Developing and managing ambulatory surgical centers throughout the U.S.
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Providing Value-Based Care with Ambulatory Surgical Centers with Chris Bishop, CEO, Regent Surgical Health was automatically transcribed by Sonix with the latest audio-to-text algorithms. This transcript may contain errors. Sonix is the best way to convert your audio to text in 2020.
Welcome to the Outcomes Rocket podcast, where we inspire collaborative thinking, improved outcomes and business success with today’s most successful and inspiring health care leaders and influencers. And now your host, Saul Marquez.
Saul Marquez:
Welcome back to the Outcomes Rocket. Today, I have the privilege of hosting Chris Bishop. He is the Chief Executive Officer at Regent Surgical Health. He’s in charge of overseeing the day to day operations of the company as well as region partnerships around the globe. Formerly Regents president, much of his focus is on developing an executive marketing strategies that continue the pace of regents impressive long term growth, as well as driving Regents rapid rollout of new outpatient service lines. If you all remember, almost three years ago, we had Tom Malon. That was episode number 10. If you have an opportunity to go back and listen. Cover Regents. But it’s been 3 years and the work that Regent continues to do is so tied to value-based care and how to deliver on that promise. Chris is a proven leader in the health care industry with a strong commitment to Regents’ corporate values. Nearly 2 decades, he’s worked closely with physicians and other health care leaders to develop new business opportunities that are focused on delivering superior outpatient care. Prior to joining Regent, Chris was a partner and senior V.P. at Blue Chip Surgery Center Partners in Nashville, Tennessee. And there he really did such a great job of accelerating firm growth through the novo and turnaround of underperforming surgery centers, helping lead the organization toward market leadership and spine based ventures. We’re going to cover a lot about ACS value based care. And it’s such a privilege to have the talented Chris Bishop here with us today. So, Chris, big thanks for joining us today.
Chris Bishop:
Thank you for having me Saul.
Saul Marquez:
Chris, what do I leave out of that intro that you want to fill in for the listeners that are that are tuning in?
Chris Bishop:
Yeah, I think you covered it well. I’ve enjoyed each step of my career and at this stage, I probably am in the most rewarding position I’ve been in here at Regent thus far.
Saul Marquez:
That’s awesome, man. And so it’s great to have start with gratitude. You know, I’m a firm believer in that. And and so you’ve had a fruitful career. Tell us what got you started in the health care sector.
Chris Bishop:
Yeah, because in college, I knew I wanted to move into the medical career, but I wasn’t quite certain where. And after several athletic injuries, multiple surgeries in college, I really decided at that stage that I wanted to get into the surgical side. So I started in the medical device industry and then 4 or 5 years into my career, managed to transition over to the provider side, specifically in surgery centers.
Saul Marquez:
So fascinating. So athletics, got some injuries. You were a recipient of these services and you said there’s something here. I could do something here.
Chris Bishop:
Yeah, I have enjoyed this. It’s not easy to help people return to work, return to the sports field, return to health. I mean, most of our patients that come into our facilities are in pain and we get the privilege of helping alleviate that pain and return them to a healthy lifestyle.
Saul Marquez:
That, say it is a privilege. I agree with you wholeheartedly. What do you think is a hot topic that needs to be on leaders agendas today, Chris? And how are you and the folks at Regent Surgical approaching it?
Chris Bishop:
Yes, for us in the surgery center space. We have historically we’ve known that we were the low cost, high-quality provider, but a lot of the economics in the health care system didn’t necessarily drive care into our particular segment. So as we transition away more and more from the fee-for-service world that we’ve all grown up in and we start to really look at fee-for-value, we’re beginning to see payers, major payers begin to shift care or require the care to get shifts to a lower cost setting. We’re seeing healthsystem who historically were paid fee for service. And I mean obviously when you’re paid in that particular manner, your desire is to collect 100 percent of that kleck in the hospital setting at the higher rate. Well, now, even as our health system partners transition to value based care through a CEO, through pop health strategies, they’re finding that their operating rooms, which historically were profit centers for them, if they could then turn around and invest in the less profitable or money losing departments, they’re now taking these monthly or quarterly fees to treat a population of patients and finding that their operating rooms are actually expense centers. So why do I need replacement, for example, for fifty thousand in the hospital when you can do it for twenty thousand in a surgery center and that thirty thousand savings now becomes a profit center for them that they can then invest in other areas of their organization. So all health care providers are really beginning to think through in the new world, how are we going to deliver these service through some kind of value-based approach?
