Ep. 129: Live from New York: Perspectives from a Surgeon, an ASC Leader & a Policy Expert
Here’s what to expect on this week’s episode. 🎙️
Surgeon. Administrator. Policy insider.
Live from this year’s NYSAASC conference, three perspectives converge on one theme: ASCs are built for this moment.
- Dr. Daniel Choi — the founder of Spine Medicine & Surgery of Long Island shares why adding an ASC makes sense after scaling his private practice to 10k+ annual visits
- JoAnn Vecchio — an experienced administrator discusses how the ASC of Western New York’s partnership with Catholic Health adds resources and scale to sustain growth and expand community access to care
- Kara Newbury — ASCA’s advocacy chief updates us on the policy clock: shutdown ripple effects, bills to watch, and what leaders should prioritize now
The takeaway: safer care, smarter costs, and real runway for growth — if you execute.
Watch the episode on YouTube or listen to the full discussion on your favorite podcast platform.
Episode Transcript
[00:00:24] Alex Larralde: Hi everyone, and welcome back to this Week in Surgery Centers. Today’s a special episode, which I actually had the opportunity to record live from the New York State Association of Ambulatory Surgery Centers Conference in Albany. A few weeks ago, I sat down with three very special guests, a spine surgeon who built his own private practice throughout the pandemic. A veteran ASC administrator who helped transition her center from physician-owned to a joint venture with a health system, and then the Chief Advocacy Officer at ASCA. So, three very different roles within the industry, different perspectives, but one common theme throughout, and that’s that policy tailwinds are in fact creating real growth opportunity within the ASC industry.
First up, we’ll talk to Dr. Daniel Choi, a board-certified orthopedic spine surgeon and founder of a growing private practice on Long Island. He’s expanded from a solo startup to a multi-physician team across multiple locations. With 10,000 plus annual visits. He’s now planning an ambulatory surgery center guided by a simple question, would I send my own family here?
Next, you’ll hear from JoAnn Vecchio, the administrator of the Ambulatory Surgery Center of Western New York, and a member of the Board of Directors of NYSAASC. For more than 25 years she’s led the center shift from ophthalmology only to a true multi-specialty center, and recently helped guide secession planning that brought on a health system partner to scale operations, protect business continuity, and preserve community access to care.
Finally, I’m joined by Kara Newbury, ASCA’s Chief Advocacy Officer, to discuss how a federal government shutdown could impact ASCs, potentially delaying the CMS 2026 final payment rule and other key legislation. We also talk about what leaders should prioritize right now in this moment amid so much pending change.
It was energizing to have these conversations in person, and it was a great reminder that face-to-face time still matters. So, today’s format’s a little bit different. You’ll hear these interviews back-to-back, and then I’ll pop in at the end for a quick wrap up.
I hope you enjoy the episode, and here’s what’s going on this week in surgery centers.
[00:02:41] Alex Larralde: I’m so excited to be sitting here with Dr. Daniel Choi. We’re going to chat a little bit about some future plans that he has. So, tell me first, Dr. Choi, a little bit about your private practice and what you do currently.
Dr. Daniel Choi: Absolutely. So, I’m Dan Choi. I’m a board certified orthopedic spinal surgeon, and I started a private practice in Long Island, New York about five years ago during the COVID Pandemic. And this was a pretty challenging time to start a private practice. Nobody was lending. I had a business plan that I shopped around.
Actually, about seven banks turned me down. Even though, a medical practice is like a bond, right? It’s very safe. But at that time, they weren’t lending to any startups, so the eighth bank, was M&T Bank and one of their tellers sent my business plan up the chain and I was able to meet with them.
They gave me a five-year term loan, and I was able to start my practice. From a solo practice, we have now grown to. Three orthopedic spinal surgeons and two interventional pain management physiatrists. We also have a nurse practitioner, a physician assistant. We have now two locations and are growing to four this year, with, over 10,000 patient visits last year.
So really, uh, serving a need in the marketplace. Right now, there’s a lot of heavy consolidation in healthcare. We know in all marketplaces and there is a big demand for private practice, believe it or not.
