Independence Blue Cross will judge its new surgery center venture through its own claims data, a spokesperson for the Philadelphia-based insurer told Becker’s.
IBX, Penn Medicine and Regent Surgical plan to develop at least 18 ASCs across Pennsylvania, New Jersey and Delaware through a jointly owned company announced Sept. 24.
Here are the four measures the spokesperson named:
- Total cost of care
- Member out-of-pocket costs
- Utilization patterns
- The shift of appropriate procedures from higher-cost hospital settings to ASCs
“ASCs are a proven lower-cost setting for many procedures,” the spokesperson said. “They give us more opportunities to lower members’ costs and manage rising healthcare expenses for employers.”
IBX President and CEO Kelly Munson cited MedPAC data in the announcement showing Medicare payment rates for most ASC services are about 46% lower than in hospital outpatient departments.
The partners will start from a low base. Only 33% of ASC-eligible procedures in the Philadelphia region have moved to surgery centers, compared with 56% nationally, according to Regent data cited by The Philadelphia Inquirer.
Regent CEO Travis Messina said the number of centers is what will move the market.
“To do so at scale, just given the number of ASCs we are going to launch within the market or invest in, is something that’s going to make it a pretty substantial market mover,” he said.
Higher-acuity cases are also expanding what ASCs can take on. CMS removed 285 procedures from the inpatient-only list in 2026, 271 of which are also permitted in ASCs.
“The acuity of cases that are able to be performed in ASCs has drastically increased, and thus it takes a different operating model,” Mr. Messina said.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
