Kathy Meccia, RNBC, BSN, CNOR, CRCST, Nurse Administrator at Lake George Surgery Center

Summary

Becker’s Healthcare Podcast — Episode Summary

Guest: Kathy Meccia, RNBC, BSN, CNOR, CRCST, Nurse Administrator at Lake George Surgery Center
Host: Francesca Matthews
Date: August 31, 2025
Duration: ~8 minutes (excluding intro/outro)

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Episode Overview

This episode features Kathy Meccia, a seasoned nurse administrator, discussing key trends, opportunities, and challenges facing ambulatory surgery centers (ASCs) today. Drawing from her 42 years in nursing and extensive experience in perioperative leadership, Kathy offers actionable insight on competition, financial pressures, and growth strategies in the ASC sphere.

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Key Discussion Points & Insights

Kathy Meccia’s Background and Career Trajectory

• [00:28] Kathy introduces herself as a nurse with 42 years’ experience, over 30 of which were in perioperative surgical administration, including roles in pediatric, med-surg, CCU, and emergency care.
• Five years ago, she transitioned from hospital leadership to open and manage a new ambulatory surgery center, describing the shift as "interesting and challenging."

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Top Trends in ASCs and Healthcare

• 1. Increasing Competition and Consolidation [01:21]

  • More ASCs are consolidating or partnering, often joining with larger hospitals or healthcare systems to increase market share.
    • “It has caught on that [ASC] is the future of surgical health care.” — Kathy Meccia [01:26]
    • Kathy’s own center recently partnered with a larger facility:
      “We have recently partnered with a bigger hospital and healthcare facility to be able to grow in ourselves and in the market of ASCs.” [01:37]

• 2. Stagnant and Challenging Reimbursements [02:07]

  • Collections are increasingly difficult for ASCs. Declining reimbursements mean many procedures only break even.
    • Hospitals have more flexibility to withstand receivables, but ASCs feel the pinch more acutely.
    • Detailed insurance pre-authorizations and proactive patient communications are critical: “When we're talking about reimbursement, getting some good insurance contracts... making sure your staff, your front end staff are getting good pre-authorizations… That seems to help a lot in satisfaction, but also helps a lot with keeping up with the reimbursements and collections.” — Kathy Meccia [02:47-03:18]

• 3. Rising Costs—Especially Anesthesia [03:20]

  • Supply and medication costs keep increasing, but anesthesia is the most significant pain point:
    • “Anesthesia costs are so high right now that it's very difficult to offset what you're getting in collections and isn't going to pay the anesthesia providers, because that just makes us work harder on consolidating our block times and utilization, which in the end can be a positive. Right. If you're using more of your utilization of your blocks, then you're also more efficiently staffing and operating your ASC.” — Kathy Meccia [03:33-04:10]

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Positives & Exciting Developments in the ASC Landscape

• Insurance Company Referrals to ASCs [04:32]

  • Insurers are now steering patients directly to ASCs for lower costs—an encouraging shift.
    • "We're getting referrals from actual insurance companies where they're telling the patients that they'll approve them to go to an ASC, but not to a hospital. So that's exciting for us to see." — Kathy Meccia [04:35]

• Potential Expansion of Procedures (CMS Inpatient Only List) [04:54]

  • Hopeful that CMS may allow more procedures to be performed in ASCs for Medicare beneficiaries.

• Attractiveness to Physicians [05:09]

  • More surgeons are choosing ASCs for efficiency and safety, making ASCs more popular among providers.
    • “The ASC market is becoming more attractive to physicians... biggest reason being safety and efficiency.” — Kathy Meccia [05:13-05:32]

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Strategies for Growth

• Adding Specialties and Surgeons [06:01]

  • "Growth for an ASC is... quite exciting." — Kathy Meccia [06:01]
  • Her center is multidisciplinary despite higher startup and operating costs. They offer ophthalmology, podiatry, orthopedics, pain, general surgery, and endoscopy—and are looking to add more specialties and providers.

• Expanding Operating Hours [06:53]

  • Considering opening for weekend cases, likely Saturdays, to better serve patients who work weekdays, enhancing community access.

• Nimbleness of the ASC Model [07:10]

  • ASCs can adapt quickly and customize services to community needs, unlike some larger organizations.

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Notable Quotes & Memorable Moments

• “ASCs are becoming more exciting because they're becoming more the trend for minor surgeries and a lot of even major surgeries. And I have found that from transitioning from a hospital setting to the ASC setting, the customer satisfaction is off the charts.”

  • Kathy Meccia [07:32]

• “It's safe to come to an ASC. We don't take care of sick patients. And it's nice to see that, you know, that overall patient satisfaction and physician satisfaction, it makes work fun again.”

  • Kathy Meccia [07:50]

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Important Segments & Timestamps

• Kathy's Background: [00:28–01:12]
• Industry Trends: [01:21–04:11]
• Exciting Developments (Insurance, CMS, Physician Trends): [04:32–05:40]
• Growth Strategies: [06:01–07:10]
• Customer & Physician Satisfaction: [07:31–08:11]

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Conclusion

Kathy Meccia provides an experienced, candid perspective on the dynamic ASC landscape, highlighting rising competition, financial challenges, exciting reimbursement trends favoring ASCs, and strategies to promote growth and patient satisfaction. Her optimism about the future—coupled with a focus on adaptability and community needs—makes this a valuable listen for ASC leaders and healthcare professionals navigating a rapidly evolving sector.