Alex Larralde: Mm-hmm.
Dr. Daniel Choi: Even though we see less and less private practitioners, patients seem to be seeking out the private practices that are left.
I think private practice, we can be more agile, we can move quicker, if patients are demanding it, uh, we can meet those demands, uh, much quicker. So that’s why I think, our practice is growing.
Alex Larralde: That’s fantastic, and I understand that you’re going to be expanding even more into the ambulatory surgery center space.
So, tell me a little bit about that.
Dr. Daniel Choi: Absolutely. That’s our hope. We are currently in the planning stages of this right now. I would say that, and I’ve written about this on various social media platforms, that, uh, we have a crisis looming in this country, and I think the one of the biggest crises in healthcare is our physician shortage.
What you’re seeing, across 50 states is, young physicians, now the opportunities for employment are all with corporate healthcare systems, right? It’s either hospital systems or if it’s private equity, or it’s actually insurers. United Healthcare is actually the biggest employer of physicians in this country.
12% of physicians are employed by Optum. And Optum, many don’t even know, is actually owned, it’s a subsidiary of United Health Group. With all this employment, what once was a profession where you had total control over your delivery system, your work environment, the employees you hired, and how your patient care got delivered.
That’s now been controlled by corporate healthcare. And so you see physicians in that type of environment. They’ve lost their autonomy. And I, I don’t think to their fault it’s just the way that legislation and the healthcare system has been shaped, it’s been driven towards consolidation.
And because of that, physicians are burning out earlier. Uh, there’s a lot of early retirement. There are physicians who, you know, trained for 10 years, got to a place where they get to practice now and they’re saying, oh my gosh, this is not what I envisioned, and they’re looking to get out.
So there’s actually physicians who are trying, uh, side gigs, like instead of your practice being your main source of income, now there’s a physician group called Physician Side Gigs on Facebook that has over like 20,000 members. And these physicians are looking for other ways to supplement their income and potentially off ramp and get out of the practice of medicine.
And there’s a ton of discussion about this. This is a really sad thing for really, our patients. Because the patients are losing out on a ton of expertise. I mean, the amount of experience and training a board-certified physician has; to get to that point, we’re talking about immense resources. In the education system we’re talking about from the high school level, pre-med, college, med school, then residency. I mean, the amount of man hours that takes to train a surgeon or a primary care physician is immense and they’re quietly exiting the workplace.
And so, I think that staying independent as a private practice, is critical to alleviating that physician shortage. And I would say that the ambulatory surgical center is one of the key ways that I’ve discovered that private practices across the country have stayed viable. Yeah.
Because what we hear about is that professional fees have always been going down. And you see Medicare rate cuts to professional fees to physicians constantly every year getting cut, whereas facility fees are actually either staying neutral or they’re going up thanks to the lobbying of, um, American Hospital Association and big entities that are keeping those facility fees buoyed.
You know, I think that private practices that have actually jumped on to, starting the ambulatory surgical centers have stayed autonomous, stayed financially viable. That’s critical. And then the working environment actually becomes one that is more physician centric, in my opinion.
Alex Larralde: Absolutely.
Dr. Daniel Choi: And you know, unfortunately the hardest part about my week as a private practice doctor is actually stepping foot in a hospital. Look, the hospitals are great. They do a lot of things really well. Complex care, ICU care, emergency room, trauma centers.
But some of this stuff that we’re doing in hospitals, like basic elective surgical care, doesn’t need to be done in a 1200 square foot OR. They can be done in a 500, 400 square foot OR in an ambulatory setting. They’re usually being discharged the same day. And that’s the niche of the ASC to get these basic bread and butter cases in and out, with higher quality, better safety metrics. You’re not doing your case in a hospital where there’s a life-threatening infection just next door.
There are so many advantages to the ambulatory surgical center that I think are going to provide a lot of value to the patients and also to the physicians. And um, and I think that the ASC is very key to potentially alleviating the physician burnout, where physicians are not just operating in an outpatient setting that they like, but they get to operate with in their cases. Surgeons get to do their cases in a setting that’s very physician-centric driven. The ASC model has their customer is a surgeon, right?
