Guest Brett Spark started his career in health systems and has led many private practice groups. Today, Brett is the president and Co-Founder of Aroris, a company that helps private practices capture more revenue through payer contracts. Tune in as we discuss the impact payer contracts have on revenue, the importance of strong leadership, and maximizing your team’s potential.
You can find Gino Wickman’s book “Traction: Get A Grip on Your Business” by visiting https://www.eosworldwide.com/traction-book .
Listen to the full episode using the player below, or by visiting one of the links below. Below is the episode’s transcript which has been edited for readability. If you have any questions or would like to learn more, email us at info@byrdadatto.com.
Transcript
Intro: [00:00:00] Welcome to Legal 123s with ByrdAdatto. Legal issues simplified through real client stories and real world experiences. Creating simplicity in 3, 2, 1.
Brad: Welcome back to another episode of the Legal 123s with ByrdAdatto. I’m your host Brad Adatto with my cohost Michael Byrd.
Michael: As a business and healthcare law firm, we represent clients in multiple sectors and multiple specialties, especially healthcare. This season we are searching for common ground for our diverse audience, and we’ll be bringing in many guests to help us. This season’s theme is The Universal Language – Business.
Brad: Love it, Michael. Well, speaking of love, you know I love me some football.
Michael: Well that has nothing to do with it. And your timing is pretty terrible. This episode is being released in the middle of the off season. And so I’m getting suspicious that you’re trying to shoe horn some Saints talk.
Brad: No Saints talk?
Michael: And then we just, we [00:01:00] are going to lose the listeners. Other than your dad, he will stay with us.
Brad: Yeah. He’ll stay with us. Well when I was preparing for today’s show on the universal language business, I couldn’t stop thinking about the best, the most cliché football quotes, which is, you know, as you can imagine its own unique language from when we have players or coaches or even the owners start coming up with stuff.
Michael: Well, as you know, Brad, I’m a Cowboys fan. And as you also know, the last 25 plus years of my life have been very painful. And you can relate because most of the first part of your life was that way as a Saints fan.
Brad: That’s true.
Michael: But here are some really good Cowboys quotes. And really, I mean, I should go back, really go back to my childhood when the Cowboys were really good, but it’s so hard. Once Jerry Jones became the owner, we could do a whole episode on all of his quotes. But a couple of my favorites of course, that everyone knows is of course, Jimmy Johnson [00:02:00] with the famous, “How about them Cowboys?” Do you know when and what situation he said that?
Brad: After it was an NFC win the very first time they were going to the Super Bowl, is that right?
Michael: Yeah. When they beat the 49ers in San Francisco. And don’t fact check me on that, but I’m pretty sure that’s right.
Brad: I think that’s right.
Michael: Okay. And then Jerry Jones, I mean, I was trying to look up some of the bizarre ones we’ve heard over the years.
Brad: They would be explicit.
Michael: Yes, we didn’t. But there was a time when he started coming under scrutiny because it had been several seasons since the wins and he was.
Brad: You mean still?
Michael: Yeah. But the beginning of that time. And someone came on the radio station that we listened to all the time and he, or maybe it was a reporter, I can’t remember the circumstances, but he started getting not happy about the questions. And he said his quote was, [00:03:00] “Do you like those three Super Bowl rings? I hope you do, I hope you do very much.” As a response to the reporter. And so that gets thrown out in the radios as drops even to this day.
Brad: Those are some good ones. Alright I have a few other ones. I’ll try to stay away from the Saints. One of my former neighbors, I don’t know if you’ve heard of this guy named Peyton Manning, but he had funny one.
Michael: Humble brag.
Brad: I’m sorry. “Pressure is something you feel when you don’t know what the hell you’re doing.” I like that one. And then since I’m not allowed to talk about the Saints, but the former head coach of the Saints, Jim Mora, who also happened to be the coach of Peyton.
Michael: Is he your other neighbor?
Brad: Yes and he’s like, “Playoffs? Don’t talk about – playoffs? You kidding me? Playoffs? I just hope we can win a game!” Do you remember that one at all? That was so awesome.
Michael: Your voice just brought it back.
Brad: I was trying to sound like Jim Mora. And then my favorite of course is, you know, Joe Theismann, who was a former NFL quarterback and ESPN announcer. He was trying to get really deep ones that he said, [00:04:00] “Nobody in football should be called a genius. A genius is a guy like Norman Einstein.”
Michael: Well, he proved his point. He’s a guy in football and he should not be called a genius. And you know, Joe Theismann was a quarterback for the Redskins who were very hated by the Cowboys. I was not a fan of his. Now that you’ve managed to talk about football in the middle of the off season, what in the world does this have to do with today?
