Strategic investments are crucial for healthcare leaders to stay ahead of trends, prepare for future challenges and ensure long-term success in a landscape that is changing rapidly.
The 40 leaders featured in this article are speaking at Becker's 30th Annual Meeting: The Business and Operations of ASCs, set for Oct. 30 to Nov. 2 at the Hyatt Regency in Chicago.
If you would like to join the event as a speaker, please contact Rosie Talaga at rtalaga@beckershealthcare.com.
As part of an ongoing series, Becker's is connecting with healthcare leaders who will speak at the event to get their insight on pressing questions facing the industry. The following are answers from event speakers, lightly edited for clarity.
Question: What is the biggest investment you'll make this year?
Alex Andrade. COO of Medical Associates P.C. (Dubuque, Iowa): Our commitment to investment in our team remains steadfast, with a primary focus on enhancing stability in hours and shift schedules. Additionally, we are dedicated to supporting our workforce through funding scholarships tailored for technical roles that are traditionally harder to fill. By nurturing our team in these ways, we aim to foster a thriving and motivated workforce poised for continued success.
Ali Ghalayini. ASC Administrator, Munster (Ind.) Surgery Center: As the administrator, our primary investment this year is in expanding our medical team by adding new orthopedic specialists and upgrading our facility to a Type I classification. By recruiting top-tier orthopedic surgeons and medical professionals, we aim to offer a broader range of surgical procedures and attract a wider patient base. The upgrade to a Type I facility involves significant enhancements to our operating rooms with advanced surgical equipment and state-of-the-art sterilization systems, enabling us to perform more complex surgeries. This strategic move will elevate our capabilities and position us as a leading ambulatory surgery center in the region. These investments reflect our commitment to providing superior care, expanding our service offerings and enhancing the overall patient experience.
Aman Mahajan, MD, PhD. Senior Vice President of Health Innovation and Enterprises for UPMC (Pittsburgh): At UPMC, we are committed to investing in the patient experience and innovating our clinical practices. Specifically, we are focusing on optimizing adherence to perioperative care pathways using digital health technologies. Providing patients and care teams with the necessary resources, knowledge and tools to boost adherence to perioperative care pathways leads to shorter lengths of stay, lower readmission rates, fewer wound infections and overall better surgical outcomes. By empowering patients and care teams, we can achieve the goals of improving clinical outcomes, reducing financial costs and enhancing patient satisfaction.
Andrew Oh, MD. President of Pain Care Specialists of Oregon (West Linn): We typically try to reduce costs by pre-purchasing spinal cord stimulator implants and implanted pulse generators in bulk. This year will be more difficult, given the climate surrounding most businesses dealing with inflation and the cost of employees.
Brian Cole, MD. Managing Partner, Associate Chair and Professor at Midwest Orthopaedics at Rush (Chicago): In 2024-2025, we think our biggest investment will be in clinic office space for maintenance and expansion. Additionally, there is a possibility for some form of practice ASC consolidation.
Brian Fornataro. Administrator at Mountain Surgery Center (West Orange, N.J.): The biggest investment I will make this year is in people. Without great people, there is no center. They are the face of your center.
Brian Gantwerker, MD. Neurosurgeon at the Craniospinal Center of Los Angeles: My biggest investment will be in building out my endoscopic spine practice. After having done a number of cases and seeing patient demand, I think we all know it is here to stay. Doing more complex cases is certainly on the horizon. Robots are cool but endoscopy is the future.
Caleb Ashmore. Orthopedic Rehabilitation Services Supervisor at Harris Health System (Bellaire, Texas): This year, I'm investing in my leadership potential. I started an executive MBA with an emphasis on healthcare organization leadership at the UTD Naveen Jindal School of Management. This program is a collaborative cohort with Harris Health, Baylor College of Medicine and UTHealth. The unique cohort approach allows for invaluable cross-organizational networking opportunities and leads to gaining valuable and diverse perspectives. I've learned various tactics regarding motivational leadership for healthcare organizations, pertaining to honing my coaching skills as a leadership style, organizational behavior and marketing management. This year promises to be one of incredible professional growth and development.
Deena Edwards, BSN, RN. Administrator at The Surgery Center of Southwest Ohio (Moraine): Our ASC's biggest investment this year is in capital equipment to expand our ENT service line, add a new retina service line and expand our CLIA waiver into a CLIA Lab to perform fresh frozen segments. For our ENT surgeons, we have purchased a NIM monitor to add Inspire implants and thyroid procedures to our approved case lists. We have also purchased instrument sets, sinus scopes and an additional TruDi navigation system to avoid any scheduling conflicts. Along with our new retina service line, we have purchased the new Ngenuity True Digital 3D enhancement system from Alcon, which can also be utilized by other surgeons who want to operate in a “heads-up” position. Ultimately, as we grow and begin to show profitability, we understand that it is necessary to purchase additional equipment to eliminate scheduling barriers and drive more of our investors' procedures to our ASC.
