John Russell, Director, Area Operations, Sutter Health System Office

Summary

Becker’s Healthcare Podcast Episode Summary

Title: John Russell, Director, Area Operations, Sutter Health System Office
Host: Chanel Bunger
Release Date: August 12, 2025

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Introduction

In the August 12, 2025 episode of the Becker’s Healthcare Podcast, host Chanel Bunger engages in an insightful conversation with Dr. John Russell, the Director of Area Operations at Sutter Health. Recorded live at the 22nd Annual Spine, Orthopedic, and Pain Management Driven ASC Plus the Future of Spine Conference, the discussion delves into current trends, financial models, growth strategies, and the crucial role of patient advocacy in modern healthcare.

Guest Background

Dr. John Russell brings nearly two decades of experience to Sutter Health, where he oversees seven surgery centers within a division of 36 facilities, including surgical hospitals and Ambulatory Surgery Centers (ASCs). With 18 years at Sutter Health, Dr. Russell emphasizes his commitment to enhancing patient care and optimizing healthcare operations.

Top Trends in Healthcare

Dr. Russell identifies several key trends shaping the healthcare landscape:

1. Patient Preference for ASCs:

   • Dr. Russell notes, “[00:56] patients want to come to our centers... [ASCs] are in a situation to partner with hospitals to ensure patients are seen at the right facility.”
   • The increasing patient desire for procedures followed by swift recovery at ASCs, avoiding the prolonged and often costly hospital stays, is a significant shift.

2. Optimizing Utilization and Access:

   • Addressing patient backlogs, Dr. Russell highlights, “[02:10] we had several thousand patients that couldn't get seen last year because we are just that impacted.”
   • Strategies include revamping scheduling policies, maximizing block time utilization, and minimizing unused space to accommodate more patients efficiently.

3. Partnerships Between ASCs and Hospitals:

   • Ensuring seamless collaboration between various facilities under the Sutter Health umbrella, Dr. Russell emphasizes the complexity of managing contracts and payer mixes while maintaining high-quality care standards.

Reimbursement Models and Financial Management

Dr. Russell provides an in-depth look into the financial frameworks underpinning ASCs:

• Fee-for-Service Model:

  • “[03:37] we get paid not as much as the hospitals because our pay structure is completely different... we usually have a bundled package.”
  • Unlike hospitals that charge for each service separately, ASCs operate on a bundled payment system, necessitating meticulous financial oversight.

• Charge Master and Financial Oversight:

  • The importance of an updated charge master is paramount. Dr. Russell states, “[04:15] it's important to make sure that your charge master is up to date... so you can be paid a fair FMV when you're using supplies or implants.”
  • The finance team collaborates closely with administrators to ensure accurate billing and fair reimbursement rates, crucial for the sustainability of not-for-profit ASCs.

• Reinvestment into Community and Quality Care:

  • Despite their not-for-profit status, ASCs must remain financially viable to reinvest in community health initiatives, equipment, and staff salaries. Dr. Russell emphasizes maintaining high standards of care without incurring the higher costs typically associated with hospitals.

Future Growth and Expansion

Looking ahead, Dr. Russell expresses excitement about the growth trajectory of Sutter Health’s ASCs:

• Expansion of Facilities:

  • “[06:06] We are in full throttle to make sure that we either acquire or build facilities based on geography and based on needs to make sure that these patients can be seen.”
  • Addressing the high demand, the organization is actively seeking to expand its physical footprint to accommodate more patients.

• Optimizing Existing Spaces:

  • Dr. Russell discusses the challenge of room utilization: “[07:26] how can we be as effective and efficient staying in one room and doing six or seven total joints in one room versus two rooms.”
  • By enhancing efficiency within existing spaces, the organization aims to increase patient throughput without necessarily expanding the number of rooms.

• Extended Operating Hours:

  • The potential for operating more Saturdays and possibly moving towards 24/7 operations in the future is on the table. Dr. Russell muses, “[07:33] in 10 years we could be sitting here having this conversation. And ASCs may be 24/7 operations.”
  • Flexibility in scheduling not only meets patient demand but also accommodates staff preferences, promoting better work-life balance.

Enhancing Patient Advocacy

A pivotal part of the conversation centers on empowering patients:

• Encouraging Patient Engagement:

  • Dr. Russell passionately states, “[09:33] I just really empower patients to ask questions. And when they apologize for asking questions, I'm like, don't apologize.”
  • Emphasizing the importance of patients being active participants in their healthcare decisions ensures better outcomes and satisfaction.

• Advocacy for Self-Advocacy:

  • He reinforces, “[10:04] We're advocates for the patients. But no one can be a better advocate for you than yourself.”
  • This perspective underscores the role of education and communication in fostering a collaborative patient-provider relationship.