Transcript

[A]

Hello, this is Francesca Matthews with the Becker's ASC Review Podcast. I'm thrilled to be joined today By Kathy Mecchia, RNBC, BSN, CNOR, CRC, ST Nurse Administrator @ Lake George Surgery Center. Kathy, thank you so much for being here today.

[B]

Thank you for asking me.

[A]

All right, to start off, could you just please introduce yourself and tell us a little bit about your background?

[B]

Certainly. My name is Kathy Mecchia. As you'd said, I've been a nurse for 42 years. I've worked in nursing administration for over 30 years and all of that has been in the perioperative surgical arena. I was a director at a Hospital for 30. Let's see, I worked there for 32 years, but a lot of that was also in other administration. Pediatric, med, surg, CCU, ER. The surgical arena I've been in for over 30 years. I opened a surgery center five years ago and have worked in the ASC arena since, which has been an interesting and challenging transition.

[A]

Yeah, I'm excited to hear more about what that transition has been like. What are the top three trends you're following in healthcare and ASCs today?

[B]

The biggest trend right now for an ASC is increasing competition. It has caught on that it is the future future of surgical health care. And so Most of the ASCs are consolidating, partnering, joining with other facilities to market themselves to grow. And that's been even the experience for us. We have recently partnered with a bigger hospital and healthcare facility to be able to grow in ourselves and in the market of ASCs. The second trend that I'm seeing a lot in is more in the arena of stag netting reimbursements, if you will. The collections are poor for ASCs and I imagine even for hospitals, although they can assume a better debt than an ASC can. So that's been quite a trend lately. Seems like the reimbursements tend to go down, not up. So covering cost only most of the time when you're getting collections in analyzing case profitability has been really important for us. And knowing the balance that you need to have of the surgical complexity to be able to offset the cost of doing business, you have to work with a good billing company as well. When we're talking about reimbursement, getting some good insurance contracts that you know you're getting better collections back and then also relative to that is making sure that your staff, your front end staff are getting good pre authorizations prior to patients coming and of course in the no surprise act, letting patients know up front what is expected of them to be paying and what the cost is. That seems to help a lot in satisfaction, but also helps a lot with keeping up with the reimbursements and collections. And then the third trend that I see a lot of is more the rising cost that goes along with that of everything. Supply costs, medication costs have went up. And I don't want to belabor it, but anesthesia, anesthesia costs are so high right now that it's very difficult to offset what you're getting in collections and isn't going to pay the anesthesia providers, because that just makes us work harder on consolidating our block times and utilization, which in the end can be a positive. Right. If you're using more of your utilization of your blocks, then you're also more efficiently staffing and operating your asc.

[A]

Absolutely. Yeah. The anesthesia component is something we talk about a lot on this podcast. So, yeah, not. Not belaboring. It's. It's just the truth and the reality right now, it seem. But onto kind of more exciting good news things. What are you most excited about in the ASC world right now?

[B]

That's a better topic. Yes. We're getting more excited about transitioning. I've noticed now that we're getting referrals from actual insurance companies where they're telling the patients that they'll approve them to go to an asc, but not to a hospital. So that's exciting for us to see. The insurance companies are really picking up on the lower cost that an ASC is going to bill versus what a hospital will bill for the procedures. So that's exciting. It will be exciting to see if CMS can give us a little bit more from the inpatient only list so that we can do a little more in the ASC off of that for the Medicare patients. And also when you see that the ASC market is becoming more attractive to physicians. Right. So we're seeing more surgeons that are attracted to the ASCs for many reasons, but biggest reason being safety and efficiency. They're seeing it as well. So it's becoming more attractive to them to move over to doing more cases at an ASC versus a hospital.

[A]

Absolutely. And that trend you mentioned of, you know, seeing insurance companies, you know, kind of push increasingly towards ASCs, it's something we've definitely picked up on here at Beckers as well, and something definitely just very interesting to hear. And how are you thinking about growth over the next 12 months?

[B]

Growth for an ASC is. It's. That actually is quite exciting. As well. So looking at growth as adding multidisciplinary, adding more surgeons, adding more specialties. So my center is a multidisciplinary center, which is good. It costs more for a startup and to run just because of the capital outlay and the varying supply costs that you have to have for the multi specialties. However, it is nice to have an ASC that does. We do ophthalmology, we do podiatry, we do orthopedics, we do pain, and we do general surgery, including endoscopy right now. So growth and adding more specialty, more procedures is very exciting for us. The other thing that we're looking at for growth is the possibility of opening up on a weekend day.

[A]

So.

[B]

So maybe a Saturday for half day, full day. But that's something that I think would be beneficial for the communities to have that because everybody works. Not everybody. A lot of people work Monday through Friday. And having that availability as an option I think will help us grow as well.

[A]

Absolutely. Yeah. And I think something that's always interesting about ASCs is just being nimble and able to make those accommodations and adjustments more quickly than some larger organizations and accommodate community needs in that way.

[B]

Absolutely.

[A]

Is there anything else relevant to this conversation that you think is important to share?

[B]

Just that, I mean, ASCs are becoming more exciting because they're becoming more the trend for minor surgeries and a lot of even major surgeries. And I have found that from transitioning from a hospital setting to the ASE setting, the customer satisfaction is off the charts. So it's nice to have that from both physicians, patients, but not just patients, visitors that come with them. So it's safe to come to an asc. We don't take care of sick patients. And it's nice to see that, you know, that overall patient satisfaction and physician satisfaction, it makes work fun again.

[A]

Absolutely. I like ending on that note because that is all I have for you today, Kathy. But thank you so much for joining us today. It's been a pleasure speaking with you and I look forward to connecting with you again in the future.

[B]

Thanks so much, Francesca.