3 tips to help ASCs stay afloat amid the changing payer landscape

The growing popularity of high deductible health plans is encouraging more patients to seek care in lower-cost outpatient settings. However, trends in payer consolidation are making it more difficult for ASCs to ensure maximum reimbursement for their work.

At Becker's ASC 25th Annual Meeting: The Business and Operations of ASCs, which took place Oct. 18-20 in Chicago, three revenue cycle leaders shared their advice for ASCs juggling these changes during a panel discussion on payer consolidation and high deductible health plans.

Here are three tips the experts shared on bundled payments, materials management and more:

Editor's note: Responses have been lightly edited for clarity and length.

1. Amy Colleti, senior manager at ECG Management Consultants: "It comes down to ASCs understanding their value and being prepared to have the data to discuss with their payers. We are seeing more and more payers developing what they call "bundled" cases for the ASC setting, so be prepared to know your costs [and] your data when you enter into those new types of contracts. Position yourself to have those conversations and develop relationships with payers. Payers want to have meaningful conversations about which procedures your ASC can do, who your surgeons are and what volume you anticipate brining in."

2. Raymond Hino, administrator of Skyway Surgery Center in Chico, Calif.: "Know your costs, because as bundles are coming, we are going to be working with physicians, surgeons and anesthesiologists, so it's important to be prepared to have those discussions. Know your costs, but also become best friends with your materials manager. Your materials manager can have huge impact on the success of your facility. A screw is a screw is a screw ,but our manager talked to one of our surgeons recently and said, 'Do you realize if you switch the exact same screw from this vendor to another vendor we will save $100,000 next year?' Know your costs, work with your physicians and find your niche in the market."

3. Debbie Welle-Powell, chief population health officer of Essentia Health in Duluth, Minn.: "If you are an ASC, your future is bright. You’ve got site-neutrality occurring, you’ve got health systems that get this and know it is happening. Position yourself with the top two stakeholders in your market and make sure that hospitals know your value proposition because they’ll want to include you in their total cost of care."

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