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Becker’s Healthcare Podcast
Jacob Rodman, Chief Executive Officer of Raleigh Neurosurgical Clinic
00:15:29
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- [00:03]
A
Today's clinical providers and healthcare systems need a strategic partner that is focused on the evolution of healthcare delivery. At Surgery Partners, we are redefining the healthcare industry. As a nation's leading independent operator of surgical facilities and ancillary services with an extensive presence spanning over 180 locations nationwide. Our commitment extends beyond healthcare. It's about fostering successful partnerships that enhance the quality of care in the communities we serve. Surgery Partners is more than an operator or service provider. We are your strategic ally, committed to transforming healthcare delivery. Learn more@surgerypartners.com.
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B
This is Laura Dearda with the Beckers Healthcare Podcast. I'm thrilled today to be joined by Jacob Rodman, Chief Executive Officer at Raleigh Neurosurgical Clinic. Jacob, it's a pleasure to have you on the podcast today.
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C
Pleasure to be here. Thanks for having me.
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B
Absolutely. Now, I know we're going to get into some of the big things that are happening in the ASC industry as well as in spine and neurosurgical care. But before we do, can you tell me a little bit more about yourself and your background?
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C
Yeah, I've been in my current role about 14 years here with the clinic. Been in healthcare leadership for about 25 years, and I've been in Raleigh about 20 years and from Kentucky originally.
- [01:29]
B
Well, it's great to hear and, you know, definitely awesome to have that kind of background in healthcare and leadership management, too. So from your perspective, what are some of the top three trends that you're following in healthcare and ASCs today?
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C
I would say number one is anesthesia. Trying to sort out how anesthesia works in the ASC and how to be efficient and, you know, work with the anesthesia teams that we have and make sure they're adequately compensated and fairly compensated while keeping an eye on the bottom line from the center. It's probably first and foremost, secondly, really hoping the government reopens and gets Medicare payments flowing again. But more importantly, for 2026, there's some great proposals for spine that is coming off the inpatient only list, that we can start doing some more cases in the ASC for Medicare patients. So really, really hoping that comes through and stays the way it is so we can still continue to shift some cases out of the hospital. And third, I'd say is just really AI. You know, how can we utilize AI and make our center more efficient, help patients get the information they need, kind of where it fits. So for me, I'd say those are the top three.
- [02:49]
B
Absolutely. That's great to hear. And, you know, I wanted to dig Deeper into all of those themes, especially. You mentioned anesthesia first. I know that's something that we have seen just a huge uptick in interest about and challenges for surgery centers across the board. Whether it's, as you mentioned, making sure you can find the right anesthesiologist and enough anesthesiology support and leaders for the surgery center, but then how you can develop those partnerships and compensation, because it is a challenge. So can you tell us a little bit more about some of the things that you've been seeing and doing to make all of that work?
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C
Yeah, we had an external group for a while and they did really well. Good partnership with them. But we got kind of. They were asking for some stipends, which we know is a national trend, and just needed clear data. So we actually transitioned July 1st and ended up hiring our own anesthesia team that works for the clinic. And so we're doing the billing and collections. And so it just kind of for us felt like it really aligned the incentives of the center, of the practice and of the anesthesia team kind of all be under the same umbrella and kind of on the same team, if you will. And we've seen that go really well. We've actually, we're averaging about 14 cases more per month since we made that move in the asc. So we're really, really happy with that and pleased with the move.
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B
Absolutely. Wow, that's significant results, you know, just from that one switch. And when you look at hiring your own internal anesthes, did you have to, you know, do anything differently from operations perspective, or was it really just a matter of, you know, making those hires and recruiting people in house?
- [04:39]
C
Yeah, we definitely had to make some adjustments and kind of get our team up to speed on anesthesia building because we never really did that before. We've got plenty of anesthesia pain docs in our group, but mostly just doing office based and ASC based pain procedures. So it was a big shift for our team to kind of of modify our billing procedures to make sure we're getting that right. Thankfully, we found a great anesthesiologist who's kind of leading the efforts. And he's been in this market for about 20 years. We knew him from the hospital previously and so he. He's fully versed in anesthesia billing and units and all the stuff that goes into it. So he's been a great asset. So I think having him on board to kind of lead the efforts has really been a game changer for us. I can't say we would have done, done it as well or been successful without.
