The Power Shift After CON Reform

Ep. 139 – Dr. Leo Spector: The Power Shift After CON Reform

Here’s what to expect on this week’s episode. 🎙️

Dr. Leo Spector is the CEO of OrthoCarolina, one of the nation’s largest independent physician-owned orthopedic practices, where he leads strategy across a growing network of ASCs while continuing to practice as a spine surgeon. With decades of experience navigating joint ventures and certificate-of-need restrictions, Dr. Spector brings a physician-leader perspective on what it takes to successfully own and operate ASCs today. In this episode, he shares OrthoCarolina’s journey from hospital joint ventures to wholly owned surgery centers, how CON reform is reshaping growth opportunities, and what independent groups should consider as they evaluate their ownership options.

In our news recap, we’ll cover five ways CMS is continuing to impact the ASC industry, two HCA medical centers that sold, cybersecurity concerns around generative AI, and how Amazon same-day delivery can help your ASC with patient outcomes.

One other note: our other host, Alex Larralde, unfortunately needed to step away from HST so that she can help with personal family needs full time. That means this will be the last episode she’s included in. I’m sure she’d appreciate a kind message from you if you’re up to it.

Ok, all that said, I hope everyone enjoys the episode and here’s what’s going on This Week in Surgery Centers.

Episode Transcript

[00:00:00]

Hey everyone. Here’s what you can expect on today’s episode. Dr. Leo Specter is the CEO of Ortho Carolina, one of the nation’s largest independent physician-owned orthopedic practices, where he leads strategy across a growing network of ASCs while continuing to practice as a spine surgeon. He has decades of experience navigating joint ventures and certificate of need or CON restrictions.

So he brings an interesting perspective on what it takes to successfully own and operate ASCs today. And in today’s [00:01:00] episode, he shares Ortho Carolina’s journey from hospital joint ventures to wholly owned surgery centers. Also, how the CON reforms are reshaping growth opportunities and what independent centers should consider as they evaluate their ownership options.

In the news recap, we’ll cover five ways. CMS is continuing to impact the A SC industry couple HCA medical centers that sold cybersecurity concerns around generative AI and how Amazon’s same day delivery can help your a SC with patient outcomes. One other note, our other host, Alex ald, unfortunately needed to step away from HST so that she can help with personal family needs full-time.

That means this will be the last episode she’s included in. I’m sure she’d appreciate a kind message from you [00:02:00] if, if you’re up for it. Okay, all that said, I hope everyone enjoys the episode today and hears what’s going on this week in surgery centers.

Alex Larralde: Hi everyone, and welcome back to this week in Surgery Centers. I’m super excited today to be joined by Dr. Leo Spector, and we’re going to chat about all things a SC ownership at OrthoCarolina today. Dr. Specter, thanks for joining me. If you could just introduce yourself, that would be great.

Dr. Leo Spector: Great. Well, thanks so much for having me today. I really appreciate it. So my name’s Leo Spector. I am the CEO of OrthoCarolina.

We are a independent physician-owned and physician governed, operated organization. Based out of the central area of the Carolinas with our headquarters in Charlotte. But we have offices stretching up to Hickory and Winston-Salem and down into the Fort Mill, rock Hill area of South Carolina.

So the, what they call the Central Piedmont of the Carolinas [00:03:00] practicing spine surgeon by, my background and training I still see patients once a week. I still operate once a week and I was over at our surgery center last week doing two or three cases in the morning, so still participating in our ASCs as well.

Alex Larralde: That’s fantastic. So you have a busy schedule.

Dr. Leo Spector: It keeps me busy. Yep.

Alex Larralde: I love it. Well thank you for that. Could you tell me a little bit about how Ortho Carolina got into the A SC business? What did that journey look like? How did you kinda first start thinking about a SC ownership? And then tell me about what that footprint looks like today.

Dr. Leo Spector: Yeah. So, it started it started well over a decade ago, maybe close to two decades ago, and it actually started with a joint venture between ourselves one of the healthcare systems and one of the large national management companies. And at that time, or North Carolina was still as well, South Carolina were both certificate of need states.

