pretty much everything right now.

spk_1:   14:56
Yeah, that's for sure. So I and and when you mentioning about the supplies? I do remember. I saw this on the news a couple nights ago that somebody there's a couple in Ohio that had came up with a great idea. They basically took a container, a shipping container, sterilized it, put rack senate and what they're doing is, um, putting masks inside to the container. And then they have, um I can't remember what it was that they had, but they were sterilizing those mask inside the container. And I thought that was a really good idea, and I just saw on the news here. I'm based in Pittsburgh. One of our hospitals, I understand is has bought one of those already. I just saw the news. It was an idea just a couple of weeks ago, and here we are. Um, they've got a container where they put all their their mask inside so they can reuse them and and sets one way. If we can't make enough, then maybe we are just using more than once some house. And that I thought was a great idea. So there's gonna be some opportunity for people to It sounds like so, but, you know, actually, another area we talked about this the supplies, and we all know that's gonna be an issue going forward. But I'm hearing and I also read some of the articles you know, backers that another area is going to be staffing so many facilities and practices, especially the independent practices have had to lay off their staffs. So how is the staff and going to be affected? With the reopening of practices and looking facility owners administrators due to help with keeping their staffs on board or re calling them one? Hopefully that time comes here soon.

spk_0:   16:39
Yeah, that's a huge and very important question. Aziz. I'm sure you saw when you were perusing our site just dozens and hundreds of furloughs and layoffs, right? You for especially independent practices being hit hard. Um, it's something we've been watching up. Becker's was how? Obviously, when elective surgeries were delayed, the immediate following question is, Well, how are they gonna be brought back? And if, um, surgery centers air, preserving their finances, too? Bye bye, laying off staff, then will they have enough staff when these elective procedures restart? Yeah, it's, um it's actually really interesting how it's unfolding. I think a lot of the industry organizations have advised practices to reopen and sort of a gradual fashion. So it's, you know, obviously, that's much easier to handle than just bringing back full capacity immediately, which is basically just out of the question right now for infection concerns and all that so what? I've seen some practices doing. Some groups are rotating staff, so staff members may be in the office or in the surgery center for one week, and then the next two weeks. After that they'll be off and another group will rotate in. So that kind of in beds a quarantine it automatically into their scheduling so that it can lower the risk of staff members passing infections on and and losing. You know your host half If everyone falls, I'm so that's one really smart way that that facilities air doing it. And obviously, I mean, beginning of May is when these have really started to be implemented. So we're still seeing how they're actually working and if there's any troubles. But so far, um, that's one of the ideas we've been seeing. And then other groups are bringing staff back in waves or phases. There was one group and I believe Cincinnati that had furloughed around 219 workers, or so um, and so you know, you can't bring all back all 219 back at once, so they're they're adjusting their staffing and bringing them back according to what procedures are being rescheduled so not doing a bunch of cases that require anesthesia right off the bat they're not going to bring in. Their whole entire team of anesthesiologists will bring in, uh, whatever is needed for for those caseloads and adjust as things gradually get more. Um, hi, Volumen and maybe start looking back to normal.

spk_1:   19:34
Yeah, exactly. So it sounds like the volume is it's really not. As you said, it's almost unfeasible to bring. All 219 employees are furloughed back at once. So actual volumes or practices, it's gonna take a gradual step, isn't it? Yeah, definitely. Exactly. So I know when you you brought up a little bit earlier about the consolidation part, and I know when people are hearing this, especially, ah, the, uh, the physicians and the administrators of these independent practices. And as you said, they may be feeling the pinch. Now we know that Hey, we worked some. Hey, they're doing great. They really are They prepared for this as much as they can. Um, but there's gonna be a lot of anxiety here. So are there certain healthcare segments that seemed to be more prone to this consolidation than others and just kind of curious. You know what? What you've been hearing so far on this.

spk_0:   20:30
Yeah, So maybe this will quell some anxiety is, But I don't think anything will be a surprise as far as what specialties air, um, going to be targets for consolidation and acquisition. Like I mentioned earlier, we were already seeing some consolidation and a lot of there Not a lot, but a significant amount of private equity investment in specifically orthopedics. Ophthalmology was also a really big one. And the G I space was seeing a notable amount of investment pre pandemic. So I think will we'll see those same specialties continuing to generate interest. Um, and for many groups, I think some may see it as, ah, a decent option if they're looking to retire. And I need a way to transition out of ownership. Um, then there's a financial aspect where it's harder to have negotiating power when you're an independent practice operating just on your own. So actually, this morning, um, I wrote about a dermatology collective that was just organized. It's being led by the former CEO of Cardinal Health, and they're banding together as independent groups and this is something I've seen in the urology space as well. They're banding together and pulling the resource is as an alternative to relying on acquisition by a health system to access those resurfaces.

spk_1:   21:54
Oh, that's a great idea.

spk_0:   21:56
Yeah, exactly. So I've seen a few of those. And I think, if, um, people turn their anxieties about consolidation into action, I think that's something we could see trending a lot more. Is independent groups banning together to remain independent in a pretty ironic way?

spk_1:   22:15
Yeah, exactly. So that's that's that's good stuff. Um, so we all know that overnight now, this has been gone for a while, but it just seemed like overnight telemedicine just really popped up and become prevalent, you know? So how do you feel that telemedicine is going to impact the future of health care? And what have you heard about the PCP coats? Will they continue on for being able to charge her telemedicine as now appointments? Where do you think those codes are gonna go? Go away over time? What are your thoughts?