Brad: So again, when I was preparing for today, I was thinking back to when I met today’s guest. We met him in Las Vegas. We were all there speaking at this orthopedic conference and as you know, currently the Las Vegas Raiders, formerly of LA and Oakland now’s there. And they were dominated forever by one person.
Michael: Well, you got to put a big asterisk by it since the Raiders have been there for like a year, but I’m guessing you’re speaking of Al Davis, right? [00:05:00]
Brad: That’s right. Yes, Al. If you remember that he was actually a coach before he actually became the owner of the Raiders. He has like Jerry Jones, a ton of great quotes. Like, “You don’t adjust. You just dominate.” But of course his most famous one “Just win, baby”. And this Vegas connection to Al’s quote, when I kept thinking about getting prepared for today’s episode, today’s guest, Brett Spark, you know, that’s what he does with his clients. He tries to find a way for them to dominate and win.
Michael: Oh, wow. Way to shoehorn that in there, buddy. But yes, Al Davis was colorful to say the least and not surprisingly, I think he’s an idol of Jerry Jones. Cut from the same cloth. But these funny, and sometimes, you know, inspirational quotes also remind me of some serious laughter we had when we first met Brett and his business partner, Jeremy [00:06:00] Carroll at dinner in Vegas, because we started making fun of their business partner, Chad Smoak who obviously was there with us because he’s a Pittsburgh Steelers fan. And somehow there became a running line of Ben Roethlisberger jokes, which I didn’t even know was a thing but I laughed so hard. And now he’s, unfortunately for that joke string, he’s retired.
Brad: I know, and it really did get out of hand because it just got too easy. Too bad that Ben retired, we lost all this material that we could make fun of Chad, but I actually Chad was a really good sport about us making fun of him and his idol. But Michael, I think enough football talk. Let’s bring on Brett.
Michael: All right Brett, I’m so glad that you could join today and a brief intro on Brett is Brett began his career with a large health system in Minnesota and has since led several private practice groups, kind of on the [00:07:00] administrative side. Brett is the current executive director for the Minnesota Epilepsy Group and founded his own business, which is how we all connected. He is the president and co-founder of Aroris. Aroris maximizes contract revenue for private practices through negotiation and leveraging of proprietary data. Aroris maximizes contract revenue for private practice. Would love to first welcome Brett and hear a little bit more about Aroris.
Brett: Yeah, thanks guys. I appreciate you bringing me on. It’s fantastic to see you guys again. And I think the Ben Roethlisberger jokes just continue on more than in a retirement fashion now for him. So I don’t think we let those die that quick. [00:08:00] Um, no, I appreciate you having me. A little bit about my background, I’ve spent my entire career in the healthcare space as you mentioned before. I started with a large health system in the Minnesota Minneapolis area here and spent about 13 years working with that group in a number of different fashions, mostly on the care delivery side. And then as you mentioned, I moved into the private practice space and I was kind of summoned away from the large health system world many years ago which has become very valuable. And ran several different groups as an administrator CEO level and in a few different administrator or a few different service lines there. And then about a year and a half ago now started Aroris and you mentioned we’re focused on payer contracting and a lot of our attention is pushed towards [00:09:00] private practices because there’s just not enough resources in the space and payer contracting, reimbursement methodologies, it’s a complex world. It’s a complex world for somebody that lives and breathes it every single day, let alone having a private practice that it’s your secondary fashion. You know, we have physicians that are trying to do this in some groups, we have Administrators that are trying to do it in some groups, and there’s just not enough time in the day. And so we wanted to create a business that really filled that gap with resources. At Aroris we have payer contractors, we have negotiators in our group, we have legal experts in our group, we have account managers in our groups and we have a data analytics team that really gives a full comprehensive approach to the payer contracting world and [00:10:00] allows these practices to be more competitive when they’re going into the negotiation role.
Michael: We’ll talk about, so you went out on your own a year and a half ago, which is exciting and scary all at the same time. Talk about kind of your experiences in your professional career that led you to identify this need and kind of gave you the unique ability to be able to lead Aroris with this kind of this business platform.
