Joe Peluso, administrator at Aestique Surgery Center in Greensburg, Pa., recently connected with Becker's to discuss seven ways to address healthcare costs.
Editor's note: This response was edited lightly for brevity and clarity.
Joe Peluso: Policymakers must take action, despite lobbying and partisan politics, in at least seven areas to address some of the root causes of rising healthcare costs. We need to focus on what matters most: taking care of patient healthcare needs.
- Ensure patients receive high-quality care delivered at the right place, at the right time, at the right price with a level payment playing field. (ASCs are reimbursed an average 40 percent less vs. hospital outpatient departments).
- Enhance patient access to lower cost prescription drugs by the federal government negotiating lower drug prices with pharmaceutical companies, addressing the length of a drug's exclusivity period and manufacturers gaming of pricing for top selling drugs and blocking generics and biosimilars from entering the market, in addition to the FDA providing a timely approval process for new drugs.
- Disenfranchise integrated healthcare delivery systems that monopolize the marketplace representing a conflict of interest by being both a payer (insurer) and provider (hospital system) network that results in gaming the system by eliminating site-neutral community healthcare competition and keeping prices high and limiting accessibility.
- Eliminate healthcare noncompete agreements that will encourage more independent physician practices to provide patient-centric care. Seventy percent of physician practices are owned by hospitals and health systems that bill hospital outpatient rates for the same services billed at two to three times higher rates than the rate billed by an independent physician office, which also often results in decreased quality of care.
- Remove barriers to the appropriate use of telehealth services that will provide better patient access to underserved areas and medical specialists.
- Address increased regulations that limit or restrict competition and cost containment tools such as barriers to interstate insurance, network management designs that restrict providers, benefit designs that restrict any willing provider.
- Healthcare policy that provides reimbursement for pursuing community-based health and wellness initiatives coordinated across a continuum of care vs. only episodic care.