Absolutely. They want to drive cases to the center, so they’re, they’re making sure that every part of that, experience for the surgeon is very seamless and smooth. Uh, and that’s why I think it’s the future.
Alex Larralde: Absolutely. I could not agree more. And, uh, we talk about this a lot, especially when it comes to anesthesiologists,
Dr. Daniel Choi: Mm-hmm.
Alex Larralde: and the shortage there. How can we convince more anesthesiologists to come and potentially work at an ASC? How are you thinking about anesthesia, is that something that you’ve given a lot of thought to how to approach that?
Dr. Daniel Choi: Sure. We’re in the planning stages. We’ve definitely thought about different options in the marketplace, how are we going to do it? Are we going to have an independent practice come in and staff the center, they bill for themselves? Are we going to bring it in house? Are we going to use different groups? We’re playing around with different models. I would say that, for me the highest priority is patient safety. Quality and making sure that we have great anesthesiologists that, I feel really confident just bringing, I’m, I think my metric for any decision I make for my center is, what can I do to ensure that my family member, if my family member, I was going to send them to this center, what would I want being done for my own family member?
And I actually operate my private practice with that framing, uh, for every decision that I make. And that served us well. Our reputation for quality safe care has really grown in the community and we want the center to be the exact same way.
So, we’re leaning towards utilizing a private practice that I trust that I’ve already worked with, I know they’re phenomenal. You know, I would want my family to get taken care of by them and bringing them in to be a part of our center. And they would operate independently, and they would be responsible for staffing and, uh, they would do all the billing.
Obviously, they would reap the financial rewards of being very reliable and staffing our center, all the time.
Alex Larralde: Yeah, that’s great. That makes perfect sense. I have another question, uh, related to kind of some of the legislative changes
Dr. Daniel Choi: Sure.
Alex Larralde: In New York, so a lot’s happening mm-hmm. And there’s been a lot that’s been talked about that’s finally starting to be pushed forward.
Do you see that as being an opportunity for your ASC other ASCs? How do you think that’s going to kind of shift the healthcare landscape in the state of New York?
Dr. Daniel Choi: No, absolutely. So, I think that everything going on politically and in healthcare in general, is that healthcare, I believe the spend now nationally, it’s about 20% of our GDP.
Alex Larralde: Yeah.
Dr. Daniel Choi: That’s absolutely mind-boggling. And actually, hospital systems are now the biggest employer in every state, in every metro. You go anywhere. Cleveland. Cleveland Clinic, they’re the biggest employer. You go to Texas and all the big cities, they have a big, major hospital system.
In New York where I’m at, it’s Northwell. Northwell is one of the biggest employers in the state. Healthcare is such an economic driver and the spend is so large and I think that what we’ve gotten to in, unfortunately, with some of the legislation that was written all the way back to the Affordable Care Act in 2010, is that we have driven healthcare to be bigger and bigger.
Healthcare consolidation, right? We want these, all these tiny little hospitals to all get into one big system. We want it, all the insurers, there’s only two or three big insurance payers in every marketplace. So, there are good things that can be done with big corporate entities. There’s a lot that can be accomplished. Maybe you think it’s more efficient, the capital deployment is more efficient ’cause you have big sums of money that you can deploy. But there’s also a lot of inefficiencies that come with consolidation. And if you think about just the free market. Why do we have such a robust free market in America?
You have anyone who thinks that, you know, if they can run a business that can meet the marketplace demands, you don’t have to be Starbucks to run a coffee shop, right? You can come in there and through your own sweat and hard work, build a cafe that is so much nicer and so much better and so much the coffee is so much tastier than Starbucks.
You know this in your local marketplace and in healthcare, that is just not happening anymore. Doctors can’t come out of training and feel like they can open up the shop and open up a private practice that can serve the needs of their community. And so what happens in any marketplace and history has repeated this over and over just basic economics 101 is that if you lose competition, prices increase. Right? If you can’t increase the supply, if people are not competing to try to capture the market and they’re not working hard to be more lean, more efficient, or higher quality then the prices go up. You have fewer people.
