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Unique Methods of Payment: Opportunities for ASCs?

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The Oklahoma City-based Surgery Center of Oklahoma's Keith Smith, MD, is well-known for his progressive attitude toward price transparency and alternative payment initiatives. His center is an industry pioneer in medical price transparency, making its prices available online for all to see. In early 2014, the center entered a deal with the Oklahoma County Budget Board to promote value in medical care by providing low-cost surgery to public servants. If individuals chose to receive their surgery at the center, the state would waive the copays usually required by their government insurance.

More recently, the ASC has been in the news for another reason: It's accepting Bitcoin. In the last two years, the cryptocurrency has been splashed across front pages of finance sections and news websites everywhere, first for its jump in value from $13 to more than $1,000 in 2013, and most recently for the ultimately incorrect outing of the pseudonymous creator of Bitcoin, "Satoshi Nakamoto," in Newsweek's first print issue since 2012.

Dr. Smith's contribution to Bitcoin in the news cycle is no less radical. "I have made it known that if I'm offered Bitcoin, I'll take it. I have yet to have it offered to me as payment, but I would take it," says Dr. Smith, who does not yet have a Bitcoin account. He says that the moment a patient offers to pay for a surgery in Bitcoins, he'll be on the computer setting up the process. Creating an account is an apparently quick process, requiring only 15 minutes and an internet connection. After being transferred between accounts, Bitcoins can be instantly converted to any desired currency, which protects against the wild fluctuations in value for which the cryptocurrency is infamous.

News of Dr. Smith's acceptance of Bitcoin appeared after he did an interview with a pro-cryptocurrency group who asked him for his thoughts on the matter. For Dr. Smith, however, it's not specifically about Bitcoin. "All I've tried to make clear is that as a provider, it's incumbent on me to be convenient to the buyer in terms of exchange and incumbent upon me to encourage buyers to use my service. As a provider, I have more responsibility in any exchange, because as a buyer, a patient can take his business elsewhere," he says.

He adds the mindset of the typical patient attracted to the Surgery Center of Oklahoma's pricing policies tends to be niche. "We've attracted a Ron Paul, libertarian crowd to the way we do business here. Many of those people are very currency conscious," he says.

All other things being equal, the ASC's unusual pricing policies have created a great deal of buzz for business. The center is considering an expansion, due to the fact that it is serving patients from all over the country, who are finding the center en masse through its website.

Dr. Smith himself continues to lead in making payment information accessible to patients. He is about to launch a new national association, the Free Market Medical Association, a group that will assist ASCs in displaying their prices to attract patients who, in Dr. Smith's words, are motivated to find quality, value-based surgical care. "It's probably the biggest blockbuster thing I've been involved with in the last five years. It's an exciting development, and I think it will help the entire ASC industry," says Dr. Smith.

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