Payers driving surgeries to the outpatient setting in North Carolina
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.
More Articles on Coding and Billing:
PQRS group practice reporting option now open
Value-based care: Taking healthcare's biggest paradigm shift one step at a time
ASC payer mix – developing the best in-network, out-of-network strategy
© Copyright ASC COMMUNICATIONS 2017. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.
To receive the latest hospital and health system business and legal news and analysis from Becker's Hospital Review, sign-up for the free Becker's Hospital Review E-weekly by clicking here.
- 5 effective pre-procedure steps to guarantee maximum reimbursement for your ASC
- 10 highest, lowest earning US regions for physicians
- AAFP submits physician-focused alternative payment model: 6 things to know
- Marathon Pharmaceuticals withdraws from PhRMA: 4 notes
- 3 strategies to improve patients' opioid storage, disposal practices