Devi Nampiaparampil, MD. President and CEO of Metropolis Pain Medicine (New York City): The cost of labor has been higher than ever. Artificial intelligence can scribe and perform other functions that previously required human effort. For these reasons, I am not investing as much in labor as I traditionally have. After the 2024 election, I anticipate that taxes will come down, and there will be fewer people working from home. Therefore, I predict a decreased reliance on telehealth and an increase in people looking for more specialized jobs. In preparation, I'm purchasing more equipment now to receive the higher tax deduction in 2024 and to be ready if more people enter the labor force in 2025.
Devin Mehta, MD. Co-Director, Advanced Heart Failure, North Region, Endeavor Health; Medical Director, Advanced Heart Failure, Northwest Community Hospital; Acting Vice Chair, Northwest Community Hospital (Evanston, Ill.): One of the biggest investments cardiology practices should be making is developing high quality programs to wrap around procedures within Medicare's ASC Covered Procedures list. Performing the procedures is only the beginning: the commitment to maintaining high-quality programs at ASCs will speak to sustainability in cardiology.
Earl Kilbride, MD. Orthopedic Surgeon at Austin (Texas) Orthopedic Institute: As corny as it may sound, the biggest investment I plan to make is in myself and those around me. We can't control all the variables that we encounter on a daily basis, whether it be political, personal or professionally. We need to invest in a healthy lifestyle and healthy relationships, both personal and businesswise. This will give us strategies to handle some of those less-than-optimal work situations.
Elaina Turner, MSN, RN. Administrator, Commonwealth Pain and Spine (Louisville, Ky): The biggest investment we will make over the next year is largely related to the new ASCs we are building. Not only will we be making a massive capital investment with the land and buildings, but we will also be investing in high-quality equipment, an efficient EHR system and highly trained staff. There is a high cost associated with all of these, but we feel it is worth every penny to bring high quality, safe and affordable surgical care to more patients.
Elisa Auguste. Administrator at Precision Care Surgery Center (East Setauket, N.Y.): The biggest investment I will make this year is in new technologies. Running ASCs is hard but fulfilling. We are always looking for new ways to be more efficient and organized. Partnering with new technologies like RFX and Ospitek are game changers for my ASC. Implementing paperless systems that allow for the electronic tracking of everything from credentialing and logs to surgery times will allow us to be organized and identify opportunities for improvement. My team and I want to be on the forefront of the new age of ASCs, in and out of the operating room.
Fawn Esser-Lipp, BSN. Executive Director of The Surgery Center (Franklin, Wis.): We are anticipating an increase in volume of total joints, so we will be upgrading our SPD. This includes an additional washer and two new sterilizers. Our equipment alone will be a major portion of our capital budget, which doesn't include the construction costs. The center has also hired an additional technician. SPD tends to get overlooked since it is hidden, but it is just as deserving of a facelift as any other department.
Gabriel Figueroa. Administrator at Manhattan Reproductive Surgery Center (New York City): The most important investment I will make this year isn't any different than other years. It's people. Finding good people who align with the organization's core values and mission is, in my opinion, the key to success. Brick and motor development, capital equipment and other investments don't mean a thing without the right team.
Gail Lagman, RN. Director of Northwestern Medicine Surgery Center (Warrenville, Ill.): We will be updating our sterile processing area with the latest models for sterilizing and washing equipment. This assists in decreasing downtime and additional processing time for the sterile processing department. Additionally, we are continuously investing in our team members to ensure that we continue to provide safe and excellent care to our patients and patient family members with our increasing volume. This encompasses efforts to ensure the best work environment for our team members and physicians. Investing in your team leads to better outcomes regarding appropriate workloads and metrics that impact your ASC's efficiency, such as first case on time starts, turnaround time and employee retention.
Gayle Bultsma, BSN, RN. Director of Clinical Quality at Copper Ridge Surgery Center (Traverse City, Mich.): The biggest investment I am choosing to make this year is in people. I want to focus on staff well-being by helping my co-workers find their personal purpose and meaning in the caring work they do, while connecting it to our organization's mission, vision and values. Creating an environment where staff can make meaningful connections with others, achieve recognition for the value they bring and be encouraged to grow are just a few ways employees can have a greater sense of satisfaction in their work.
Heather Lara, BSN, RN. Manager of Ambulatory Services and Perioperative/PACU at Fort Sutter Surgery Center, Sutter Health (Sacramento, Calif.): The biggest professional investment I will make this year is in my staff. There have been a lot of changes at our facility in the past year, one being my promotion to manager of ambulatory services for perioperative/PACU. With the restructuring of our leadership team, one of my priorities is ensuring I am available to my staff. As a manager, I will do my best to provide the team with a safe environment to speak freely, offer support and resources for professional development, ensure clear communication of job expectations, hire team members who will contribute to increased work performance and efficiency, and create an overall environment that promotes work-life balance.
