'Death by a thousand Medicare cuts': The reimbursement issues ASCs are facing

As operation costs soar, most healthcare providers are struggling to meet margins. 

Craig Sarine, former CEO of Chattanooga, Tenn.-based University Surgical Associates, joined Becker's to discuss his biggest issues regarding reimbursements. 

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

Craig Sarine: We are in a strategic position, and a part of the country where we have not seen appreciable decreases in reimbursement, other than the droning death by a thousand Medicare cuts. However, more noteworthy than these minor, in relative terms, "death cuts" are the comparative gouges resulting from rapidly rising costs of operation. 

Every business needs to have an operating margin to survive (save for a major cash reserve, of course). All providers are suffering right now, granted to varying degrees, with relatively fixed revenues and burgeoning expenses, largely in payroll. So my biggest concern is that reimbursement is not keeping up with cost increases and instead is shrinking back. In an ASC, it means lower distributions for owners – in a physician practice, it means lower salaries for the providers. It is simply not sustainable in the long term.

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