As payers intensify efforts to steer cases to lower-cost settings, ASCs are increasingly becoming a focal point in contracting.
More payers are tying network participation and reimbursement to measures like site-of-care optimization, quality outcomes, patient experience and physician alignment, pushing ASC operators to show value at scale. For Deerfield, Ill.-based SCA Health, Optum’s ASC arm, aligning reimbursement with quality, outcomes and site-of-care efficiency has become a central focus as health plans continue shifting more outpatient volume away from higher-cost hospital settings.
Matthew Humbarger, group vice president of payer engagement and strategy at SCA Health, joined Becker’s to discuss how value-based alignment is shaping negotiations and how SCA approaches physician incentives and pay-for-performance programs.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: How would you describe SCA Health’s payer contracting strategy today, and how do you see that shifting in the next year?
Matthew Humbarger: Our payer strategy is very focused on value and will continue to be in 2026 and beyond. That means aligning reimbursement with quality and cost, and reinforcing ASCs as one of the highest-value sites of care.
We work closely with payers across fee-for-service and value-based arrangements to support appropriate site-of-care utilization. We’ve seen some payers lean into physician incentives, and we’ll continue focusing on that so physicians are economically supported in making the right site-of-care decisions.
We’ve also seen payers recognize ASCs’ impact on quality and outcomes through pay-for-performance programs. We’ll continue expanding those, so our ASCs are rewarded for strong outcomes. Overall, it’s about deeper value-based alignment, scalable programs and delivering strong value for patients, payers and members.
Q: Are there specific metrics you’re prioritizing within those value-based programs?
MH: Yes, continued focus on site-of-care optimization and ensuring cases that can be safely done in ASCs are done there. We also align with ASC quality collaboration measures and other quality outcome metrics.