And so, as your listeners. Probably know or I’m sure you do in a certificate of need state, in order [00:04:00] to be able to open up whatever that asset may be you need to go to the state, get that certificate of need. And that was a highly regulated and essentially, controlled and monopolized by the hospital system.

So at that time, in order to do an ambulatory surgery center as an independent physician organization, you have to do that as a joint venture. With the hospitals. So we have a number of joint venture ASCs with a number of hospitals today, which are all a part of that legacy of CON. Now, interestingly enough, about 10 years ago.

The state of North Carolina started a pilot program where they were starting to look at CON reform. And of course, there’s always pros and cons to it, different people on different sides. And so what the state did was they said, well, let’s do a pilot. Let’s go ahead and award three, two room centers throughout the state of North Carolina.

And the stipulation was that there could not be [00:05:00] hospital ownership or partnership in that venture. And I think it also, if I remember, had to be single specialty. And so we applied for, and were granted one of those three pilots. And so we were able to open up our own, wholly owned, not joint venture with anybody ambulatory surgery center about 10 years ago.

And so we have been owners, operators of our own center for about 10 years. We’ve grown that center a little bit by adding procedure rooms. But given that North Carolina is a CON state, or was I should say, ’cause that just changed about two weeks ago, we can talk about that later. We were, we kept it as a two room a SC with a procedure.

Now, more recently, about two or three years ago, we actually had the opportunity to buy out one of our hospital joint venture partners which was a pretty unique circumstance. Typically, it’s the other way around. But we had a joint venture ambulatory surgery center with one of the large hospital systems here in.

The Charlotte area and for a lot of reasons we could [00:06:00] discuss was not going as well as anybody wanted to, both on our side and the hospital side. And so we got to a point where, I told them, I said this isn’t working. I don’t wanna call it a bad marriage, but maybe it was a bad marriage and it’s time for us to make an amicable divorce.

And so we went out and got a fair market valuation and as you’d expect, it was a fair market. It was a price where I would’ve been happy to sell them my half. Or I would happy to buy their half. I think with the fact that CON legislation had been passed and we knew was gonna come into effect, I think with them knowing that, I think a lot of the traditional leverage, perhaps, that a hospital system had, they knew that was starting to go away.

And so I think that probably is a part of what brought them to the. Decision to either buy or sell this asset with us. And also I think we both recognized it was a, an unnecessary thorn in the side of our relationship together. And there’s more that we could be doing that’s positive. [00:07:00] And so, about a year and a half ago now, we completed that transaction and we purchased.

The 50 we picked, bought them out of their 50%. So now we have two wholly owned ambulatory surgery centers. Again, a two room a SC now that we are post CON reform we’re really excited about what the future looks like as we expand those centers and hopefully build some others.

Alex Larralde: Yeah that’s really exciting.

The CON environment certainly has had a big impact on growth and those types of strategic decisions, not just for you, but I’m imagining, all over the Carolinas now that, that is shifting. What do you see on the horizon? Not just for yourself, but for the industry writ large, within the Carolinas, and do you have any, specific moves planned, in the immediate future to take advantage of the opportunity opening up to expand?

Dr. Leo Spector: Yeah, I think, I think it’s gonna be a very interesting landscape, right? When you have any. Commodity, if you will, that’s monopolized and you remove that monopoly and you start to let market forces start to come into [00:08:00] play, you start to see a lot of change. That’s what capitalism is all about, which is, hugely important.

Obviously, there’s this fear that, that private equity and others will come into the state and build, a zillion surgery centers. And what I have explained to my colleagues and the hospital folks and others is. That could happen, but you can build a hundred ASCs, but you need the surgeons, the patients to fill ’em.

And so if you try to do that, if private equity or others, or whoever it may be, tries to do that without a partnership with, a physician to surgery group, they’re not gonna be very successful. So I really don’t see there that there’s gonna be this massive influx or explosion. I do think you’ll have folks coming into the market and wanting to partner with the surgical practices that belong in an ambulatory surgery center.

The ENT folks. Urology orthopedics obviously is a huge one. The spine component for the neurosurgeons, our GI colleagues. So [00:09:00] plenty of opportunities. What I think you’ll see is that it really does change the conversation now between the physician groups and either the hospital systems and or the management companies that you used to need to be able to do these.