Brett: Yeah, it’s a good question. And after working with several different groups in the private practice space I started doing some consulting in the same type of fashion, but more quick in and quick out for groups that were mid to large size organizations. I was planning on just going down that path, being a consultant and supporting private practice from the administrative role. And [00:11:00] after doing it for a couple of years and working with a lot of different groups, I started thinking about what’s the one thing that I would do with every single group that I went into. And on day one, I’m looking at their payer contracts, you know where’s the revenue coming from in the business? What payers are paying well, what payers haven’t been touched for years on years. And then I would go out and try and renegotiate for them and try and create revenue without going to the physicians and asking them to work evenings or weekend schedules and add days in there, which nobody is pleased to do. And so through that, I really identified that there’s a massive gap in the private practice space, especially for resources to be able to understand the need and really be able to take the time and effort to go out and get movement with insurance companies.
Michael: And do y’all [00:12:00] help with, if a practice is having trouble with collections with a payer and they’re having kind of conflict and appeal type stuff? Is that something that you guys do or is it more on the front end with the negotiation?
Brett: Yeah it’s more on the front end with the negotiation, but it’s a question that we get all the time from either client partners or from groups that are reaching out. And so we’ve partnered with a few different firms that do the denial management, the AR management, really the back office functionalities. But we’ve kind of formed our lane in the front end process of actually negotiating fee schedules, negotiating those reimbursement rates, and hitting that.
Brad: Yeah. And I think for our audience that is listening to this who’s not in the world, whether you deal with payers or just our audience here in the business world. I think the most [00:13:00] important takeaway that you can have when you partner with someone like Brett’s group, is that you show up and you work the whole nine hours and you’re dead tired at the end of the day. Well, if you have the right payer contracts, you’re going to get paid more, no matter what. It doesn’t matter how many hours you put in, it’s what are some willing to pay for that? And it’s not how much you bill for it, so you can bill $10,000 for something, but they’re only going to pay you $2,000 for it. You know, it does not make a difference. And I think a lot of people don’t realize that when they first start practicing, whereas you said, it was a great example, is they just continue to renew and they don’t look at the numbers and all of a sudden the numbers start dropping. That’s what I loved when we met you in Vegas, just understanding that is a need that a lot of people don’t see.
Brett: Yeah. And its variable, you know, these price points are so variable based on specialty, based on geographic area, that there’s so many factors that play into it. And the complexity of it, you know, it’s just not worth the time of a [00:14:00] lot of these groups to dig into them. And then they ultimately just start taking what they can get and they’ll go three, four or five years without actually being given an opportunity to go out and negotiate. And that’s where we come into play and try and fill that void and really demystify some of the process itself, but also open the eyes of the shareholders within the businesses on what’s current state. And where do we see some opportunity?
Brad: Sure. Well, as Michael started this episode, he mentioned that this season we’re really concentrating on the universal language of business. So, with your background in these different other healthcare groups, and starting your own business, talk about some things that you’ve noticed that in your experience, certain commonalities that you’ve seen.
Brett: You know the value add of a strong workforce or strong leadership team has become so apparent. When I was doing consulting with a lot of groups, you know, that was a lot of where my [00:15:00] focus went. Initially, I’d look at payer contracts and I’d be looking at the leadership team, you know, what’s the reporting structure? What does the leadership team look like? We’re now finding ourselves doing the same thing as we’re building out our team from scratch at Aroris as well is, you know, the heavy focus on having the right people in the right seats. It’s a cliché kind of way to look at it, but you have so much disruption in private practice or in any really business environment that I’ve been in when you have the wrong talent in the wrong, the wrong, you know, type of skillset trying to put the puzzle together. And so I think one of the things that I pieced together as we’re building out Aroris is it’s a really important focus that you build out the correct service signs with the right people in the right seats.
Michael: Makes me really sad because I hear you [00:16:00] saying that ByrdAdatto is in trouble with Brad being here, but that’s okay. We have managed so far despite you.
Brad: Was that why you keep having me sit out in the hall? It’s not the right seat for me? It’s really weird. You’re like, no, this is your seat to stay in the hall, don’t answer the phone.
Michael: As you can tell, we digress quickly into making fun of each other whenever we can. So yeah, that’s awesome and I love that observation. Yeah, I would love just also to kind of flip the coin and go with it where you want, but just to hear some lessons learned whether it’s in your first 15 months of starting your own business or lessons learned when you were kind of in that CEO slot or a consulting role that maybe has saved you as you’ve started your own business.