Isiah Gordon. Administrator, St. David's Austin (Texas) Surgery Center: This year, my biggest investment will be in finding effective ways to improve the patient experience using artificial intelligence. AI is both a mystery and a wonder. In order to harness AI's potential, I believe we must focus on creating meaningful, trust-based relationships between patients and AI applications. An understanding of the patient’s needs and the capabilities of AI will ensure that the technology enhances human life, while maintaining ethical standards and user trust. My goal is to bridge the gap from proven customer service solutions in healthcare to ones that leverage AI’s capabilities.
JoAnn Vecchio. Administrator and Vice President of Ambulatory Surgery Services at Ambulatory Surgery Center of Western New York, Catholic Health System (Amherst): The biggest investment we will make this year is in staffing and anesthesia coverage. There is a critical shortage in the ASC arena, and being able to keep up with the pay rates at the acute sites and other independent ASCs has been a consistent challenge. An ASC employee is responsible for being proficient in multiple specialties, and the types of cases ASCs perform makes the pace much faster than an acute site. Another challenge is balancing the financial "bucket" to ensure that the revenue percentage per case allocated to payroll does not exceed the budgeted amount. Reimbursement rates have not caught up to the inflation rate that employees are facing in their lives, so it will be one of the biggest investments we make this year. In terms of anesthesia, income guarantees are now becoming prevalent if not standard, making it another one of our biggest investments. For specialty staffing challenges, it will require its own line on the balance sheet to be able to meet the market rates for coverage.
John Brady. CEO of Fox Valley Orthopedics (Geneva, Ill.): We've focused the first half of 2024 on creating more efficient and cost effective processes to reduce our fixed and variable expenses. This has come in the form of renegotiating leases, service agreements and contracts for supplies. From an investment perspective, we are focused on ensuring our wages and benefits are on par with other facilities and health networks in the area. While adjusting salaries is initially costly, it can increase overall efficiency and save money by helping avoid turnover. Training new staff is a timely and expensive endeavor, but it impacts the practice's ability to optimize volume and improve overall revenue capture. With these combined, it can lead to costs that are greater than nominal market adjustments. The key is to integrate the adjustments into departments over time to flatten the overall financial impact. If we are unable to maintain a full staffing model, our ability to achieve our growth strategies and targets is adversely affected.
John Prunskis, MD. Medical Director and Principal of DxTx Pain & Spine (Chicago): The biggest investment I'll make this year is the investment of my time improving DxTx Pain & Spine. We now have 60 interventional pain and spine clinics in 10 states. I will also invest my time and work with government officials to improve healthcare coverage issues.
Johnny Russell. Director of Area Operations at Sutter Health (Sacramento, Calif.): We are investing in our patients and staff. We are reviewing ways to increase access to care throughout our entire footprint. Staff retention is vital in what we do. It encourages our teams to step up and provide optimal care in challenging times. Sutter Health prides itself on patients first and people always.
Joseph Booker. Administrator of Rush SurgiCenter (Chicago): The biggest investment this year for our center will be a new HVAC system and a remodeling of our SPD department.
Ken Rich, MD. President of Raleigh (N.C.) Neurosurgical Clinic: The biggest and most important investment we're going to make in the upcoming year is to stabilize our staff. We all know that they could make more money being travelers or working in a hospital with holiday and weekend responsibilities, which is not something we can match. However, between lifestyle, which is very important to people nowadays, and reasonable wages, we can keep an excellent staff of people who get better and better with time.
Les Jebson. Regional Executive of Orthopedics and Sports Medicine Network at Prisma Health (Greenville, S.C.): With continued migration of elective joint replacements of knees, hips and shoulders, our investments focus on assistive robotic technologies and key clinical support staffing, such as technicians, registered nurses and sterile processing department.
Marco Araujo, MD. Medical Director of The A Clinics & Elite Hormones (North Richland Hills, Texas): The biggest investment will be in human talent. In the service industry, employees with good soft skills are pivotal.
Mark Mayo. Administrator of Associated Surgical Center (Arlington Heights, Ill.): Our biggest investment is in people, not money. As we prepare for accreditation, we want to engage staff at all stations to ensure they understand and take pride in their role in ensuring positive surgeon and patient experience. Each person contributes to patients feeling comfortable and surgeons performing smooth procedures. We are proud of their hard work.
Neal Kaushal, MD. Executive Director of General Gastroenterology at University of Oklahoma Health Sciences (Oklahoma City): The biggest investment I will make this year is in people. In today's complex healthcare environment, it is important to remember that the number one goal is serving the patient first and foremost. To accomplish this, we need the right people to lead the way: people who have a vision for quality, efficient and cost-effective care delivery, along with the skills to leverage system-based practice and deliver excellent GI care.