Saul Marquez:
That’s such a great idea, Chris. And you know, before we we hit the record button, folks. You know, Chris mentioned, hey, you know, today in an era of value-based care, where providers and also industry are looking for ways to get creative, it’s not necessary to reinvent the wheel. And that’s where ASC come into play, ambulatory surgical centers. It’s a critical segment that we could take advantage of to maximize value based care strategies. So give us an example, Chris, of what you and your team are doing to create results, whether it be improved outcomes, increased profitability or both.
Chris Bishop:
Yeah. So about three years ago, we really changed our vision statement from surgical procedures to surgical solutions. And what that allowed us to do is to really begin to think outside the box of not just strictly getting a patient into the surgery center and delivering care, but how can we deliver solutions even beyond that. And so for us, we’ve invested heavily in the last couple years in particular around bundled payments. One of the big spend areas in American healthcare are joint replacements and spine surgery. Today, the surgeon is paid their professional fee and frankly, we pay them the majority of their fee from their skin to skin time. So I bring patients the O.R., I cut patient, I quote, to treat whatever their disease is, replace the knee and then closed that wound and send patient on to physical therapy. Unfortunately, under that scenario, what happens is you have a lot of different care providers and it’s really not. There’s no continuum of care that necessarily really thinks through. Can I achieve the necessary outcome with 12 physical therapy visits versus 20 and the medications that I’m using post-operatively, are there less expensive solutions? So the idea of a surgical solution whereby the physician is empowered and has the business resources around them that take a 90 day episode responsibility versus just the 60 Minutes skin to skin, they are best positioned to squeeze costs out of that clinical pathway. So we’ve really empowered a lot of our orthopedic and neurosurgical partners to begin shifting from a certain just simply a surgical concept and where they are heavily compensated to really beginning to take on risk and watching these physicians really kind of battle through a lot of these clinical pathway decisions that they were never paid before to pay close attention to. So having that 90 day episode responsibility really allows them now to improve the quality of the outcome while also thinking that from an economic perspective and delivering that service in a more cost effective manner.
Saul Marquez:
I think that’s really brilliant way to approach it. And non-traditional Right.. I mean, let’s just call it what it is. Right. You’re as a surgeon focused on that and that episode and an episode of care, not that 90 day window of taking care of the patient, the medications, the physical therapy. And it’s all about aligning incentives, right, Chris? And so you guys have figured out a way to align incentives and not waste as much. And so I love to hear maybe some takeaways and maybe even a setback that you guys had that help you get to that sweet spot. And I know there’s no like her sweet spot. Right. You’re always developing and innovating. But I’d love to hear what a setback was that helped you get to where you’re at today.
Chris Bishop:
Yes. So I think to the younger leader, when I would organize teams to come together, I would pose the problem. The mistake that I often made was, hey, here’s the problem and here’s what I believe the solution to be. But what did I just do? I just took 4 or 5 or 10 million individuals that have come into this meeting that I’ve scheduled. I’ve cured within the problem, which is perfectly logical. But then I have essentially now painted them into a corner and said, here’s what I believe to be the solution. And I have just eliminated their ability to creatively thing. So it’s one of the things that I have really learned, I would say in the last five years of my career, as you load up the bus with great power and you are faced with problems daily, weekly, monthly, that I certainly don’t always have the solution too often don’t have the solution to. And so when I do bring those individuals to my team that I believe are uniquely qualified to bring value to that decision making process. Now, I’ve learned, even if I believe I have the solution, I hold back on that so that I don’t limit the creativity of the team. And what I have learned from that is that oftentimes my solution, which maybe took 10 steps to get us there. The team may arrive at the same solution, but they figured out how to get there in four steps. So really leveraging or harnessing the power and creativity of your teams by not necessarily cornering them or pulling them into or pinning them into a corner, but really allowing them to use their creativity to arrive at a solution that oftentimes is better than than what I was thinking as we were headed into. Problem solved.
