Working in healthcare 'tenuous at present,' CEO says

Craig Sarine, CEO of University Surgical Associates in Chattanooga, Tenn., joined Becker's to discuss what he wishes his co-workers knew about his job and the migration of procedures to the outpatient setting. 

Editor's note: This response was edited lightly for clarity and brevity. 

Question: What do you wish your co-workers knew about your job?

Craig Sarine: I guess it is a "wish they knew, but they are probably glad they don't know" thing. This has been a challenging time in healthcare. Navigating regulations, insurance company gauntlets and maintaining competitive pay scales in an environment of continually shrinking payment rates make continued participation in our industry tenuous at present. It would be nice if the staff knew what it took to keep the ship sailing, but part of our job is to take care of all that so they can continue to focus on providing the best care possible.

Q: Are you seeing payers moving procedures to the ASC setting, or are you seeing more obstacles to securing reimbursements?

CS: We actually manage an hospital outpatient department for a hospital, so we somewhat fall in the middle between hospitals and ASCs. In my "day job" as the administrator of a surgical practice, we are finding payers pushing to move procedures to local ASCs and away from any hospital (inpatient, outpatient and HOPD) facilities. Fortunately and unfortunately, in Chattanooga, there is only one general ASC — all the others are specialty (orthopedic, gastroenterology, ophthalmic) oriented — so we are still able to get procedures reluctantly approved at a hospital.

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