spk_0:   22:51
That's a great question. I want to clarify first that I'm not super immersed in health. I t space with that. That's ah whole, another monster and beast of itself. We have people specializing in the Mars I t infrastructure and telehealth. But I can tell you that five days ago, CMS actually increased payment for telephone visits by about 140%. Um, very beginning of May. That's what happened. And I think that's a sign of what's to come. Um, I personally don't think telemedicine is going away. I I have a hard time predicting how insurance companies were going to deal with it, and there's gonna be all those policy differences from insurer to insurer. But I do know that every practices that's reopening pretty much is continuing to offer telemedicine services. And that's especially because patients right now aren't necessarily comfortable going back to a facility. Um, if there, if there need, isn't completely urgent, definitely a lot of anxieties around infection right now. So physicians need to build trust to even get patients back and to reschedule procedures that had previously been scheduled. Um, I think telemedicine will be playing a huge role in that. Plus, as was the case, pre pandemic costs is in immense issue and health care and tell a motel medicine. Um e think, especially G. I has been finding that there are certain things that really can be done over telemedicine that we've been doing in facilities for years and years. They're gonna be paying attention to that and saying, Well, why would we have a patient spend all the time and resource is coming into the office when we could do this? Um, you know, pre pre surgery, uh, consultation or a follow up appointment via telemedicine? No, I definitely don't see it going away. Um, the codes again, a different monster. Uh,

spk_1:   25:04
yeah, that's for sure.

spk_0:   25:06
Yeah, that just see incredible amount of codes out there right now. I can imagine that, um there might even be various different codes for different specialties that are developed. And, um, it will be interesting to see what the what next year's code changes entail for this, Like the formal, your loan co changes, but, um, there will be some, I'm sure.

spk_1:   25:31
Well, what's your advice for doctors to keep up on their coats? Especially again. I know the larger hospitals and little systems. Okay, They've got this down, but the smaller independents, you know, they're so Buswell. They'd like to be so busy seeing patients were getting to their But how did it? How can they quickly find out? And how can their staff quickly find out? You know what's the latest on the codes? Because I know this is gonna be changing like you alluded to. So what do you recommend? Where should they go toe? Get that information real quickly? Or backers have a spot where they can go to that.

spk_0:   26:06
Absolutely. We do have, ah coding and billing channel on R S C. Site that pertain specifically to outpatient coding because obviously there's difference between outpatient codes and impatient codes are Hospital Review site has dedicated finance writers covering? Um, you know all all financial aspects and could, including codes, so they can definitely use our websites as a resource. Um, you know, you know, if they personally want to go directly to the to the spot where they see changes made, um, I get a lot of information from the American Medical Association and just updates that our annual toe watch out for those. I think you you brought up something important when you said practices would like to be busy and how toe keep up with these codes if they are not busy right now, this is the time to sit down and review everything that they have not had the time to dio And because And I've seen some some practices invested marketing right now finally have time to upgrade their websites and bring it into money. Um, coding is definitely an area that always deserves attention. And from everything that I've read from expert, um, expert coders and billers, you have to have a dedicated person dealing with that. You tried, uh, to run a surgery center, run into surgery and then also memorize all these codes. And you just have to have a dedicated, skilled person, uh, whose job description involves checking on code updates and making sure there they're keeping them top of mind.

spk_1:   27:49
Yep. Exactly so. Well, Angie, we've covered a lot, and I do mean a lot today, and we could probably go on and on, but this is definitely a very unique time for healthcare. So before we go, is there anything that you feel is very important that maybe we haven't talked about yet?

spk_0:   28:07
Like he said, I think we've covered a lot of great ground on and I appreciate you having me on the podcast. I think the only other thing I would add is that there's a huge need for content right now, like what you guys were doing with the podcast and what we're doing at Becker's content that helps practices deal with challenges that were already there and the challenge that have now been exacerbated or emerged. Um, so I guess I just say if anyone needs a good resource, that gets the quick, salient points, that's what we're trying to dio

spk_1:   28:43
Great. Sounds good. Well, last thing you guys are on the cutting edge with anything that's really gone with health care, and people can sign up for updates on their particular field of interest. So tell any everyone here how they can subscribe to backers, hospital review or get more information. What do they need

spk_0:   29:02
to do? Well, we send out newsletters on various topics, like the ones I mentioned at the top of this podcast. We send out the newsletters every weekday and Saturdays, so different days for different specialties. Anyone can sign up for the areas that interest them or apply to them by going to Becker's hospital review dot com in visiting the E newsletters page. Then you just fill out that form with your email address and you'll be getting really important updates in your inbox every morning and every afternoon.

spk_1:   29:33
Well, I gotta tell you, I signed up and I'm getting them. I I feel informed I'm not a hospital professional by any means or in a health care professional. But I actually feel like I've got somewhat of a pulse on what's going on and and I've been on it for a couple weeks now. The information you guys put out there is it's very easy for somebody who's busy. That's what I like, because you can. You can almost get of pulse on what's going on by just reading your headlines, and your articles are short, sweet to the point they're not drawn out. Um, I think it's perfect for health care professionals. So but anyways, once again, as special things to Angie Stewart of Becker's Hospital Review for sharing some great information today, I really hope that you've heard something today that will help your practice or just better understand what's going on in health care today. So, Angie, thank you so much for helping our listeners today.

spk_0:   30:29
Thank you, Brad. Appreciate you having me