Texas Surgical Specialists founder is hoping to transition from fee-for-service to value-based care

Rick Ngo, MD, is the founder and a general surgeon of Texas Surgical Specialists in Fort Worth.

Dr. Ngo will serve on the keynote panel “What CMS, Private Payer Trends Mean for Physician-Owned ASCs” at Becker’s ASC Annual Meeting. As part of an ongoing series, Becker’s is talking to healthcare leaders who plan to speak at the conference on Oct. 27-29 in Chicago.

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Question: What is the smartest thing you've done in the last year to set your organization up for success?

Rick Ngo: First off, I created a new organization: I started my own independent surgical practice called Texas Surgical Specialists, with a subdivision called Texas Hernia Specialists. The reason I did that was for more autonomy in figuring out the structure of my independent practice and what organizations/accountable care organizations I would possibly be in, and also in determining where I would be performing my surgeries. 

Q: What are you most excited about right now and what makes you nervous?

RN: I’m most excited about the transition in healthcare from fee-for-service reimbursements and payments to value-based payment. I think it’s important to have not just volume, which is the quantity aspect; too often the quality aspect has been undervalued. The value based system, although it’ll hurt some positions which are mainly about volume, it’ll be a big contributor to the improvement of more accessible and affordable surgical care, and hopefully all kinds of care.

I’m nervous about that in that there may be a lot of physicians who are mainly about fee-for-service and volume may exit the profession. Maybe my own personal salary will take a hit, depending on how we derive these formulas. So it’s important for positions to be involved in the discussions on how they get reimbursed under the umbrella of value-based care. 

It’s exciting and nerve racking at the same time. No one’s ever accused me of being a good businessman if I’m the one arguing for value-based care over a fee-for-service system, but I would think that if you have high volume and high quality, it’ll work out.

Q: How are you thinking about growth over the next 12 months?

RN: My marketing is really targeted towards a philosophy of providing the patient with well informed decision-making tools, and then allowing them to use that information to make a shared decision with me on the best approach to their treatment, instead of having me just tell them what to do. I’m trying to really empower them to learn about their issues.

My growth strategy is to share my philosophy with my referring doctors with my patients, so they can share that with their networks and also with the internet. That’s part of the reason I went solo: to have a little more say in that sort of marketing and philosophy.

Q: What will healthcare executives and leaders need to be effective leaders for the next five years?

RN: They need to be, number one, aware of the different forces out there. Really learn the key issues for all the major stakeholders: the patients, the providers, the facilities, the health systems, the employers, the insurance companies, and be aware of each category’s top two or three issues. Then, be able to listen to the concerns, goals and expectations around those two or three issues. A lot of times, we’re pushing our own agendas, our own initiatives, without truly listening to what the other stakeholders’ issues are. Until we do that, we’re not able to offer solutions that incorporate as many of those key stakeholders’ goals.

Q: What is your strategy for recruiting and retaining great teams? 

RN: It’s hard, and it’s painful, and it’s expensive to hire someone and have it not work out. So you’ve got to do your due diligence on the front end. The resume is just one thing, really delve into the references and have a genuine and thorough interview with multiple members of the team — not just the c-suite or executive suite.

To retain them is to have them really adopted into your culture and philosophy and to treat them as a team member and not just an employee or someone that’s under you. Really show them that they’re a valuable member of the team while still holding them accountable for their responsibilities, but in a productive way.

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