And so the question then becomes, in the past, the main thing the hospital would bring to the table would be the certificate of need, right? And then we as a surgeons would bring the surgeries, now that we don’t need the hospitals to bring that certificate of need, the question then becomes, okay what can you bring to the table?

Right? And there’s still plenty of value that hospitals can bring to the table. Same conversation for the management companies, right? What value are you gonna bring? So I think it just becomes a conversation of what’s the value proposition for us immediately. Immediate plans would be to expand our existing centers.

Both of those centers have the capacity to expand upwards. Probably to four rooms each. Although we’re taking a hard look and you wanna get the number right, right. [00:10:00] Based upon geography, Beth based upon staffing based upon working with our anesthesia partners. And so our immediate plans are to expand both of those centers.

And to look to break ground on a de novo center at least one, if not two in 2026.

Alex Larralde: That is super exciting. You mentioned anesthesia which is a hot topic issue. It comes up all the time in almost every conversation I have because it really is probably one of the biggest limiting factors, I think to growth in the a SC space nationally just because of the supply and demand issues that we keep encountering.

But let me ask you, from your perspective, how are you thinking about anesthesia as you’re looking at your growth plans and what. What role is that kind of playing in your strategic planning and what kind of solutions are you brainstorming or thinking up to, to help with that?

Dr. Leo Spector: Yeah, no, I think you’re right. Anesthesia is a big issue and especially nationally. We are, somewhat fortunate in the Carolinas to have a number of [00:11:00] good anesthesia groups. A lot of good anesthesiologists. But I think it’s important we don’t take that for granted. I think, the way I look at it is we really have to look to see how we can partner with our anesthesia partners, because, we both need each other, right?

They, if their surgery’s not being done, that they don’t have business. If we don’t have anesthesiologists to care for our patients, then we can’t do, we wanna do. So we have to look at it as a business, and I just think it starts. From a place of mutual respect and understanding where each are coming from.

You’re right, there are areas of the country where I hear about tremendous shortages. There’s conversations about who should employ the crna, should it be the anesthesia group, should it be the center? Then there’s even conversations about centers employing their own anesthesiologists out of necessity.

My hope is that, we continue to be able to have good working relationships with the different anesthesia providers within our community and to be able to continue partnering with them. But obviously I’m not naive to think that may potentially change and we’ll have to have, alternative options to that.

Alex Larralde: That makes sense. [00:12:00] So going back to wholly owned versus joint venture ASCs, I’m really curious from the physician perspective, as a practicing surgeon what are you able to do in a physician owned center? What feels different? What kind of, what are the advantages, of having a wholly owned center versus a jv?

Dr. Leo Spector: Yeah. I think at the end of the day, a lot of it really boils down to, incentives. Reward systems tend to drive behavior, right? If, I’ve got two kids are getting older, but, when they were little, depending on how we rewarded ’em from certain behaviors, that definitely informed how they behaved, right?

And so I think if you look at least in the Carolinas, traditionally when it was CON and you had joint venture ambulatory surgery centers. The hospitals, not by any fault of their own, just, but because of the circumstances, they were highly conflicted in the sense that every outpatient case we moved from the hospital to the joint venture.

That was a net loss for them. Because if that case stayed in the main, or in the hospital outpatient [00:13:00] depart. They were gonna make a larger facility fee than if it moves to the ambulatory surgery center where we know that facility fee is lower and they were having to split that with a group. So the incentive structure, the reward system was not set up for the hospitals to necessarily want or to be good stewards of ASCs.

And so I don’t fault them, for that. That’s just the structure that was there. When the center’s wholly owned by the surgeons, the alignment between them, us and our patients, number one, and the payers whose foot in the bill is fully aligned, right? We’re a hundred percent aligned to deliver the highest quality at the lowest cost because.

For us that lower total cost of care is a net benefit to us and to our patients, right? So it’s one of those circumstances where we can be benefiting our patients, benefiting our payers, and also benefiting ourselves at the same time. That’s great. Alignment of incentive structures, quality is obvious, right?