That’s right. That don’t need to compete. And that’s what’s happened in American healthcare. You just see the competition cratering. So, you’ve seen prices go up, you’ve seen health insurance premiums every year, 20% hike, 20% hike, families are now paying $24 to $30,000 a year in premiums. This is pre-tax dollars. That could be, going to their families. Instead, employers are also pitching in where, their share of what they’re, and you see this actually today right now with the government shutdown. Yeah. All the buzz now is talking about, what is the government paying for in healthcare and how, why is the government subsidizing these premiums?
Why have the premiums? And then everyone’s starting to ask these questions like, how crazy is it that we’re paying $24 to $30,000 a family in healthcare premiums? So, and this all comes back to why is the ASC so critical in today’s environment? Because the ASC has been proven time after time to bring down costs because it is introducing competition to the marketplace. It is another place that the big entities that do surgery now have to compete with, they have to try to be just as good as the ASC or better or start their own ASCs to retain those cases. And when you introduce competition, the prices will come down. And the healthcare spend, uh, will be more manageable, hopefully. That’s why I see that this is an economic no-brainer that this is the future. Unless again, in America we have a lot of regulatory capture, a lot of lobbying interests that go in and convince our policy makers that what is obviously correct is wrong, and what is totally wrong is the right way to go.
Alex Larralde: Exactly.
Dr. Daniel Choi: And we have these backward laws that have produced a mess that we have today. So, we just hope that common sense will prevail and we can continue to introduce more competition to the marketplace through ASCs.
Alex Larralde: I love that, and hopefully the Medicare final rule that we’ll hear about soon will continue to reinforce that procedures should be moving into these lower cost, higher-quality outcome environments and there will be even more momentum.
Dr. Daniel Choi: Absolutely.
Alex Larralde: Well, fantastic. I am so excited that you stop by to chat. Thank you so much. Absolutely. I wish you the best of luck as you’re building out your surgery center, and I can’t wait to talk to you then when you open it.
Dr. Daniel Choi: Thank you so much.
[00:15:57] Alex Larralde: Well, thank you so much, JoAnn, for joining me. I know it’s a busy day here at the conference, but I would love to just chat with you about your work and what you do. If you could give me a quick introduction, that’d be great.
JoAnn Vecchio: Sure, sure. My name is JoAnn Vecchio. I have been in the ASC industry for about 25 years.
I am the administrator at the Ambulatory Surgery Center, Western New York, which is in Amherst, New York, which is very close to Buffalo, New York. We are one of the largest ASCs. We were one of the first ASCs in our Western New York area. We have quite a few in the Western New York area, but we are one that has been in existence since 1999.
We’ve been around a long time, multi-specialty. Uh, we still do pediatric cases at our surgery center. And we see on average probably between maybe, 15,000, upwards of 29,000 patients a year.
Alex Larralde: That’s awesome. And you have been with the ASC of Western New York for 25 years.
JoAnn Vecchio: Yes. Yes.
Alex Larralde: So, tell me about that. The industry has changed a lot Yes. And evolved a lot. Yes. How have things shifted in that time?
JoAnn Vecchio: You know, the industry has changed a lot. We started at the ASC with a single specialty, you know, it started with a bunch of ophthalmologists that tried to get out of the hospital for access reasons.
We were seeing at that time, back in 1999. So many ophthalmology-only centers starting with ophthalmology, and then, uh, I think it was somewhere around 2002 or 2003 we started to break into other specialties, seeing that ophthalmology was great, but there was room for growth in the industry.
And some of the regulatory things made it a little bit easier at that time to expand services and, you know, to get the multi-specialty licensure in the state of New York at that time was a different process, obviously. While things evolve, we’re constantly looking, to expand services in ASCs and you know, I think one of the good things of all the people that are here at this conference are, we’re always striving to work together to try to expand the services that we are able to offer, through safety and efficacy, and can they be done? And, being fortunate enough to, have the state organization behind us and listening to the members to say, ‘Hey, listen, we’re thinking we could maybe do these at the ASCs,’ let’s work together to see what we could do from a legislative point of view to help us get these, you know, maybe recognized a little bit.
