Here are 15 statistics:
Out-of-network adjustment approaches
1. Convert revenue to total in-network: 63 percent
2. Apply higher risk factor/discount rate: 16 percent
3. Adjust multiples downward: 5 percent
4. Combination: 5 percent
5. Cannot generalize: 5 percent
6. Reduced out-of-network by 50 percent then apply market multiple: 5 percent
Out-of-network multiple adjustment for centers not contracted with any commercial payers
7. Less than 0.5 multiple: 0 percent
8. 0.51 to 1.5 multiple: 10 percent
9. 1.51 to 2.0 multiple: 20 percent
10. More than 2.0 multiple: 70 percent
Percentage of total revenue in out-of-network volume that exceeds risk tolerance for the ASC company
11. Twenty percent OON: 53 percent
12. Forty percent OON: 26 percent
13. Sixty percent OON: 0 percent
14. Eighty percent OON: 0 percent
15 No threshold: 21 percent
More articles on surgery centers:
30 things for ASC leaders to know for February
19 ASC partnerships for SCA in 2016
5 ways CMS changes are affecting reimbursement for ASCs, anesthesia practices and providers
At the Becker's 23rd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, taking place June 11-13 in Chicago, spine surgeons, orthopedic leaders and ASC executives will come together to explore minimally invasive techniques, ASC growth strategies and innovations shaping the future of outpatient spine care. Apply for complimentary registration now.