As a [00:14:00] surgeon, I’m not gonna operate anywhere that doesn’t have good quality because. The most important thing is taking care of my patient. And if I’m not taking my patient to a place that is safe and gonna provide good outcomes, I’m not gonna be in business long as a surgeon, right? I’m gonna be dealing with all kinds of upset patients and complications.

I don’t want that. And so when the surgeon owns that, I. The only person I have to answer about changing the quality there or the processes to improve it is myself and my partners. I don’t have to answer to either an outside management company or an outside hospital that may or may not have differing incentive structures.

And so I think when you have a wholly owned. Surgeon, wholly owned and operated center. I think the alignment is there to really align those that are providing the care, the surgeons, to those that are receiving the care that the patients and those that are paying for it, which often is corporate America or the federal, state government, depending on whether it’s Medicare or Medicaid.

Alex Larralde: Yeah, that makes absolute sense. I wanna take it back to OrthoCarolina and your philosophy, as one of the founders [00:15:00] and the CEO. You have described in our previous conversation as OrthoCarolina as being physician led and patient centered. How does the a SC strategy extend that and what does that look like in that environment day to day?

Dr. Leo Spector: Yeah, at the end of the day we are a group predominantly of orthopedic surgeons. I do have some physiatry colleagues and partners. And candidly our physiatrists, led the way of this right back in the day. I remember my physiatry colleagues and partners doing procedures in the hospital.

And then in the A SC, and now pretty much everything they do is in our, our procedure rooms in our offices office-based. So now some of that obviously was driven by insurers and payers, right? But they really led the way in lowering the total cost of care for our patients. But. I look at it as the thing that we do as orthopedic surgeons, as physiatrists, when we treat patients, ’cause we’re treating the whole patient is the number one thing we can do is decide do they need, do they even need a procedure or a surgery?

Right? And so we can help to improve [00:16:00] outcomes and lower the cost of care by avoiding unnecessary procedures and surgeries first. And. Once we have decided that it is in the patient’s best interest to improve their quality of life, to either do a procedure or a surgery, the next lever, if you will, that we can pull to help lower the total cost of care, improve outcomes.

Is the site of service, where are we delivering that? And so by moving that from, high cost centers to lower cost centers when it’s appropriate, that’s the second way that we can lower the total cost of care. So as a physician-owned and patient-centered organization, we can do that. We can focus on what’s best for the patients.

And at the end of the day, in our opinion, what’s best is. Improving the outcome, quality and lowering the total cost of care. And the way that we can do that most effectively is by offering the right procedure or surgery to the right patient at the right time, in the right location. And so the ASCs fit into [00:17:00] that last bucket, right of the right location and be have, being able to have access so that our patients have access to those high quality, low cost centers is a huge part of that strategy.

Alex Larralde: Absolutely. That makes total sense. Okay, so next question. For groups like yours, independent physicians or practices that want more control, kinda more ownership to create those patient-centered experiences, what first steps or conversations do you recommend they start having as they’re looking toward kind of changing up their strategy?

Dr. Leo Spector: Yeah. I think first and foremost they have to have the internal conversation first, right? You have to meet with your partners and make sure you have alignment as to, what is your why, right? Our why is our patients, right? Patient-centered care. You’ve gotta first and foremost determine as a, as an independent practice or any kind of practice, what’s your why?

‘Cause not everybody’s why is the same. And make sure you have a line general alignment. We’ve got 110 partners. To sit here and tell you that 110 [00:18:00] surgeons agree on everything a hundred percent of the time, everybody would know that I’m lying, right? But you have to have general alignments as to this is our why, our mission, our vision, our values.

So I think you start there. Once you have that alignment. You then have to look and make sure that you’ve got the structure and the processes in place to be able to deliver on that, right? Because it’s all, it’s great to have a strategy, everybody. You need to have a strategy, right? A well thought out strategy, but without execution, strategy goes nowhere.

And so once you. Have that, then you’ve gotta work on executing. And that’s both on the physician side, but then it’s also on the administrative side. Make sure you’ve got the right resources. And I think when it comes to that I really think it’s important that you step back, take a deep breath, and really have some humility as to what you are and not capable of.

