Narrator: 0:01
Welcome to the
Advancing Surgical Care Podcast brought to you by ASCA, the Ambulatory Surgery Center Association. ASCA represents the interests of outpatient surgery centers of every specialty and provides advocacy and resources to assist them in providing safe, high-quality, cost-effective patient care. As with all of ASCA’s communications, please check to make sure you are listening to or viewing our most up-to-date podcasts and announcements.
Bill Prentice: 0:27
Hello, and welcome to the
Advancing Surgical Care Podcast. My name is Bill Prentice. I’m the chief executive officer of the Ambulatory Surgery Center Association, or ASCA, and the host of this discussion. On today’s podcast, I’ll be speaking with Dr. Dayne Jensen, a maxillofacial and oral surgeon from Utah who practices in both Salt Lake City and St. George. Dr. Jensen graduated from the University of Nevada Las Vegas dental school and received his medical degree from the University of Nebraska Medical Center. He also completed five years of residency in his surgical specialties. And I’ve asked Dr. Jensen to join me for a discussion about his surgical practice and why he believes ambulatory surgery centers are a beneficial site of service for patients in need of dental and other facial surgeries. Dr. Jensen, welcome to the ASC podcast.
Dayne Jensen: 1:13
It’s an honor to be here. Thank you for having me.
Bill Prentice: 1:15
So, Dayne, before we get to some of my ASC-related questions, it might be helpful for some of our listeners if you could tell us about the kinds of surgeries you perform and maybe give us a lay person’s definition of maxillofacial conditions and surgical treatments.
Dayne Jensen: 1:30
Yes, that would be great. So, I’m an oral and maxillofacial surgeon is my core training. So we go to dental school, and then medical school and then Oral Maxillofacial Surgery Residency. And then I went on and did a cosmetic reconstructive fellowship through the American Academy of Cosmetic Surgery. And so, I wanted to make sure that I could practice full scope oral maxillofacial surgery and cosmetic surgery and so that’s why I thought it was so important to have an ASC, so the kind of the common procedures we do is of course, wisdom teeth dental extractions, kind of on the rise now for us is that we call it an ALL-ON-X procedure or teeth in-a-day. where we take out all the teeth and then place implants and put the new smile in that same day. And then we do lots of things from like mandible fractures to facial trauma surgeries, as well as reconstructive surgeries like, jaw advancements or chin advancements or facelifts, things like that. That’s kind of what the scope of our practice is.
Bill Prentice: 2:29
It’s very interesting. So, can you tell us about how you came to the decision to practice in a surgery center and what you believe distinguishes it from a dental office or hospital setting, and the advantages that it might provide to both patients and to providers like yourself?
Dayne Jensen: 2:47
Yes, that’s a great question. So, I decided that it was going to be able to practice the way I wanted to practice and provide the level of safety that we wanted to be able to provide for our patients, I knew that an ASC was in our future. And so, what really kind of spurred that on was, all of those procedures that we mentioned, that we commonly perform, are not really high on the ticker list for a hospital. And so, as we would have a patient that would want to get scheduled, or we’d have a last minute add on, we were finding ourselves continually getting bumped to the next day or later that day, or the only surgical block that we get was like 10:30 In the afternoon, right in the middle of our clinic. And so there just wasn’t the same level of urgency that we felt for our patients that was experienced by the bigger healthcare institutions. And then on the opposite side, just a regular dental office didn’t feel safe to do something to somebody who had a big mandible fracture, or a big facial trauma or say a big was attacked by a dog or you know, needed to be put to sleep in a safe environment, but the urgency was now. And so that’s something that we’re really proud about in our practice, you know, through Oragen, our company, is that we’ve made the decision that we were going to create that for our patients so that they could receive the highest level of care and immediate kind of timeframe.
Bill Prentice: 4:04
Great. And so, in your surgery center, do you do only dental procedures in that facility? Or do you have other specialties that take block time?
Dayne Jensen: 4:12
Yes. So, we started out just thinking that it was going to be something that we would use and we wanted it to just be ever present, if you will. But what we found out is that there were other specialties like ours that felt like that they didn’t have a home in some of the bigger institutions. And so currently there’s podiatrists and pediatric dentists and other oral surgeons and other specialties like that, that come through and use our facility and it’s turned out to be a great community builder and kind of builds this collegiality amongst providers that kind of feel left out more or less.
Bill Prentice: 4:45
Interesting. Well, Dr. Jensen, I’m going to ask that we pause for a brief message from our podcast sponsor. Standby and we’ll be right back.
Narrator: 4:52
This episode of the
Advancing Surgical Care Podcast is brought to you by AMSURG, a national leader in the strategic and operational management of ambulatory surgery centers. AMSURG partners with more than 2,000 physicians and health systems and more than 250 ASCs operating in 34 states. Learn more by visiting
amsurg.com.