So we’re very fortunate. You know, at first in a million years, you would’ve never thought you would be doing a Total Joint in an ambulatory center. You never thought in a million years you would be taking care of a pediatric patient that was under the age of, 10 at an ASC. But we do it, all of us do it all the time, and very safely.
And, you know, with a very high level of throughput with quality outcomes and patient satisfaction. I mean, parents love to bring their kids to an ASC, more so than a hospital, depending on what they need done. And the same thing with our adult patients. So, we’re seeing that expansion happen more and more now.
First it was, you know, the ENT and the Orthopedics with the Total Joints. You’re seeing plastic surgery, a lot of bigger plastic surgery cases being done in ASCs, where before they would be in hospital with the bigger mastopexies and some of these mommy makeovers that you’re seeing now that are really popular are being done in ASCs and they’re longer cases.
So, those are happening, and now we’re on the precipice in this state of hopefully adding cardiology procedures to ASCs. Which I think just brings a platform of growth to the community, not just to the ambulatory centers, but there’s benefits here, for hospital-owned physician practices to expand and to be able to recruit into an area of New York that you’re able to see your patients and have access to a hospital system and to an ASC.
You know, I think those are things that are on the forefront for the ambulatory centers that I think are going to be great.
Alex Larralde: Yeah. That’s fantastic. There’s so much exciting growth on the horizon.
JoAnn Vecchio: So much. Yes.
Alex Larralde: And you’ve had some changes at your ASC in the last few years.
JoAnn Vecchio: Absolutely. Absolutely.
Alex Larralde: So, tell me a little bit about now, what it’s like working with the health system.
JoAnn Vecchio: So, we were a, uh, freestanding, a physician-only owned ambulatory center, started in 1999 by just a group of, uh, ophthalmologists that grew into a multi a multi-specialty surgery center. I’d say right before COVID. We were planning, doing our succession planning, and we kind of took a look at the list and said, ‘Hey, listen guys, you know, how are we going to do this?’ How are we going to keep this place open?
You know, we’re all fighting time here, but there is going to come a point in time where, we need to make some decisions on how you want to move forward and in order to perpetuate the business, it was decided amongst the group to go out and find a partner.
And we are very, very lucky and very fortunate to find a really great fit, within the Catholic Health Organization in Western New York. They have been an outstanding partner for us. Coming in to support us from a regulatory point of view. When you are looking at this from an ambulatory site.
You have this small group of people that you are relying on and you may have to call in consultants, or work with other sites that you may or may not be able to work with but being able to partner with a larger organization that is a health system. Not just a hospital, but a health system, it opened up access for us to be able to, to tap into resources that we never had before. Between regulatory readiness and compliance and physician education. All of the things that were shortcomings for our center, it is just because we didn’t have access to them.
You know and now looking at the changes that we are making, because we are early on in the relationship, but the changes that we’re making are so beneficial to the, not just to the owners, but to our staff and to our business line. I think that this is just a home run and we’re so fortunate to be able to work with them every day. You know, on whatever it is, patient satisfaction and quality metrics, key performance indicators, all the things that, that before were so siloed to just our site. Now the benchmarking is there. We can see what others are doing, and we have the support.
And so, I have to say it’s a been a positive experience. It really is good for this business. I think as we move forward to be able to lean in on a larger health system.
Alex Larralde: That’s really the best of both worlds. It’s, you get all of the access to the scales that you didn’t have before.
JoAnn Vecchio: Absolutely.
Alex Larralde: But you can absolutely maintain all of the benefits of working in an ambulatory surgery center setting.
JoAnn Vecchio: Absolutely. Absolutely. And we’re very fortunate that we are able to keep some of the autonomy. So, we work very closely with the contract negotiations, and we look at, what is more beneficial for us and for the system, and we’re able to kind of work together so that it’s a win. So very fortunate.