Conclusion

The episode with Dr. John Russell offers a comprehensive overview of the strategic initiatives and operational challenges faced by ASCs within Sutter Health. From adapting to patient preferences and optimizing facility usage to navigating complex reimbursement models and fostering patient advocacy, Dr. Russell provides valuable insights into the future of ambulatory surgery centers. Listeners gain an appreciation for the intricate balance between financial viability and delivering high-quality, patient-centered care in the evolving healthcare landscape.

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Notable Quotes:

• Dr. John Russell at [00:56]: “Patients want to come to our centers... [ASCs] are in a situation to partner with hospitals to ensure patients are seen at the right facility.”
• Dr. John Russell at [03:37]: “We get paid not as much as the hospitals because our pay structure is completely different... we usually have a bundled package.”
• Dr. John Russell at [07:33]: “In 10 years we could be sitting here having this conversation. And ASCs may be 24/7 operations.”
• Dr. John Russell at [09:33]: “I just really empower patients to ask questions. And when they apologize for asking questions, I'm like, don't apologize.”
• Dr. John Russell at [10:04]: “We're advocates for the patients. But no one can be a better advocate for you than yourself.”

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This summary encapsulates the key discussions and themes presented by Dr. John Russell, providing a clear and detailed overview for those interested in the operational and strategic aspects of ambulatory surgery centers within the U.S. healthcare system.

Transcript

[A]

Hello and welcome to the Becker's Healthcare Podcast. My name is Chanel Bunger, and I'm recording live at the 22nd annual Spine, Orthopedic and Pain Management driven ASC plus the future of Spine Conference. And I'm sitting down with John Russell, Executive Operations at Sutter Health. Thank you so much for joining me today.

[B]

Thanks for having me.

[A]

Perfect. Well, to get us started out, can you please introduce yourself and tell us a bit about your background and organization?

[B]

Sure. I'm Dr. John Russell. I work for Sutter Health out in the great state of California, and I've been there for about 18 years. I oversee seven surgery centers in our surgery center division of about 36 total between surgical hospitals and ASCs. So I'm happy to be here and happy to talk about things that we're looking forward to over the next couple of years and current practice and future practices.

[A]

Well, perfect. Let's just jump right in. Can you talk about maybe the top three trends that you're watching in healthcare in your role today?

[B]

So one of the things that we're looking at is patients want to come to our centers. Right. No matter what part of the nation you're in, hospitals are incredibly expensive for patients. So the ASCs are in a situation to partner with hospitals. If you're affiliated with a big organization like we are, we have hospitals, HOPDs, and ambulatory surgery centers. So you really want to see patients getting care at the right facility. Now, that means that if you take from the hospitals, then you need to backfill. Right. Because the hospitals are incredibly busy, but also an intricate part of our organization. So partnering with the CEOs or their executives to make sure that patients are being seen in the right facility is a lot of work. There's a lot of things that go behind that. You know, contracts, payer mixes, all these things are factors. One of the things that we're noticing is patients want to come in, have their procedures, and go home. So we're in a situation where we can provide that service. However, ASC struggle sometimes because we typically don't work 247 like the hospitals do. Right. So we're trying to look at how we can best utilize our space. One of the things that we are looking at based on some data that we have been recently given by our president and CEO, is that we had several thousand patients that couldn't get seen last year because we are just that impacted. So having more physicians come on board, making sure we utilize our space, looking at block utilization, block time, and making sure that White space is not unused because that's an opportunity missed to take care of a patient. So what we're doing is we are revamping our policies to reflect real block time schedules and partnering with those physicians and their offices to make sure that they have a month, or sometimes up to three months of time to schedule in and then release block time if it's not being used. And with pain and ortho and all these other service lines that come to the ASCs, we are in a situation right now where we have to do something. We can't sit back and wait because we're already behind the eight ball, right. If we've got thousands of patients that can't be seen, we need to figure this out. So utilization and access are two very strong key factors that we're looking at now and over the next few months just to make sure that we are going in the right direction, because again, we've extended hours, we open up on Saturdays, Whatever. Whatever it takes to take care of the patients. What we're willing to do.

[A]

Absolutely. And kind of going off script here, what does reimbursement look like? Are you fee for service or how does that work?

