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Payers driving surgeries to the outpatient setting in North Carolina

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Will payers be the major impetus behind the surgical migration from hospitals to ambulatory surgery centers?

Recent projections predict that three out of four surgeries in the Triangle region of North Carolina will be performed in ambulatory surgery centers, according to a Triangle Business Journal report.

Patients and physicians may be the key decision makers when it comes to surgery location, but payers are about to become key players in the arena, especially as demand for value and price rises.

"I believe we are on the cusp of patients being directed by their payers to the sources that are most value driven. I think we will see payers be a lot more aggressive," said WakeMed Health & Hospitals senior vice president of ambulatory and physician operations Carolyn Knaup, in the report.

The report turned to Blue Cross and Blue Shield of North Carolina as an example. The payer has been naming certain designating facilities as "Blue Distinction," as a way to identify high-quality, cost-effective providers.

Though the shift may be gradual, payers are revealing more pricing and quality information in an effort to drive patients to effective, low-cost providers: a niche that ASCs have long occupied.

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