Alex Larralde: That’s great. Yes. That’s great news. And let me just ask you this, what are you most excited about as you look ahead to all the changes on the horizon? Oh, cardiac, coming into New York, the legislative change. What gets you excited about the industry?
JoAnn Vecchio: So many things get me excited in looking down the road.
You know, there’s a lot of challenges that we’re going to be facing in order to get there, but I think that the cardiac is a big thing. I think maintaining a program of excellence for the outpatient Total Joint procedures as well as. Being able to maintain the Medicaid population in granting access, additional access, you know, an alternative site of service, to the patients and the population of Western New York to be able to come to our center and know that it’s safe and know that, they have a place to come that’s outside of the hospital.
Alex Larralde: Absolutely.
JoAnn Vecchio: And now being able to offer, potentially being able to offer cardiac procedures, I think is just going to be. You know, just going to be, turn the whole thing upside down because we are now able to offer these services. You know, whereas they may have been limited before or people may have been waiting before.
Absolutely. You know, and that’s a proven thing with like the pediatrics and the ENT things. So Yeah.
Alex Larralde: People may just not be getting those procedures due to access.
JoAnn Vecchio: Exactly. And you know, being that it’s an ambulatory center, we do have the flexibility of, you know. Being able to add cases on late in the day and you know, the physician satisfaction you know, the surgeon satisfaction is there to be able to get the patients taken care of on the same day as they, you know, if they have a fracture and they need to get in right away or something’s going on.
You know, we’re very fortunate to be able to offer that. That’s, that’s very exciting as well.
Alex Larralde: That’s fantastic. Well, I’m so glad that you stopped by. Absolutely. I’m so impressed by the advocacy work that the board of the association’s been doing. I mean, it’s just a really phenomenal example, I think for other state associations to see how when the community comes together that you can really affect change in the state.
JoAnn Vecchio: I agree. And, you know, we’re very fortunate, uh, at the board level and from the state association level to have. Such a diverse group, while we’re all pulling in the same direction, there are different, ownership models. Some are private equity, some are hospital-owned, some are still freestanding. You know, it’s good to understand that we have everybody’s point of view and everybody’s voice is heard.
It was nice to meet you and thank you for having me. Enjoy the rest of the conference.
[00:24:37] Alex Larralde: Well, hello Kara. Thank you so much for taking a few minutes to join me. I am excited to get to chat with you a little bit about what’s going on at the federal level. You oversee all things legislative and regulatory for, ASCA.
So, there’s some stuff going on. Fill me in.
Kara Newbury: Yeah. So, as of this recording, we are in a federal government shutdown. And so, while that hopefully is not impacting access to care at this time, it could impact some things. Um, you know, our federal payment rule is set to come out in early November. That could potentially be delayed. Surveys could be delayed.
You know, the big picture also is the fact that, legislation both positive and negative, outside of just funding the government is probably not being considered right now. One of the big pieces of legislation that ASCA has been advocating for, is a Medicare beneficiary, patient responsibility bill.
Right now. Hospital outpatient departments have a cap on what the Medicare beneficiary would pay. It’s right now $16.76. And there’s no such cap in the ASC. So, if your Medicare beneficiaries are paying more out of pocket than $16.76 to have a procedure done in your ASC, they’re paying more than going to an HOP, which, is counterintuitive, but that’s what’s happening right now. So, we are trying to get a similar cap to what the hospital outpatient departments have. So, that’s a big piece of like legislation we’re proactively pursuing. There are a couple other bills that we have concerns with that we’re, pushing back against.
So, there’s a piece of legislation that’s been introduced in the Senate, geared towards site neutrality. And I know on its face a lot of ASCs think this sounds great and you know that they’re going to get reimbursed what hospital outpatient departments get reimbursed, and that might be the case, but it would be because HOPs would come down to us.
There are no discussions of increasing rates because the federal government is trying to save money, it’s all about, going to the lowest common denominator. So, we have concerns about that. And then physician offices are also part of that. And so, for some codes it might negatively impact ASCs and drop us to the physician rates.