Currently we are capable of owning and operating, two, two room centers. We feel confident that we can own and operate those centers at a little bit of a larger [00:19:00] scale. We’re not sure if we can go to three or four or five rooms. We may need to bring in a management partner, or we may need to dedicate more resources to grow it internally.

Those are the kind of conversations you have to have. And I think you have to realize that you could have a really good plan, but you have to also be prepared to pivot. I think it was Mike Tyson, the one who famously said, everybody’s got a plan until I hit him in the head or her face or something like that.

And the real world hits you in the head pretty hard sometimes. And so, especially as surgeons, we can be a little hardheaded at times. So I think we have to have that willingness to make changes and to pivot based upon how things are going.

Alex Larralde: For sure. And I’m also curious, you mentioned when you were looking to restructure the hospital joint venture that we were discussing earlier that you went out to do evaluation what does that process look like?

Getting started there for, potentially physicians or ASCs that are in a similar situation that might be looking at, Hey, we wanna bring somebody in, or, Hey, we actually wanna run this thing on [00:20:00] our own. Yeah, I,

Dr. Leo Spector: These are tough conversations, right. They’re not easy conversations to have with your hospital partners, because at the end of the day, we are still partners, caring for the community, caring for patients.

They can’t exist without us, and we can’t exist without them. So there has to be that, that, that recognition, I think you have to have an understanding of what you as a group are willing to do, to understand what kind of, I hate to use the word leverage when I’m talking about caring for patients, but the business side of things, you have to have understand what kind of leverage do you have, right?

So if you have a surgery center and you feel like it’s not working well and you wanna restructure it, what are you willing to do? Are your doctors willing to walk away from an investment? If they are, then you’ve got tremendous leverage because if you walk away from that, then you’re leaving the hospital with a hundred percent of nothing.

In which case, hopefully they’ll come to the table and you guys will figure something out. Now, if you’re not willing to walk away from it, then you don’t have as much leverage. And so, before you’re into negotiation, you better [00:21:00] know what you’re willing to do because you never wanna make threats at all during a negotiation.

Right? But you don’t wanna say. That you will do X, Y, and Z. And it turns out as the leader, you look behind you and nobody’s standing behind you anymore. Right? So you need to make sure that whatever you are willing or committing to that that you’re, that you’ve got the general buy-in to do that.

So I think you first have to assess again, what’s your goal? Is your goal to a hundred percent own and operate it? Okay? If it is, then what are you willing to sacrifice to do that? And once you know that, then you can have that conversation. We’re having a current conversation with another hospital partner about restructuring a syndication and, those conversations are going, very well.

And I think both sides have an under clear understanding of what both want and both are willing to do. And I think that allows you to better get to Yes. Because that’s the goal of any negotiation is get to Yes. And also if you can’t get to yes, know that quickly and move on because you don’t want.

Just because you couldn’t make something work here, [00:22:00] you don’t want that to fester and then start souring the relationship in other places. For sure.

Alex Larralde: So zooming out and looking at Ortho Carolina as a whole what does the future look like over the next three to five years for growth of the practice?

Just generally even beyond as.

Dr. Leo Spector: Yeah, we’re blessed that Charlotte this kind of greater Charlotte market, because when I say that, you just think of the city of Charlotte, but I really think of the greater Charlotte market because there’s so much within one or two hours of Charlotte.

We’re blessed to be one of the fastest growing areas in the entire country. Southeast in general is a very fast growing area. North and South Carolina within that are fast. Growing in Charlotte is one of the fastest growing. I think my chief growth officer tells me there’s 170 or so.

That move to this area every day. So that’s tremendous growth. And so first and foremost, we need to match that growth because those folks are gonna need access to high quality care. And we also need to realize that those folks moving to the area, [00:23:00] they don’t know us, right? They’re new. And so we’ve gotta make sure that we do a good job making sure that they know that we are, are.

Hopefully the choice when it comes to orthopedic care. So for us it’s really a lot of growth within what’s affectionately called the Central Piedmont area. We’re never opposed to growing into other markets. If there’s a right opportunity and the right alignment but really.