Bill Prentice: 5:13
So, Dr. Jensen, before we took our break, I want to follow up on some things that I read about you is that I understand that, you know, Utah is a Medicaid expansion state with broader eligibility than non-expansion states in terms of being able to access Medicaid services, and that you actually accept Medicaid patients in your practice. At ASCA, we’re taking a closer look at Medicaid programs in several states to see if there are opportunities for more ASCs to serve more of these patients across the spectrum of surgical care. And unfortunately, as I’m sure you’re well aware, lower reimbursement is often a big obstacle to be able to provide care to that population. But we also know that many of these low-income patients also have transportation and post operative care challenges that also make it kind of hard for providers to see patients in that, you know, Medicaid eligibility. Could you tell us about your experience with Medicaid and Medicaid patients in Utah and with your practice?
Dayne Jensen: 6:08
Yes, this is a topic that I’m actually pretty passionate about, I think access to care is a huge reason for the surgical centers doing so well. And the Medicaid patients are a large group of patients that are largely underserved. And so, we’re proud to be able to serve them in our practice and we found that it’s been a very rewarding thing for us, maybe not as much financially as we would like it to be, but from a lot of the reasons that we went into medicine were to care for those that had kind of been neglected. And so, by opening up your practice, and kind of being inclusive to everybody, regardless of their financial situation, or their insurance situation has been very rewarding for us, they seem to be the most kind of grateful patients, they understand that they don’t have a lot of options. And so, when you offer those services to them, they’re very, very grateful. And they’ve been very respectful of our time, we’d heard before we started accepting it, you’ll have massive cancellations, you’ll have people that won’t show up, there’ll be all these problems that you’ll experience it your mainstream patients of your private insurance won’t like mingling with Medicaid insured patients. And that has not been our experience at all. In fact, we’ve had the opposite experience of that we’ve had, you know, ever since we’ve started taking Medicaid, they’re so grateful that they’re some of your biggest supporters. And so, they’ll give you those five-star reviews, they’ll let the community know that you were able to serve them. So, we’ve been very, very grateful. And we’re proud to offer that and we will always offer that as an insurance in our in our practice.
Bill Prentice: 7:37
That’s really gratifying to hear. And it’s something that, you know, we’ve been advocating for, because now we talked about low reimbursement, the issue in many states is you’re not even covering your costs. So, it’s not that you’re even breaking even you’re actually losing money when you’re seeing Medicaid patients, because of the low reimbursement rates that many states provides a surgery center, obviously, you being in Utah, I think you’ve found a way to make that work. And that’s great to hear and hopefully there’s others out here listening to this podcast that hopefully will learn from that and will help us with our advocacy to try and improve access to surgery centers for the Medicaid population, the Medicare population, and you know, everyone that we can possibly see, because of the value proposition that we offer. And so, thank you for that. I think we’d also be interesting to know a little bit more about your commercially insured patients and how they find their way to you or your patients coming to you directly or, you know, on referral from other practices through the insurance networks that you contract with, or a combination of all the above.
Dayne Jensen: 8:38
Yes, I think a combination is fair to say on that. Our providers take trauma call from the local hospitals, and so that that provides kind of the venue for where we’ll see our trauma patients. A lot of times it will be word of mouth through our existing patients. And then that network that we’ve created with the other providers, so it’s a little here and a little there but you know, ever since we’ve opened, we’ve gradually gotten busier and busier. And it’s been really interesting to see how busy we’ve gotten with providers requesting time in our center. That’s been nothing but symbiotic for all of the other providers involved because we allow them to advertise the services that are performed there. And then when people ask those questions as they have a loved one, in the OR in the in the surgical center, they’re there, they’re able to kind of peruse the services that that the center now offers.
Bill Prentice: 9:24
Interesting in terms of the commercial coverage is more medical insurance payments or dental?
Dayne Jensen: 9:32
Yes, oftentimes, the dental insurance won’t have coverage for like a surgical center clause. But what they’ll do is submit to dental and then they’ll deny it, and then we submit back. We have a medical biller who will then submit back to medical and oftentimes then there’ll be partially covered or they’ll get some coverage, but we’ve just created a flat surgical center fee to be able to do those things.
Bill Prentice: 9:57
Great. Well, I want to thank you for really thoughtful discussion about you know how you, you’re bringing dental into the surgery center model and the advantages that you see there. And I want to thank you for being an ASCA member. And I’ve enjoyed talking with you, I’ve learned a lot, and hopefully our listeners will as well. Anything you want to say in closing before we end the podcast?
Dayne Jensen: 10:16
I would just say that we couldn’t have done it without the organization, you know, all the all the free content that is available to the members was really, really helpful for us. And we’re grateful to be a part of the association and look forward to learning from others at the national meetings and things like that.
Bill Prentice: 10:30
Well, thank you, Dayne. I think there’s a lot of folks out there going to be willing to learn from you as well. So, appreciate you being on the podcast. And finally, before closing, I’d like once again to thank our podcast sponsor, AMSURG, a leading ASC management company with more than 250 ASC partners in 34 states. To learn more about them, visit
amsurg.com.