Imagine this. You're at the Hyatt Regency Chicago surrounded by the top minds in the ambulatory surgery center industry. Welcome to the Becker's 30th annual meeting, the business and operations of ASCs from October 30th to November 2nd 2024. Picture the excitement as you collect business cards from over a 1000 executive level attendees forging priceless connections. Feel the buzz of conversations as you participate in more than 60 sessions led by over 225 elite ASC speakers. Envision yourself gaining actionable insights on topics like private equity strategies, ASC business growth, and innovations in spine, orthopedics, GI, ophthalmology, and cardiology. Now imagine yourself listening to inspiring keynotes from Hall of Fame boxing world champion, Lila Ali, and professional basketball player, Caitlin Clark. Their stories will motivate you to take your business to new heights. You'll leave with a wealth of knowledge and a network of connections to help lead your ASC into the next year. Don't miss out. Get registered today. Visit beckershospitalreviewdot com and click on the events page to find the conference website. That's the beckershospitalreview.com events page. See you in Chicago. This is Alan Condon back on the Becker's podcast, and I am delighted to be joined today by Taylor Sarah, who is the chief operating officer at the Orthopedic Surgery Center. Taylor, fantastic to have you back on the podcast with us again. For those who might not be familiar with you or your organization, you take a moment to just talk a little bit about your role and your background at the Orthopedic Surgery Center? Sure, Alan. Well, first, you know, thanks for having me back. Always enjoy, doing these with Becker. So to start, I'm Taylor Serra, Chief Operating Officer at the Orthopedic Surgery Center, which is our ASC and also Youngstown Orthopedic Associates, where I focus on optimizing revenue, implementing new technologies, streamlining processes, and optimizing resource management. I've had the privilege of leading this team of of, that were recognized for our, you know, intelligence, highly adapted structure, and and always trying to to to foster a culture of of growth and innovation. I'm I'm very passionate about creating, systems not only to improve profitability, but also elevate, our quality of care that we provide to patients. And I think, you know, moving forward, my goal is to continue to stay ahead of industry trends and ensure our centers deliver the highest quality of patient care while maintaining cost effective operations. Absolutely. That's the the biggest challenge we're all chasing. Right? Taylor, I'm really excited to have you back on today. I'm always excited talking about folks who are at the forefront of business and the operational side of ASCs, particularly in the orthopedic space. You talked a little bit there about creating systems to improve profitability, but also systems that elevate quality of care. And just to hear more about those, but before we do, can you give me 2 or 3 trends that you're really following in healthcare and the ASC space today and why? Yeah. Well, healthcare and and ASCs as we know it, that landscape is is continuing to evolve quite rapidly. For me, the top three trends I'm closely monitoring are the continued shift to outpatient care, outpatient care, value based care models, and, of course, technology and the use of data analytics and, you know, decision making. If the outpatient care, data analytics, value based care as well. I'd love to dive a little bit deeper into what we hear a lot from recent conferences, from executives, the surgeons, physicians, the evolution of AI, data analytics, penetrating all walks of life, specifically health care. Could you give me a specific initiative or something that you're working on within that realm? What are you most excited about or kind of a project in that area? Yeah. You know, as as we talk about this continued shift, very excited about how we can deliver innovation in an outpatient setting. As health care continues to move away from traditional hospital based care, we're finding more efficient and effective cost models in ambulatory surgery settings centers. And, you know, this ability to bring more complex procedures into the outpatient environment is is changing this land landscape, offering patients convenience at lower cost, quicker recovery times, and, of course, at a higher quality of care. More specifically, innovations in surgical technologies such as robotic assisted surgery are really making this possible in the outpatient space. You know, I think the combination of growth in the outpatient setting and continued, cutting edge innovation is truly what excites me, and it's about to continue, you know, improvement, for patient patient outcomes and the overall efficiency in the ASC operations. Yeah. The the the evolution of robotics, particularly in the orthopedic space, the spine space for hips and knees, has been fascinating over the years. I know that will become an even greater component of orthopedic practices and ASCs in the future. Do you do you see is this we hear often about how robots are being used as being being used to recruit the the latest, top talent of orthopedic surgeons coming out of fellowships, coming out of residencies because they're now searching for practices, searching for ASEs that have these technologies, which come with a pretty pretty expensive price tag as well. Right? I'm curious just to kind of hear your your prediction for robotics that are evolving in the ASC space, and kind of how they kind of trend into marketing on the patient side, but also recruitment on the surgeon side? Yeah. And and and, Alan, you're correct. As we continue to train the the latest and and and, let's say, experts in orthopedic surgery and and specifically, total total joints, you know, these individuals are picking up and believing in the robotic assisted surgery. And so, you know, as as private practice, you know, physicians and administrators, you know, we're being, forced in a positive aspect. We're being forced into how do we acquire robotics into our orthopedic, methoskeletal care campuses, because that's what the physicians, are requiring. And so, you know, working with vendors, there are very strategic and and specific ways, to negotiate these deals to to bring robotics into, into your center. From a from a patient standpoint, you know, I think the orthopedic vendors have done a great job in providing patient facing marketing, and storytelling, and successes of robotics and orthopedics, because, you know, patients are aware of it and they're