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. 

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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.  

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.

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Is ambulatory care healthcare’s big margin engine? 4 leaders weigh in

Wednesday, July 29
1:00 PM - 2:00 PM CDT

Presenters: Joe Ganley, athenahealthJeffrey Flynn, CASC, Gramercy Surgery CenterBryan Tsao, Access Center, Loma Linda University HealthJason Zepeda, Northridge Hospital Medical Center, CommonSpirit HealthGreg DeConciliis, PA-C, CASC, Boston Out­Patient Surgical Suites

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