Robert Lerma, the administrator of Blue Springs Surgery Center in Orange City, Fla., spoke with Becker’s ASC Review on the challenges he sees in regard to bundled payments
Note: This response was edited lightly for clarity
Question: What are common mistakes ASCs make when handling bundled payments?
Robert Lerma: Depending upon the negotiated managed care contract, the biggest problems with bundled payments are the following:
1. The inability in some bundled payment contracts to charge for supplies, disposables and sometimes implants.
2. ASCs negotiating the fees based upon the Local Total Payment as opposed to Local Medicare Payment. The rates are lower for the latter. Sometimes the higher rates are non-negotiable, but I always start with the highest rate possible and then negotiate to the center bottom line number for profitability.
3. ASCs not negotiating for a contract review date at least every two or three years.
4. ASCs not knowing or using the specific language for deductibles.
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.