Brett: Yeah, I think the communication platform, you know, I’ve adjusted internally just for myself as [00:17:00] I’ve worked with different groups, worked with different types of leaders that shine in with different types of either value add or different types of communication platforms. And so I think what I personally tried to work on in the last several years here going into this is trying to create those lines of communication with those that are either working internally or directly with me, but also getting to know and dig into on a personal level. How do the employees that I’m working with, how do the leaders that I’m working with want to be valued? And what are things that I can do from my chair? Whatever it may be with the group that I’m working with, you know, what can I do to really pull out the best in them and show the value that they’re bringing to the organization on a broader level? And, you know, we’ve done that with a number of different factors and a lot of it can be just [00:18:00] exposing what goes on day-to-day and in groups. And everybody’s busy, everybody gets their own level of detail or level of project work that happens. And a lot of times there’s no communication platform to really shine and hone in on the wins that are going on between groups and the hard work that happens. So I think that’s a lot of what I’ve done on a personal level and try to bring that out both with Aroris and in any consulting organization I’m helping.
Brad: Well we definitely agree with communication. That is one of our core values is that our number one core value is to communicate. So we’ll agree a hundred percent chasing you on how important it is to develop that. So let’s think about this now. We’ve been building up to this moment now as to what is one of the proudest strategies or accomplishments that you’ve done in your business or in your industry?
Brett: You know, there’s a lot of moments that come to mind. [00:19:00] What’s exciting is being able to work with so many different groups at Aroris. We see so many different specialties. We see so many different services going on in the healthcare field and being able to have a direct impact on a business, either succeeding or altering their course to be able to become more profitable or to become more available to their patient base is an exciting moment. But I think one of the proudest and biggest things that we’ve done in the short-term is, we’re Jeremy, my business partner, and I are rolling out the traction model, EOS model for Aroris. And really it’s a platform that focuses in on an accountability chart. And it’s very heavy on growing the business in the right way and multiplying the business over time. But Gino Wickman is the author of the Traction book and [00:20:00] we’ve modeled that out and we’ve had our first two full day sessions doing that. And we’ve hired employees since doing that. We’ve changed roles for employees, and we’ve had to say goodbye to some employees in doing that, but we’ve seen our organization grow rapidly through that process. And so I think that’s an exciting moment for me. You know, I don’t have a long history in the startup space. My business partner, Jeremy does, and that’s kind of his background, but I’m just a healthcare guy at heart coming into the private, kind of startup world. And it’s been exciting to put that into play and see how it has added value to our group.
Brad: And we had a really interesting conversation with your team in Vegas, on Traction and for the audience is not aware of if you want to spend another minute or two diving a little bit deeper into what it is.
Brett: Yeah. So like I mentioned, Gino Wickman is the author of the book, [00:21:00] but it takes a focused process into the accountability of the business and you put it into three different buckets is what we’ve done. We have a sales and marketing team, we have an operations team, and we have a finance team with our business. And within those three categories of how our business operates, we have an accountability chart and build up the team based on the needs for that. And what it really does is it brings the team together. You know, we have weekly what we call L10 meetings on Monday morning that involve each of those teams and they kick off the week with to-do’s, with big wins, opportunities that are coming forward. But really it’s a touch point that engages the entire team. And it allows us from a broader level to share some of the highlights of where we’re going in the organization. And we added a scorecard. So every [00:22:00] single week our team gets a full report on what’s changing, you know, how many new touch points that we had, how many new signed contracts that we had, and that keeps them engaged in the goals.
Brad: And let me ask you this now with the great reshuffle, the great resignation, whatever verbiage you want to use, how do you think your new hires are adopting to the Traction process or Traction platform?
Brett: I think the increased level of understanding of the mission and kind of vision of the organization is valuable to the team. I think it engages, you know, we’re a smaller organization, so it’s easier said than done with some of these larger organizations that have several different service lines. But I think the exposure of here’s where the organization is planning to go over the course of the next one, three and five years allows the employees to visualize where their role will be in the long-term of the organization. And if [00:23:00] they can’t or if they don’t see that, that’s when there becomes some exposure that maybe they’re not sitting in the right role. And it doesn’t always mean that it’s not the right person, but it might mean that they’re more suited for a different type of position within the group. And those things happened as we started to go through this model as well. We had employees that move from one category to another to tap in better with their skillset. And I think that’s an exciting part of the process.
Brad: Yeah. Similar to moving people around in the right seat in the bus “From Good to Great”.
Michael: Well any final observations before we say goodbye and do our little legal wrap-up?
Brett: You know it’s exciting to be able to get to know you guys get to know the group and it’s a really exciting time to be part of an organization that’s in a growth mentality, which I think a lot of groups are right now. [00:24:00] And I think digging into that and figuring out where there’s value add in the business world specifically in the healthcare space right now, which is ever changing. We’re excited to be part of that and be able to lend an assisted hand and bring private practice back into the kind of profitable margins of the healthcare space. But we appreciate the opportunity to get to see you guys and talk through all these channels.
