At the 11th Annual Spine, Orthopedic & Pain-Management Driven ASC Conference in Chicago on June 15, Sev Hrywnak, MD, CEO of The Sev Group, discussed how ASCs can prepare to enter an accountable care organization.
“By next summer, between 75 and 80 percent of the country will be involved in some kind of ACO,” said Dr. Hrywnak.
To prepare, surgery centers need to know how ASCs will work, and who the key players will be. ACOs are basically vertical integration of providers, he said, where all involved parties are equally responsible for both the overall quality of care and the cost of that care.
In this vertical integration, primary care providers will be at the top. “Primary care physicians will be key,” said Dr. Hrywnak. These physicians’ referrals will decide where patients, and payer payments, will go for surgery or other procedures, he said, decisions that will be influenced by case managers from the insurance companies who will push for the cheapest facility.
ASCs therefore are in a very good position now during this transition to ACOs because these centers are capable of performing high-quality surgery at a lower cost than hospitals. “ASCs stand to benefit the most from ACOs,” said Dr. Hrywnak.
To prepare for the transition, Dr. Hrywnak recommends investing in technology, especially electronic health records to comply with current CMS standards, and to evaluate physician performance not just for quality but also for efficiency. “To survive, you need to know what it would cost if a primary care physician sends their patient to you,” he said. Implement and standardize operating room best practices and know which physicians are the most efficient, as they are the most valuable.
Preparing now for ACOs is important because ACOs are in the future of every ASC. “Surgery centers will be an integral part of ACOs,” said Dr. Hrywnak. “If you’re a surgery center, and a hospital in your area has not approached you yet about a joint venture to prepare for an ACO, they’re behind the times,” he said.
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“By next summer, between 75 and 80 percent of the country will be involved in some kind of ACO,” said Dr. Hrywnak.
To prepare, surgery centers need to know how ASCs will work, and who the key players will be. ACOs are basically vertical integration of providers, he said, where all involved parties are equally responsible for both the overall quality of care and the cost of that care.
In this vertical integration, primary care providers will be at the top. “Primary care physicians will be key,” said Dr. Hrywnak. These physicians’ referrals will decide where patients, and payer payments, will go for surgery or other procedures, he said, decisions that will be influenced by case managers from the insurance companies who will push for the cheapest facility.
ASCs therefore are in a very good position now during this transition to ACOs because these centers are capable of performing high-quality surgery at a lower cost than hospitals. “ASCs stand to benefit the most from ACOs,” said Dr. Hrywnak.
To prepare for the transition, Dr. Hrywnak recommends investing in technology, especially electronic health records to comply with current CMS standards, and to evaluate physician performance not just for quality but also for efficiency. “To survive, you need to know what it would cost if a primary care physician sends their patient to you,” he said. Implement and standardize operating room best practices and know which physicians are the most efficient, as they are the most valuable.
Preparing now for ACOs is important because ACOs are in the future of every ASC. “Surgery centers will be an integral part of ACOs,” said Dr. Hrywnak. “If you’re a surgery center, and a hospital in your area has not approached you yet about a joint venture to prepare for an ACO, they’re behind the times,” he said.
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What do ACOs Really Mean for ASCs? Q&A With Ken Arvin, Esq. of Sheridan Healthcare