asking for it. And so regardless of the belief or not in robotics, patients are asking for it. So the the feel is that if you don't have some type of robotics as part of your orthopedic or musculoskeletal program, you're you're you're probably pulling behind in in some ways. So, you know, our thought here in Youngstown, Ohio is there is a tremendous value, to robotic surgery. You know, we've found a way to bring robotics into our practice. It has been very successful for us both from a physician recruitment retention standpoint, from a from a growth in the total joint service line standpoint, And from a patient care quality standpoint, we're having very high success rates. Yeah. Such an interest in technology. And just in the last few years, how far we've seen it grow, it's really exciting to see how far the technology will be 2, 3, 4 years from now, particularly when we think about how technologies like AI may be integrated into the decision making protocols and whatnot of these robots in the future as well. Taylor, one quick follow-up, one last follow-up on this before we turn to our next question. There there are many, many of our listeners out there, might be executives, administrators, physician owners of ASCs, considering, to look look to acquire a knee, hip, spine robot of their own. You talked a little bit about, vendors under different tactics to negotiate, payment for these high capital purchases. Could you, could you expand a little bit on that and kind of how how maybe your centers, have navigated the purchase for these robots? Yeah. Yes. There are different strategies and ways to acquire these pieces of technology. And I think the backbone of it is establishing and continuing to build relationships between vendors and facilities and of course surgeons. If you can grow those relationships and look beyond maybe total joints and look into capital equipment, you know, other subspecialties in sports medicine and fracture care, and and and better align, you know, with vendors of robotics, there are attainable and and more cost effective ways for for maybe smaller ASCs that have, you know, financial capital constraints and can't outlay 1,000,000 of dollars to obtain equipment, like I said, in better alignment with, the vendors, there are ways to to bring in these technologies, to your center. Yeah. Yeah. Absolutely. And you said that's obviously one area that is, helped your center grow in the recruitment or retention of surgeons, also in terms of patients as well who are more increasingly seeking out these products. I'd love to get a perspective, when you're looking, 12, 24 months ahead, how are you thinking about growth, Taylor? Yeah. Well, to summarize what we have discussed today, in 2025, we believe growth in ambulatory surgery centers will be driven by a few factors. First, it's a continued shift towards outpatient care that is expected to accelerate, with more complex total joint spine procedures being approved for ASCs, and then the particular payer and health systems push for more cost effective care and more cost effective settings. This is a significant opportunity, I believe, for growth in ASCs. And again, investing in technology is gonna play a huge part in driving this growth. As we continue to discuss ways to grow revenue, my focus is going to be not only to look at different service lines to be able to do this, but also not get away from focusing on, the operating margin. I think it's great to grow revenue, but increasing operating margin is better. As costs continue to rise, more pressures are being put on ASCs, physician practices. I think it's crucial to not lose sight of that operating margin. Focus on what you're currently doing. Focus on what you're currently doing good and find ways, whether it's through AI or innovation, data analytics, to either maintain or improve that operational margin. And I think it's, again, for executives, it's to not just look for the next big thing to add into your, call it, portfolio at the ASC, but to really focus on micromanaging the margins that currently exist, because I think that's going to be the focus as we go forward is continuing to maintain or improve those margins as payers, look to continue to cut rates. Right. I mean, I think that's such an important point as well, right, in terms of, not not so much use growing your revenue if your if your expense growth is outweighing your revenue growth. Right? I I'm curious, if there's 1 or 2 specific, final takeaway you could mention, Taylor, in terms of, a key initiative maybe that you've worked on, something that has resulted in, a particular benefit to to your operating margin. When I think about ASCs or physician owners out there who may be struggling to improve their overall operating margin, what are one or two key pieces of advice you might have for that? It is one thing that we believe, so we've been quite good at is again leveraging through data analytics our vendor relationships, whether that's our medication management systems, our medical surgical supply systems, and of course, implant vendors with regards to our orthopedic business. It's really leveraging those relationships and finding opportunity to decrease costs. And then second is continued, conversation and relationships with the payers, letting them understand things that are going on in your marketplace, and how steerage of volumes, whether it's outpatient total joint replacements, or outpatient spine, can be at a lower cost and a higher quality in an outpatient ASC, continuing to leverage, the opportunity that's in front of us from an ASC outpatient facility standpoint and show the wins per se by steering volumes and patients to the outpatient center. So continuing to leverage what's going on in the ASC market with payers and being able to potentially bring in and negotiate some of those procedures into the ASC setting with a bit more you know, higher reimbursements bringing those into the ASC. Yeah. I think, Taylor, it was fascinating, discussion so far. Great to be able to pick your brains a little bit on your your 3rd appearance on the Becker's podcast and some some great, really great piece of advice and takeaways there to round out our discussion today. Fascinating conversation, and look forward to connect with you again down the line. No. I appreciate it. It's always nice to talk with you and the folks from Becker's. All great stuff. Always paying close attention to it. And, thanks for raising the awareness of ASCs and all the things that we're good at producing to patients and communities and appreciate the opportunity. Absolutely. Thank you so much.