- [05:32]
B
Absolutely, absolutely. That is so helpful to know and just interesting to think about having that right team in shift, you know, in leadership in place. And then when you look at averaging those 14 cases per month after hiring your own team, is that primarily just aligning incentives and seeing increased efficiencies? Because you know, the team is internal or I guess what do you attribute that addition to? Because that's a lot of cases, but.
- [05:59]
C
Per month it is. I think it's more about aligning the vision for the center and having a steady hand. It's the same anesthesia team that's pre op in the patient, the same ones delivering care. One of the things we notice with the external team and again they're great partners for several years, but there's often times where one anesthesiologist would do the pre op for the patient and then another one would be administering anesthesia on the day of surgery. And they didn't always align clinically on the patient. And so we. That led to sometimes same day cancellations, rescheduling. So I think having the consistency now through the process and having our pre op nurse be able to go to one person kind of get some direction has been really beneficial. And then we've also noticed with the actual delivery of anesthesia, since it's again same team, they've been able to kind of customize some of the anesthesia delivery. So it's not quite cookie cutter like it is in some of large, larger systems where you know, smaller procedure, minor procedure may not go as deep with anesthesia which you know, leads to quicker wake up, quicker turnover, all those things. So definitely increases efficiency.
- [07:16]
B
That's great to hear and helpful to understand where those efficiencies are coming from. Now I know you also mentioned looking at current political climate with the government shut down and then you know, how Medicare payments have been challenged during this time. Of course, you know a lot coming down the pipe too for changes overall with Medicare and just some of the policies happening. So can you talk a little bit more through that and how you've been planning for the future when there are some uncertainties, not really sure, you know what's going to happen and then what changes are going to stick.
- [07:53]
C
Yeah, so Medicare is about 40% of our revenue stream. So any disruptions to that, you know, are pretty impactful on our practice, you know, so some of it's just been planning, you know, trying to save, you know, the. It doesn't, at least from my perspective, doesn't Feel like we're anywhere close to a resolution, hopefully. I get surprised. Both, both sides seem to be pretty dug into the positions. And so I think, you know, just navigating that with our bottom line and you know, what we need to be doing as a practice to kind of circle the wagons but, but really hopeful for the future with some of the changes that are coming. You know, hopefully we can get, get this shut down behind us and get, get the Medicare fund flowing again and then really look to the future on how we can really take great care of patients in our asc. So we are excited about some of the site of service changes coming. I think there's a huge opportunity there to really care for those patients.
- [08:54]
B
That's great to hear. And having those extra cases I know is always helpful on a variety of fronts. Finally, when you talk about AI and mentioning that becoming more efficient with it, that's something that came up a lot at our recent Ambulatory Surgery Centers conference in Chicago. And I was a little bit surprised by that because I wasn't sure how much of AI was on the radar for ASC leaders. But it seems like there's a lot going on and a lot of excitement in the space around what the potential is. So how are you thinking about things at Raleigh Neurosurgical Clinic? And you know, what are you doing now? What do you anticipate will be the most helpful ways to, you know, make those AI investments?
- [09:35]
C
Yeah, so I can tell you on the, on the hospital based side, we've been using AI for stroke treatment for many years. Company called Viz AI to kind of help read a CT and kind of give an indication if there's a large vessel occlusion or not. Kind of real time. So we've had some experience with it on our stroke treatments, but we're using it now in the clinic in terms of ambient software, ambient listening software to help kind of streamline patient care visits. And we're trying to figure out how that can be applicable and apply in the ASC setting as well. We're not quite there yet, but we do think there's some opportunities, whether it's through, you know, op notes or even just supplies through. The ordering and inventory process has been a great ad in terms of the clinic in terms of office visits and patient care. But we're trying to see what the next iteration is and unfortunately I don't have a real clear picture of what that looks like today, but we're exploring and having lots of conversations with folks.