We’re mostly focused on this. This is a really exciting time for us. We’ve been waiting for CON form for, well over a decade. And I don’t think it’s any secret, right? Healthcare is getting harder, margins are getting tighter. The cost of doing business is getting, is going up both on the human side as well as, general supplies.

And, insurance companies are not asking are not offering to pay us more for what we do. And so with tighter margins, you’ve gotta look at different opportunities. And we really think the ASCs are a huge opportunity for us, that if we grow and execute on that, it can help us to continue to man, maintain the profitability so that we can grow.

I think the other part of [00:24:00] that really is where the ASCs fit into the whole world of. And I hate the term value-based care, I think it’s a little overused. Right. But using that term, I think, how does it fit into the whole value-based care? Specifically with regards to direct to employers?

Right. A lot of employers, they’re just seeing their healthcare costs rise every year over year. And so they’re looking for ways to lower that. In the state of North Carolina the state health plan, which oversees all the state employees, they switched for their musculoskeletal care away from traditional insurance, and they’ve gone to a direct to employer plan.

And we’re really excited to be one of the three orthopedic practices in the state that are signed up for that. And so for us, that is a huge influx of patients where again, we can improve quality. We can lower the total cost of care and asds will be a huge part of that. So that’s that’s what we’re focused on.

And I think to be a successful company, you can’t try to do. Everything right? Or you can’t, you can’t try to put, you can’t be everything to everybody, [00:25:00] right? You really need to know what is your domain of expertise. And at the end of the day, as surgeons, as physiatrists, as people that do surgery and do procedures, that really is our domain of expertise.

So we really wanna focus on that, and it really works well with the CON reform. We can focus in on those sites where we deliver those services.

Alex Larralde: Absolutely. I’ll be very excited to watch and see how you grow and what moves you make in the coming years. But my final question is something we ask our guests every week on the show, and that is what is one thing a SC leaders could do this week to improve their surgery centers?

Dr. Leo Spector: Oh, wow. That’s, that is a great question. I think and hopefully people are already doing this, but I think really talking to the people that use the center on, on a regular basis and find out, what’s going well, what could go better, and what they would do differently. And that means talking to.

Surgeons obviously, but we get a little too much attention talking to the teammates that are there from the folks [00:26:00] checking in to the folks working behind the scenes in and talking to the patients. And it can’t be this once a year, patient employee satisfaction or physicians. I think talking on a weekly basis to find out, what are the barriers that to success.

Because oftentimes there are little things and as we, in management or owners of the SE, can break down those little things and make lives better for people, it’s gonna make it better for our patients and therefore make it a better place for us as surgeons to practice.

Alex Larralde: Absolutely. Well, thank you so much Dr.

Specter, for joining me today. It’s been such a pleasure to have you on and to be able to chat with you.

Dr. Leo Spector: Thanks. I appreciate the time. Great questions.

Okay, let’s jump into the news this week. First one, CM S’S final payment rule is top of mind right now in case you didn’t see these updates. These were not just routine [00:27:00] changes for 2026. They made big changes that are really reshaping the financial and regulatory foundation for outpatient surgery.

Becker has did an article recapping a few things that a SG leaders should know about this. First is that CMS finalized a major expansion of the A SC covered procedures list, adding 573 new codes for 2026. Again, 573 new codes. Many of these fall in spine and cardiovascular care, which is gonna open up the door for new service line growth.

At the same time, CMS is phasing out the Medicare inpatient only list over the next three years. That change removes the longstanding site of service restrictions and is gonna give physicians flexibility to choose. [00:28:00] Financially CMS finalized a 2.6% payment increase for ASCs and corrected prior cardiac reimbursement calculations, turning what was expected to be a cut into a 3.4 increase for certain cardiac procedures.

The oversight is also increasing. CMS launched a new pilot using AI supported prior authorization in several states. That’s gonna introduce new review protocols for certain procedures. If you take this together, these moves show that there is an acceleration to the outpatient setting, but then also there’s going to be increasing complexity, cross reimbursement and regulatory compliance.