Michael: Well, we know that we get the question a lot of who can help negotiate these contracts. We’ve been asked if we can do it and having a business that knows this specific niche is so great. I’m sure you guys are going to just keep growing. So what we will do next, we’ll say goodbye, and then we’ll go into a commercial and on the other side Brad and I will share some legal insights from our discussion today. Thank you.
Brett: Thanks guys. [00:25:00]
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Brad: Welcome back to Legal 123s with ByrdAdatto. I’m your host Brad Adatto with my cohost Michael Byrd. Now, Michael, as we said this season, we’re trying to find some common ground with our friends who keep joining us, which is all about The Universal Language – Business. And we’re pretty excited to have Brett come along because he’s really looking at it as a very unique area. And you said this at the beginning of the episode is really [00:26:00] focusing on the payer contracts. And I think I wanted to take a bigger step back is, you know, a lot of our clients concentrate on patients of course, because you want the patient to come through the door. And so our clients that don’t take commercial federal payers, sure, they don’t even think twice about hiring someone like Brett. But the vast majority of medical practices out there do need to have some type of contract with the commercial or federal payer. And they don’t realize how important is of having great contracts and of ways to try to renegotiate those contracts to get better terms and conditions. And that’s where I think Brett comes in because you know, you can show up and work your tail off on a surgery and you and I have had this conversation and one time you bill it, and its $10,000, you get $8,000 reimbursement. And the next time it’s a different insurance, you bill it at $10,000, they only pay you $2,000. So understanding when you’re setting up all those patients to figuring out who you want to accept is a huge issue too. At the end of the day, your bottom line, the business side [00:27:00] of a medical practice.
Michael: Yeah. I mean, it’s not intuitive to think about the business of a medical practice. And I mean, all of us can relate to, we have health insurance and you show up to a practice and you’ve got your insurance and you want to be treated. That business kind of going off of what you just said from a little different angle, you know, they either have a contract with that with these various providers that says they’ll get paid or they don’t. And so when someone shows up and they don’t have a contract, you go into a whole other discussion about out of network. And there’s some people that do it, but there’s a lot of downsides to it. The only way you can kind of control your outcome is to be in network, but the only way you can really control your outcome is to have someone as your advocate when you’re negotiating those contracts. Because as you might imagine, the health insurance companies just give you something to sign.
Brad: Yeah, [00:28:00] no doubt. I think this just goes back to a lot of things that we see with these clientele is that they just want to show up and practice medicine and they forget about the business side of it. And the next thing, you know, they’re limping and they’re dragging themselves from one surgery to surgery kind of like Ben Roseburg when he’s was on the field.
Michael: Yeah. I mean I can think of a story where a physician had someone in negotiated a contract with the various payers to deal with his special procedures. He got awesome reimbursements. Years later, he recruits somebody to join this practice who is doing some different things. He didn’t even pay attention to that when he negotiated it. They didn’t pay attention to it and then all of a sudden the new doctor is getting paid way below market for doing these procedures because they weren’t looking at it and negotiating their contracts, but I don’t know. Do you have any final thoughts for today?
Brad: I guess my final thoughts is, you know, [00:29:00] it’s June, it’s hot outside. I can’t wait for football season to start. You?
Michael: Well, it’s hard not to talk about football since we started the whole thing on it. And I’ll just say this. I mean, if you can somehow talk about Ben Roethlisberger who I have maybe thought of for five minutes of my life and ended up laughing for 30 minutes at a dinner. Then you can just look at insurance contracts in a little different way. And perhaps if you get help, you’ll be much happier about your reimbursements than you would be had you not talked to someone like Brett.
Brad: Well, Michael that’s all the time we have today, but don’t worry all our fans out there. We have another awesome returning guest, Michael. The one, the only, the Energizer bunny Terri Ross will be coming and rejoining the show next week! Please tune in to hear what words she’ll use and how many curse words we will be able to count.
Outro: Thanks again for joining us today. And remember, if you liked this episode, please subscribe. Make sure to give us a five- star rating and share with your friends. [00:30:00] You can also sign up for the ByrdAdatto newsletter by going to our website at byrdadatto.com. ByrdAdatto is providing this podcast as a public service. This podcast is for educational purposes only. This podcast does not constitute legal advice, nor does it establish an attorney-client relationship. Reference to any specific product or entity does not constitute an endorsement or recommendation by ByrdAdatto. The views expressed by guests are their own and their appearance on the program does not imply an endorsement of them or any entity they represent. Please consult with an attorney on your legal issues.