[B]

Yeah, so fee for service. So, you know, we get paid not as much as the hospitals because our, our pay structure is completely different. Where we usually have a bundled package, the hospitals can charge you for every single item. You know, that piece of paper, that one, Tylenol, things like that. So we do go by charge masters, and that's updated annually. We have a great finance team that looks at that and thank God, because, you know, we need them to do that. Not me. I'm there to execute. But having said that, you know, we. Not for profit, we still need to make money. Right? Because what we do when we make money is we reinvest it back into the community. So while we may be not for profit, we. We can't just sit back and not have some revenue coming in. You know, we need equipment, we need supplies, we need to make sure the lights are on all these things. So I gotta pay employees, we gotta pay our employees. But one of the good things is that we also teach our employ on how to take care of the patients at a lower cost and not compromise care. Right. So you're still going to get the same level of care that you expect as a patient. And, and I don't want to say better than the hospitals because the hospitals are really great at delivering care. But sometimes you go into the hospital and we all know this, this is not unique you end up getting sicker sometimes in the hospital with nosocomial infections or whatever. We are really striving hard to make sure that. And we track and trend infection control, quality, things like that. But we work really, really hard to make sure the, the patient experience is something that they'll never forget. And we hope it's always going to be good. Right. But we have room for improvement too. But it's important to make sure that your charge master is up to date and that your contracts are up to date so you can be paid a fair FMV when you're using supplies or you're using implants, whatever, you know. So takes a village to make this happen. So the finance team works with the administrators, they work with us. All these things play a key role in making sure that the patient gets that outcome at a reasonable price.

[A]

Got it.

[B]

Got it.

[A]

And now that we're in the second half of 2025, can you talk about what you're most excited about right now?

[B]

Growth. Our president and CEO is high. High execute. I thought I was high execute. He's got me be a lot of patients that want to come to our organization and we have no room for them. So we are in full throttle to make sure that we either acquire or build facilities based on geography and based on needs to make sure that these patients can be seen. Even me as a patient, it takes me two months to see my primary care doctor. So if I feel like I need to see him, I should get on the books today because it's going to take two months. So one of the things that we're looking at is again, utilization and access and making sure that we are doing what we can. And so one of the things that I've challenged some of my centers is when we have total joints, they like to flip rooms because they can go faster. But when you're flipping rooms, you're also having space that's not being utilized. Right. So that block time, that two hours or three hours in the day, total accumulation of time, is wasted time. So we're looking at how can we be as effective and efficient staying in one room and doing six or seven total joints in one room versus two rooms. Rooms. So we can open up another room and have all that space for other patients that need to be seen at the center.

[A]

Absolutely. And you've already touched on this a little bit. But how are you thinking about growth in the next 12 months?

[B]

One of the things that we're looking at is potentially expanding into more Saturdays. So not everybody wants to Do a Saturday, physicians included. They have families. Right. But we are looking at ways that we can optimize our space. So, you know, we don't know what we don't know. In 10 years we could be sitting here having this conversation. And ASCs may be 24, 7 operations. Who knows? You know, it seems crazy to think about that, but let's be realistic. So one of the things that we're really looking at is how we best can come together and partner with our physicians and staff. And maybe staff just want to work Saturdays and, and have that work life balance where they can have a couple of days off during the week with their kids or whatever the case may be. So expanding our hours throughout the, but also more Saturdays. Right now we typically do one or two Saturdays a quarter and it's usually for gi. But we're trying to expand that into pain and also surgical cases because if we're going to be there, we might as well do everything right that we can. All of our patients, I shouldn't say all, but most of our patients go home the same day. So when we have a 23 hour stay, it's a planned procedure. So we know that they're going to stay overnight. That's the beauty of the ASC world, is that, you know, we have certain criteria that has to be met and, and we do a really good job with our medical directors, their input, and also the nursing staff and, and our policies that we keep updated. So allowing patients who are super busy, whether that's with personal life or professional life, have an opportunity to maybe have surgery at 5 o' clock in the afternoon, recover the next day and be back at work, say on Monday or have their procedure on Saturday so they don't miss work on Friday or Monday is something that we think about.

[A]

Absolutely. Well, John, I've enjoyed our time together, but before I let you go, is there anything else that listeners should know?

[B]

You know, I think it's imperative that we as patients be very active in our care. I love when patients ask me questions. I, you know, by trade I was a nurse for a long time and sometimes, you know, you think, well, why are they asking me this? I'm telling them what I know. You're right. You're telling them what you know, but they don't know. So I just really empower patients to ask questions. And when they apologize for asking questions, I'm like, don't apologize. This is your life, your body. You have every right to know.

[A]

Advocate.

[B]

Absolutely. You know, we're, we're advocates for the patients. But no one can be a better advocate for you than yourself.

[A]

Absolutely. Well, John, I want to thank you once again for your time today and for sharing your insights on the Becker's Healthcare podcast.

[B]

Thank you so much.