So good thing to keep tabs on. Next story is around CBRE, one of the world’s largest commercial real estate services and investment [00:29:00] firms, and they just facilitated the sale of a two property a SC portfolio, anchored by HCA in Katy, Texas on orm, Utah. Both properties were built in 2025 and are fully leased with the first lease expirations, not until 2035, which shows the attractiveness to investors the buyer. Montecito Medical Real Estate is one of the largest privately held acquirers. Of medical outpatient real estate in the country with more than $6.5 billion in healthcare assets across Florida states.

The Orum facility includes 10 ORs, which means it’s in the top 5% of the largest ASEs nationally. Also has four procedure rooms and 32 recovery base. It’s a big one. The Katy location sits in one of the [00:30:00] fastest growing healthcare markets in Texas, and if you listened to last week’s episode with Jim on preparing for a transaction and valuing your a SC.

This is the type of thing strategic buyers are looking for. Scale growth markets, potential cash flow. So much capital is continuing to flow into high quality outpatient assets, especially those that have long-term lease stability. Again, if you’re interested in selling wholly or partly, it seems like a decent time to seriously explore that.

Next story is around generative ai. So this of course, is rapidly expanding across the world and in healthcare, but it’s also meaning there are new cybersecurity risks that ASCs should not ignore. In a recent interview, [00:31:00] Taylor Lemon from Google Clouds. Office of the CISO warned that AI systems may be harder to secure than traditional tools.

This isn’t necessarily because they’re more vulnerable, but because they’re more difficult to monitor when something goes wrong. For instance, if an AI model produces inaccurate output, it can be challenging to determine whether it’s a harmless error or the result of manipulation by malicious actor. Of course one instance here and there is different than a repeated pattern two, but the major, one of the major concerns is visibility.

It is important to be able to understand what model you’re using, where it came from, how it was trained, what data it’s used, the country that created it, who’s gonna be accessing it. This all helps to show the importance of strong [00:32:00] identity controls and transparency into the types of activities when using these models.

At the same time, cyber criminals are using AI to move faster. That means response times must shrink from hours to minutes or frankly, even seconds. As a SC leaders, you should think about. How yourself or your IT teams can monitor, detect, and recover from these threats. If cybersecurity in general is top of mind for you or your center.

HST Pathways has a section on their website, under the resources menu where you can find a bundle of resources called Enhancing Cybersecurity Measures. And this has insights and strategies to help protect your A SC from evolving cyber threats. Now, some of these tools also [00:33:00] have healthcare specific versions.

For instance, chat, GT if you contract with them, can have a HIPAA compliant option, which is valuable for healthcare facilities or healthcare IT providers as well. Okay. Last story here. Amazon Pharmacy is significantly expanding its same day medication delivery footprint. They’re adding nearly 2000 new communities and bringing same day service to about 4,500 cities nationwide, that same day service to thousands of new cities.

The new states include Idaho and Massachusetts, building on earlier rollouts in New York and California and others. Amazon’s positioning itself as a major competitor to traditional pharmacy players like Walmart, Optum, CVS, Caremark, and [00:34:00] Express Scripts among others. While traditional mail order prescriptions can take time, you know, sometimes five or 10 days, Amazon is really emphasizing its faster fulfillment and in some markets.

Really fast pickup through pharmacy kiosks inside their Amazon One medical clinics. The company’s also targeting access gaps created by pharmacy closures, staffing shortages, and transportation barriers. They’re delivering to remote Alaskan towns across the Navajo Nation, and even places like Mackinac Island, I guess they’re using ferries and horse-drawn carriages even in some cases.

Which if you attended the Michigan a SC conference in the past, you’ll know that is an island that is unique. Prime members without insurance can [00:35:00] also access steep discounts on generics and brand name medications. For a SC leaders, this could be a huge opportunity to ensure continuity of care faster, more reliable medication access.

Can of course directly impact the post-op compliance and recovery ability. And for patients who live alone, who maybe rely on public transportation or have limited resources, programs like this from Amazon can reduce those delays in starting treatment or medication, and of course, that can affect their outcomes after surgery as a whole.

And that officially wraps up this week’s podcast. Thanks as always, for spending some time with us. Please subscribe, leave a review, send it to a friend directly. We’d love the support. Hope you have a great day and see you in the future.

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