ASC reimbursement rates shouldn't be based on ownership, leader says

According to Dennis Fliegelman, principal consultant at West Lake Village, Calif.-based ARA Financial Services, outpatient reimbursement should be based on clinical rationale rather than ownership structure. 

Dr. Fliegelman, who is also a former hospital administrator, joined Becker's to discuss the most controversial trends in the ASC industry. 

Editor's note: This response was edited lightly for clarity and brevity.

Question: What are the most controversial trends in the ASC industry?

Dennis Fliegelman: The outpatient reimbursement of facilities should not be one of ownership but of clinical rationales e.g. a hospital-based outpatient surgicenter with immediate access to the hospital's back-up should have more procedures on an approved list and should have a higher rate than an off-campus or independent one. 

Other facilities and factors should also be considered, such as extended post-surgical facilities and coverage. They are not all equal and need to be put into categories for reimbursement in addition to outcome, satisfaction and cost-efficiency factors.  

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