← Becker’s Healthcare Podcast
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- [00:02]
A
@ Athenahealth, we know your ambulatory practice wants healthier a healthier business, healthier care teams, and healthier patients. But the complexities of modern healthcare tech make it hard for you and your care teams to focus on what matters most. That's where athenahealth can help our AI native all in one solutions reduce administrative burdens, streamline billing and payments, and deliver critical insights when clinicians need it most. That means fewer clicks, more time for patients, and stronger bottom Practicing medicine is complex, but running a practice can be that much simpler. With Athenahealth, see how simpler is healthier@athenahealth.com.
- [00:44]
B
Hello, this is Francesca Matthews with the Becker's ASU Review Podcast. I'm thrilled to be joined today by Vijay Bichani, President and Chief Chief Growth Officer of New York Bariatric Group. Thank you so much for being here today.
- [00:57]
C
Thank you for having me. Yeah.
- [00:59]
B
To start us off, could you just introduce yourself and tell us a little bit about your background?
- [01:04]
C
Sure. I'm currently President and Chief Growth Officer at New York Bariatric Group. We're the largest bariatric platform in the country. We're in five states, New York, New Jersey and Connecticut, as well as Arkansas and Oklahoma. We also have four surgery centers. So we have a surgery center in Arkansas, one in Long island, one in Paramus, New Jersey and one in Stanford, Connecticut. And my background, I've been here about nine years. Kind of really led the growth of the company for the last nine years and very different today than when I first started and you know, really responsible for strategy, growth, business development. I lead the hospital negotiations. I also assist in the payer negotiations. We've done several acquisitions of the last few years. I've led those acquisitions as well. And prior to this I spent two years at a hedge fund and prior to that I spent six years at a health IT incubator where we took a product from inception to exit and we sold to a Fortune 500 company. So I think I have a decent mix of healthcare and finance and I guess that's why I'm here. But out of all my jobs, I've loved this the best and I find this has the most opportunity. Yeah.
- [02:31]
B
Awesome. Great rundown there. It's always great. I spend a lot of time talking to people on more the physician side of things. So I'm always really interested to hear more from your perspective. What are the top three trends that you're following in healthcare and ASCS today?
- [02:48]
C
Yeah, so I'll give you more than three, but just general trends. I'm following, you know, obviously procedures coming off the inpatient only list. We always have an eye on that. The increase of the rise in self funded employers. Right. So the rise of the ASO model, we're seeing more and more employers being, you know, self funded. And with that there's opportunity. Right. There's opportunity to go direct as well. And we do have bundle agreements with several employers. Increased price transparency, I think that's good for everybody. And we definitely use that to our advantage in terms of negotiating with payers because we know exactly what the hospitals are getting paid and the services that we're providing and then just general consolidation. Right. It's very difficult, I think, for the independent physician practice and you know, they're not going to get rates from the payers. Hospitals are acquiring primary care folks and physicians and tell them to refer internally. So in that kind of environment, you know, how does, how do you succeed? Right. So for us, we, we are, you know, we are back. We do have outside investors, but nevertheless, you know, it's all about understanding, like who has leverage and how to negotiate. And that's something that, you know, we've kind of learned and improved upon over the years. But it's tough out there for, for, for, you know, the independent practice to survive in this kind of environment.
- [04:20]
B
Mm, yeah, absolutely. That question of kind of leverage and negotiation is definitely something we get into a lot here and something our audience really, you know, is talking about a lot. What are you most excited about right now?
- [04:37]
C
So, you know, so our headquarters is New York and we have Florida, lot of offices in New York. We also have offices in New Jersey and Connecticut. And you know, one thing we are excited about is, you know, next month the state of New York is going to vote on whether or not they're going to allow cardiology to be done outpatient here in New York. And cardiology is one of the fastest growing AAC specialties in AACs. This past year, I think there was something like 25 or 26 cardiology ASCs that came online. And the thing that we find exciting about that opportunity is New York is a con state and it's very hard to get an asc. And we've already been in discussions with several cardiology groups and such that up until now it's never made sense for them to own ASCs. And it's very hard. If they wanted to build one, it would take several years and negotiating, building it out, getting approval, getting contracts. So one thing we're excited about is if New York State approves it, we are in discussions with several cardiology groups in terms of potentially partnering with them and seeing if we can have that available at our asc.