So, we’re keeping a close eye on those site neutral discussions, and legislation that’s been introduced. And then just price transparency is another big topic on the hill. While we agree with, transparency in general, and of course want our, patients to know how much they’re going to have to pay to come to an ASC, what’s being considered is really far beyond that.
It’s, you know, negotiated rates, it’s standard charges. It’s the very specific rates that have been negotiated with payers. So, we have a lot of concerns, about that, and we don’t think that it would benefit the patients or the public ultimately. So, like I said, not probably likely that it’s going to, um, pass anytime soon.
Because they’re focused on trying to figure out how to fund the government. But those are some of the things that we’re really, keeping our eye on, at the federal level. And just one other thing I kind of want to note, because it came down last month. There is a new CMS prior authorization, um, demonstration project.
We’re in New York right now. New York is one of the states impacted. There are 10 states. And it’s for 41 codes primarily cosmetic. But there are some ophthalmic codes that are impacted, and it would basically require facilities to go through a new prior authorization request. Okay. And although it says it’s technically not mandatory, our sense is that if you don’t do the prior auth request, chances are you’d be denied and then you have less recourse and trying to get paid for those codes. That’s slated to go into effect December 15th. We’re writing a letter to CMS asking for a delay. We thought we needed more time anyway, and then with the shutdown and, you know, less resources, we think that it makes sense for that to be delayed.
So, we’re optimistic that hopefully we can see a delay with that prior auth demonstration. But, you know, considering the federal government is shut down right now, there still is, you know, a lot that we’re working on. A lot going on.
Alex Larralde: Is there anything that ASC administrators, leaders should be focusing on or thinking about at this current moment?
Kara Newbury: I mean, I know that ASC administrators have so much on their plate.
Alex Larralde: Yeah.
Kara Newbury: So much that they’re worrying about and thinking about. I think that. Top of mind, we’ve got issues with anesthesia and the cost of anesthesia.
And you know, so we’re tracking all that at the federal level and trying to help our facilities uh, through different means. But I think that just keeping up with ASCA and your state association and knowing what’s going on. I know that you all do a great job with these webinars as well, the podcasts.
But just trying to you know, stay up to date because things are coming down the line that will impact them whether or not they’re paying attention. But yeah. People can always reach out to me if they have any questions.
Alex Larralde: Oh, that’s wonderful. We’re so grateful for the work that ASCA does and for the work that you do.
Kara Newbury: Thank you.
[00:29:43] Alex Larralde: Thank you so much for joining us live from the NYSAASC Conference in Albany. Three conversations and one common theme, and that’s that ambulatory continues to prove its value and policy momentum is opening up real opportunity for growth.
From Dr. Dan Choi, we heard what independent medicine can look like at its best. He built a private practice during the toughest moment, scaled it to multiple locations and 10,000 plus annual visits, and is now planning his own ambulatory surgery center. His North Star of delivering patient care he’d want for his own family ultimately anchors the case for ASCs. Better access, strong safety, lower cost, and a physician-centric environment, which in turn benefits patients.
From JoAnn Vecchio, we got the long view of smart evolution. Over 25 years, her center moved from ophthalmology-only to a true multi-specialty, then executed succession planning that ultimately brought in a health system partner, adding scale, resources, and benchmarking while retaining the agility that the ASC provides. She’s bullish on what’s next in New York, including cardiology and preserving access for Medicaid patients.
From Kara Newberry at ASCA, we get insight into what the impact of a prolonged government shutdown could be on the ASC industry, we expect policy timelines to shift, think the CMS final payment rule for 2026, but there are other things in the mix, including a cap on Medicare beneficiary cost-sharing at ASCs, site-neutral proposals, which could push reimbursement rates down for everyone across the board. And of course, ongoing broader price transparency efforts.
But the bottom line here on the policy and legislative front is stay close to ASCA and stay close to your state associations for the latest news and updates.
So, a big thanks again to my three guests and to you for listening, as always. I hope you enjoyed this episode, and if you did, please leave us a rating or a review on your favorite podcast platform to help others find us. We really appreciate you being here, and we’ll see you again next time.