Omar Khokhar, MD. Partner at Illinois GastroHealth (Bloomington): We are investing in human capital and resources. That includes the full spectrum of CRNA, RN and endoscopy technicians. We'll have the opportunity to train from the ground up, so our operation will be as efficient as possible.
Ron Bullen, Executive Director, ProHealth Care Moreland Surgery Center (Waukesha, Wis.): Our biggest investment will be in new 4K video endoscopy systems to support our general, ENT, urology and GYN specialties. This technology promotes clinical excellence, making it critical to remain competitive in our market.
Samuel Jones IV, MD. Cardiologist at the Chattanooga (Tenn.) Heart Institute: The biggest investment outside of our people will be within IT: EMR software changes, upgrades to existing computer systems and the immense resources involved. Unfortunately, the current reality is that virus cyberattacks and global software patches are ways in which hospital systems can be taken offline nearly instantaneously. This disruption can last days to weeks. This compromises patient data protection and crucial healthcare delivery. In the future, resilience in the IT space will be critical. Simultaneously, we must remain on the cutting edge of innovation, including artificial intelligence. Balancing these demands in a cost-effective environment will remain one of our most significant challenges.
Sheila Thompson, RN. Practice Administrator at Twin Cities Pain Clinics & Surgery Centers (Edina, Minn.): The biggest investment we are making this year is opening our third ASC, which will be ready for occupancy in September. We will now have surgery center access for all of our interventional pain management procedures for our patients within 15 minutes of our six clinics. We understand the needs of our patients and continue to provide opportunities for their ongoing care across the Minneapolis/St. Paul demographic.
Skyler Dickson. Executive Director of Surgery Center of Southern Oregon (Medford): We are making a large investment by adding a da Vinci robot to our ASC. We are excited to provide the community with increased access to robotic-assisted surgeries. This is a large investment that will play a significant role in our strategy to broaden case mix, attract new physicians and provide high-value care to patients.
Stan Plavin, MD. President and Owner of Technical Anesthesia Strategies and Solutions; Owner of Oral Surgery Anesthesia Associates; Owner of Ambulatory Anesthesia Partners (Atlanta): The biggest investment that I will make this year is broken down into two components: professional and personal. As I get further along in my professional career, I realize that physicians don't always invest into our personal well-being. I have begun to focus on utilizing my professional commitments and investments to further my personal well being. The goal is to allow myself to stay fresh, engaged and committed to the long-term success of my professional career. As a practicing physician with many responsibilities, it is difficult to compartmentalize and create the special moments outside of one's career. However, I have the chance to convert professional investments into the biggest dividend around: family. The essence of investment is to see a result in the effort put forth, and this can take many forms. For me, it will encompass the focus on the family and our time together.
Tammy Smittle, RN. CEO of Stonegate Surgery Center (Austin, Texas): The biggest and best investment I will make this year is in leadership training. Leadership training is highly beneficial for multiple reasons. The most important reason leadership training is highly beneficial is its impact on improving patient outcomes by fostering a culture of excellence and accountability. Effective, high-quality leadership will also improve staff morale and job satisfaction, while reducing turnover rates and increasing their dedication to provide high quality care. Another plus to leadership training is enhanced organizational efficiency. Leaders with proper training can streamline operations, reduce waste, and improve the overall efficiency of healthcare organizations. We have made many positive changes within my two facilities, which can be very difficult on staff. However, we have made these changes while maintaining a 96% teammate satisfaction score. This can be entirely attributed to quality leadership.
Tina Driggers. Administrator of Credentialing at Day Surgery Center (Winter Haven, Fla.): Our biggest investment this year will be in staff, specifically anesthesiologists. As a freestanding, physician-owned ASC, our staff is important to our success. Utilizing cross training and time management are great ways to keep that work-life balance for all employees, anesthesiologists and surgeons. This has helped us maintain a great team to ensure the best care for our patients.
Travis Messina. CEO of Regent Surgical Health (Franklin, Tenn.): Regent Surgical's biggest investment this year, outside of acquisitions and de novos, will continue to be in data and analytics across three fronts. First, we have invested heavily on data integrations and process mapping with our partners, so they can evaluate and report on ASC performance within their native systems. Secondly, Regent has developed analytical tools that leverage market insights to derive actionable growth plans. Finally, we will continue to build upon our managed care data infrastructure to support our partners to create sustainable managed care strategies.
Wendy Hughes. Business Office Manager of Piedmont Outpatient Surgery Center (Winston-Salem, N.C.): The biggest investment that I will make this year is in the training of my staff. It is not advantageous to the employees or the company to put someone into a position without making sure they have all the necessary tools to succeed. It takes dedication and time to properly train our employees, whether they are new employees or existing employees transitioning into a new role within our company.