Saul Marquez:
That’s a great discipline, Chris. And I can imagine at the beginning it was hard to do. What got you in the rhythm of it?
Chris Bishop:
Yeah, I think some of the early meetings I remember calling the meeting. We’d spent 45 minutes talking through it and I had shared the solutions that beginning at the end of 45 minutes. It was the same solution that I called the meeting to help me improve. And I learned from that experience. Basically, I wasted everybody’s time for 45 minutes and I felt the problem I felt in the solution and sort of eliminated their ability to bring value. So yeah, you learned from one of two methods. You either learned from your own mistakes, which that certainly made plenty of, or you learn from other people’s experiences. And obviously that’s the smarter approach.
Saul Marquez:
Love it. What would you say today, Chris, is is one of your proudest leadership experiences in health care?
Chris Bishop:
Yeah, I know. One of the things that really drives me are seeing other people succeed and maximize their potential. So when I think about whether it’s here at Regent or I think about my time at Blue Chip Surgery Partners, my previous group, I look at the people that I had that I played a role in hiring, mentoring, sometimes helping them lead the organization to go take larger positions in other companies are a larger responsibility of another company. My wife gives me some times that I should have been a recruiter because oftentimes I’m helping people that I have networked with and come across in my career, find a fit for them in somebody else’s organization. We don’t have a seat on our bus at that particular moment. So so really for me, it’s about pouring into other people and helping them maximize their potential.
Saul Marquez:
I love that. Yeah, that’s a it’s a mark of a great leader. And you definitely have done a tremendous job there. Chris, a lot to learn from. And folks, if you haven’t heard of Regent and the work that Christina’s team are up to, definitely check them out after you listen to this will give you a link to check them out, go to outcomesrocket.health and type in Regent Surgical in the search bar. You’ll find it there. But tell us about an exciting project or or focus you guys are working on today. Chris.
Chris Bishop:
Yeah. For us, it’s really when I had the privilege of succeeding Tom Malin, the founder of this organization, he had really left behind a great collection of assets and a great team. What we have really focused on over the last three years is continuing to add new talent to the boss while at the same time really building the system to allow for scalability. So for us, we see an industry that, frankly, is growing at a very rapid clip. We believe that growth is only going to increase as surgical techniques continue to improve robotics shift to the ambulatory setting. Value based care virtually requires outpatient surgery to be done in the lower cost surgery centers setting. Even Medicare now is beginning to approve higher acuity procedures and NASD and has talked about even going to site mutual reimbursements that will once again motivate the largest health care providers, the health systems to even more quickly adopt the concept of ambulatory surgery. So the reason we’re investing heavily in process and our ability to scale more quickly so that that’s a heavy effort for us the last couple of years and we’re really beginning to see the success of that.
I think that’s great. And just going back to to one of your initial comments about shifting from procedures to solutions and what that’s done to to the approach of value based care, improving processes. I mean, it just it’s just brilliant work that you guys are doing there.
Chris Bishop:
Thank you. Appreciate that.
Saul Marquez:
So, Chris, incredible work. I mean, some awesome examples of how surgical centers are becoming the opportunity for people to do value based care. It’s time for the Lightning Round. And you ready?
Chris Bishop:
I’m ready. Let’s go.
Saul Marquez:
All right. What’s the best way to improve outcomes?
Chris Bishop:
I mean, to suggest hiring great people combined with technology.
Saul Marquez:
What’s the biggest mistake or pitfall to avoid?
Chris Bishop:
Quickly getting off mission, and when your organization gets into too many areas, you’re not best at one or two areas, but you’re trying to be average of several.
Saul Marquez:
Love that. How do you stay relevant as an organization despite constant change?
Chris Bishop:
Constant innovation is how you respond to constant change.
Saul Marquez:
And to dive there a little bit deeper, Chris. Innovation is something that we all strive for. If you had to summarize the best way to innovate, why would you say it is?
Chris Bishop:
We actually changed the name of our annual planning meeting to innovate. I even spelled it I in an overheat. What? Because I thought this will pull my millennials into the meeting. It will no longer just be a manager meeting. So for us, it’s really about embedding that into your culture.
Saul Marquez:
Yeah. And there’s so many ways you could do that. And for example, what you did Right. change in the name of the meeting. It’s a recurring thing every year.
