ASC leaders say payers too often treat outpatient surgery centers as “optional” sites of care, rather than essential providers that deliver hospital-level quality at a fraction of the cost.
Two leaders joined Becker’s to discuss what insurers misunderstand about ASCs.
Editors’ note: Responses were edited lightly for clarity and length.
Question: Where do you think payers most often misunderstand ASCs? What would you want them to recognize instead?
Peter Bravos, MD. Chief Medical Officer of Sutter Surgery Center Division (Sacramento, Calif.): Payers often view ASCs as elective or optional, underestimating their role in delivering high-quality and cost-effective care. This misconception overlooks the fact that ASCs consistently meet or exceed hospital benchmarks for safety and quality while reducing costs by up to 50% per procedure. Beyond affordability, ASCs improve patient experience and expand access. Recognizing ASCs as essential and not optional, would unlock significant value for patients and the healthcare system overall.
Trina Cole. Administrator of St. Luke’s Surgicenter Lee’s Summit (Mo.): In my perspective, the level of quality care at a reduced cost provided at the ASC level is lost in the larger picture. Insurances are often influenced by the lobbying of large systems to keep procedures in the hospital setting, understandably. However, I feel if payers would be willing to negotiate a rate that would be sustainable at the ASC level, many physicians and ASCs would be more willing to perform these cases at the ASC.
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.