- [10:41]
B
Interesting. It's just fascinating to See how quickly the technology is evolving on the clinical side as well as on the operational side in where the applications make the most sense. I think, you know, wanted to ask you now, when you're looking into the future, what are you most excited about? What is top of mind for you that you think will make a big difference for the practice and surgery center?
- [11:01]
C
Yeah, I'm really just, I love the opportunity to deliver care the way we do in our asc and it's kind of a, you know, people use the word holistic and I hate to overuse that because I feel like it's used incorrectly sometimes. But you know, our asc, our clinic space, our office based NGO suite, are kind of all cohabitated. So it's kind of one building. So we were trying to develop kind of a one stop shop for patients where they can come see their surgeon, get their non operative pain management if they need it. But ultimately if they do unfortunately need a procedure, we can take care of them kind of within the confines of our walls. And I'm really excited about again for the future with some of these Medicare changes coming. And as we continue to develop the center and expand cases, we've got some of our neurosurgeons that are really trying to figure out how to safely, you know, push to the limits. You know, I look back some of our older surgeons 30 years ago, you know, when they, a lot of them didn't even do fusions in the residency program. And now, you know, it's one of the top cases neurosurgery, neurosurgeons do today. So I think there's still some, some more changes coming on other centers across the country that are doing alifs and olifs and those type of things in their facility. North Carolina has not quite gotten there yet, but I am excited because I think we will be on the forefront of that in our center. And so I'm really excited for the future and kind of the ASCs I think continue to be strong and I think finally insurance is recognizing that they're the best place for patients to go. With the exception of obviously some cases that really do need to be in a hospital with an ICU setting. But short of that, I think people have recognized there's a big role for ASCs in the future, 100%.
- [12:42]
B
There's just so much energy, it seems like around figuring out the right dynamic for outpatient and how ASCs can complement other services and as you mentioned, just have that high quality, high value care. Are you, when you're Looking at expanding these procedures, potentially others coming into the ASC setting. Do you see needing to expand your space at all or how are you thinking about growth of the physical operations?
- [13:08]
C
Yeah, I think we will. I think we've, we've added a team of eight providers to our pain service here in Raleigh this year and that's kind of maximized our space as it sits today. So. And we want to have kind of everything under one roof. So eventually there will, will be a need for some more space in the future. Not sure exactly what that looks like. We're also exploring some smaller clinic locations kind of in and around the Triangle as a way to kind of offset some of that the space needs, but still kind of long term deciding what our, what our future holds.
- [13:46]
B
Absolutely. The big decisions, but you know, good ones for the growth of the practice overall. And just looking the next 12 months, is there anything else that you wanted to share with us or can mention about what growth looks like and how you're thinking about strategy in leadership in the future?
- [14:04]
C
Yeah, I think just for me personally, it's kind of continuing to develop our leadership team. You know, we, 14 years ago we were a small practice and kind of everybody reported to me in the clinic. We had eight total employees and today we got about 175. So kind of developing our leadership team. Leadership team and giving them the tools they need to kind of lead from the heart and lead in great ways. And I'm really excited for who we have in those roles and who we're going to continue to recruit and grow with. So to me it's really focusing on our leadership team and kind of what they look like in the future and giving them the space and the grace to fly and grow and develop. And I think that leads to excellent patient care. We're on target to treat about 55,000, 56,000 patients this year and again 10 years ago that number was three to 4,000. So we're able to kind of do a lot more today and touch and treat a lot more patients than we have in the past. And to me, that's really exciting.
- [15:06]
B
That's amazing to hear. Jacob, thank you so much for joining us on the podcast today. It's been such a fascinating conversation. I appreciate your candidness, talking about some of the things that you're seeing in the industry and how Raleigh Neurosurgical Clinic will continue to grow. And thank you again for your time today. I appreciate it.
- [15:24]
C
Happy to thank you again for having me.