- [05:56]
B
Yeah, absolutely. The momentum surrounding outpatient cardiology is definitely something to watch and something we're looking into a lot. We've been talking about this so far, but how are you thinking about growth over the next 12 months?
- [06:10]
C
Look, I think growth can come in several fashions. We have four ASCs. New York, New Jersey, Connecticut, Arkansas. All of our ASCs are very profitable, but at the same time, we have plenty of capacity. We're really thinking about how do we partner with other outside groups. One of the things that's unique about us, because we do bariatric surgery, you know, most AACs have a BMI cutoff. Right. And they may have a BMI cutoff of 40 versus US. Our BMI cutoff is a lot higher. It's 55 or 60. Right. Because our specialty is bariatrics. We also do general surgery. We also do plastic surgery. We do egds. But because we can accommodate, you know, patients with a higher bmi, whether that's, you know, anesthesiologists that are comfortable providing anesthesia services on higher BMI patients, it's the reinforced toilets, it's the waiting room furniture, the OR tables. Because we could accommodate the higher BMI patient, we think there's opportunity in trying to get volume of cases that cannot be done at other ASCs. We're in discussions with several groups. We're also in discussions with our director employers. We are probably going to launch Orthopedic and Spine. There's a lot of synergies between orthopedics and bariatrics. So we're in the process of hiring our own orthopedic surgeons, own spine surgeons, and trying to get those cases done at rac. So we're pretty excited about our diversification efforts. But, yeah, we see, again, more and more stuff is going outpatient. Employers are faced with rising premiums, the rise of the ASO model. And if we have a unique solution in which we can offer great quality at a very competitive price, like bundle pricing, then I think there's volume that we can get.
- [08:10]
B
Absolutely. Is there anything that I haven't asked about so far that you feel like is relevant or important in this conversation?
- [08:20]
C
Not that I could think of. We're just. Look, we're very bullish on the ASC market, and, you know, and especially it's really hard to get Nancy, you know, but. But there's several opportunities around the country where Several states are doing away with the con laws and, and I think, you know, for the practices out there in those states, I, I think that's something they should really, really invest and inquire upon. But at the same time, you know, my advice to them is, is, is to definitely get the right help and partner with the right folks. Because, you know, although the idea of an ASC or having the ase, the practice makes a lot of sense, it's really, really hard. So you definitely want to partner with folks that have done it before and luckily for us, we have a great ASC team. But you know, just building ASC is not enough. You have to ensure you have the volume and you have to know, you have to ensure that you can negotiate with the payers and that, you know, just because it makes sense on paper doesn't mean it's something that that is easy to do. So so definitely, you know, I would, I would encourage f folks to, to research this and, and partner with folks that have done it before.
- [09:30]
B
Absolutely. I feel like that's kind of a work smarter, not harder idea that I am. That's also just something I'm hearing a lot in the ASC space is the need to partner. So it's yeah, interesting to hear you say that. But yeah, that's otherwise all I have for you today. Vijay, thank you so much for joining us.
- [09:45]
C
Thank you for having me.
- [09:46]
B
Yeah, of course. It's been a pleasure speaking with you and I look forward to connecting with you again in the future.
- [09:51]
C
Likewise. Thank you.
- [09:54]
A
At athenahealth, we know your ambulatory practice wants healthier a healthier business, healthier care teams and healthier patients. But the complexities of modern healthcare tech make it hard for you and your care teams to focus on what matters most. That's where athenahealth can help our AI native all in one solutions. Reduce administrative burdens, streamline billing and payments, and deliver critical insights when clinicians need it most. That means fewer clicks, more time for patients and stronger bottom lines. Practicing medicine is complex, but running a practice can be that much simpler with Athenahealth. See how simpler is healthier@athenahealth.com.