Chris Bishop:
Right. he changed the name of the meeting, and even in that meeting, there’s always three questions that I surprised the team with every year break them up into teams, one of which was transparent pricing this past year. This meeting was in February. What happens two or three months later? Medicare is suggesting that they may require transparent pricing for all health systems and for all health care providers. We already had a strategy that we had built and put on the shelf in preparation for this. Had we not innovated that concept at this particular conference in our annual planning meeting and leverage the collective intelligence of our team, you know, we would not have been well prepared for that. Had Medicare required this to be executed in a short timeframe. So those are the sort of topics that our team wrestles with. Build the strategy. Frankly, the initial strategy is usually not very good. So we continue to come back to it and continue to innovate fast so that when it is time to launch it, we’ve got something that we’ve got months, maybe even years invested in.
Saul Marquez:
Wow, that’s awesome, man. And great, great example. And and we’ll you say that the core focus area that drives reasons.. surgical is.
Chris Bishop:
But I know of women, this thing and several my answers. But for us, it’s really people development. Five years ago, because I never had responsibility for an entire organization. I’m not sure that I couldn’t really define what organizational development was very well. I knew how to develop my own personal team, but I hadn’t really thought about it. The organization, why? And so we’ve invested heavily the last two or three years really looking at how are we structured, where we strong, where do we need to continue to innovate or hire stronger folks? Where do we need to take our high potential leaders today and pour into them and mentor them so that they take my job so that they are the leaders of tomorrow and they’re well-equipped. So I think one of the mistakes we often make as companies is we’re so focused on whatever that value prop is or whatever that area that drives our revenues, drives our profits that we forget about investing in your most important resource, which is really a people.
Saul Marquez:
What a great message. Don’t forget your people. And if you’re listening to this today, think about ways you could invest and pour into the people that you’re leading. That’s helping the people that are helping you reach your audience, that are helping you reach your goals as a company. What book would you recommend to the listeners, Chris?
Chris Bishop:
Yeah. And I suspect because I know you have a very educated audience, that the majority of your audience has read this book. But good to great by Jim Collins. I’ve probably read it three times over the last 15 years. And ironically enough, had it out by and looked at it in two or three years and had it out over Labor Day weekend here recently going through Chapter 6, because I feel like organization has done a nice job of really good in our flywheels. Getting the right people on the bus and for us now is really continuing to generate even greater discipline to help us ensure that we don’t miss things as we continue this scalability project. So but it is a great tool to really build and position your companies for success.
Saul Marquez:
I think it’s a great one, Chris. And for everybody that’s read the book, wanted to open chapter six today, right? That’s a good call. Go. I love that. Yeah. What about this specific chapter? Because it is a great book and there’s tons in there that it’s it’s worth revisiting. So awesome call out by Chris Bishop here, CEO of Regents Surgical. Folks, you could get all of the transcript as well as links to the company and the show notes go to outcomes rocket.health type in Regents Surgical and the search bar or type in Chris Bishop. Either one will get you the show notes. Chris, this has been incredible. I mean, what a great learning session with you. I’d love if you could just leave us with the closing thought and then the best place for the listeners could continue the conversation with you.
Chris Bishop:
Yeah. You know, it’s a fascinating time to be in health care because the way that I’ve been working in health care for nearly 25 years now, where I started at twenty five years ago and where health care sits today and where I believe it’s headed over the next decade, it’s a great time of upheaval. And when there’s a great time of upheaval, there’s a greater opportunity for leaders in this space to really lead. So I would encourage your your listeners to be courageous in their decision making. And I’ll leave you with this. My dad used to always say, if you did what you’ve always done, you’ll get what you always got. And what I take from that is continue to innovate, continue to collaborate, and you will find areas where you can better treat patients in a more cost effective manner. And that’s where health care is truly beginning to reward our industry.
Saul Marquez:
What a great parting message, Chris, and something that all of us need to take to heart. How can we apply that to our day to day to improve our businesses that in the end affect outcomes and affect the bottom line? Chris, I just want to say we’re tremendously grateful for you to have joined us today and now looking forward to staying in touch.
Chris Bishop:
Thank you for having me. Appreciate it Saul.
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