High-deductible plans are changing patient behavior, ASC execs say

Insurers pass risk to patients with high-deductible health plans, and members are becoming savvier about the cost of care as a result.

"One of the big trends I'm following in healthcare today is the continued transition of financial responsibility and increased cost-consciousness of patients and employers as healthcare costs rise," said Andrew Wade, CEO of OrthoSC in Myrtle Beach.

ASCs, which charge less for the episode of care than hospitals, are a perfect fit for high-deductible plan members shopping for quality care at the best price. Crystal Livingston,MSN, RN, administrator of Doctors Outpatient Surgery Center in Lincoln, Neb., is also seeing more requests for bundled cost estimates from patients.

"We currently have bundled costs and estimates in place for a number of our general surgeries," she said. "Patients are utilizing this option due to not having insurance or having high-deductible health plans. This allows them to make one payment, including surgeon fees, facility fee and anesthesia fee, to the facility."

Employers are also becoming increasingly interested in ASCs. John Lewis, CEO of Semmes Murphey in Memphis, Tenn., said employers are reaching out to work directly with providers to keep costs low and avoid unnecessary tests and procedures.

"We are now providing bundled payment arrangements that are helping employers achieve this by providing predictable, prospective bundled pricing and enhancing the healthcare and benefits experience of their members," Mr. Lewis said.

Even patients with in-network health plans want to make sure they won't receive a surprise bill from the ASC.

"I've been impressed with the increased knowledge patients have had about their health insurance coverage," said Celia Smith, RN, administrator of Houston Premier Surgery Center. "Many patients are verifying if our center and providers are in network with their payer. Patients are also well-versed about their deductibles and out-of-pocket expenses."

Patient awareness about their health plans and copays makes it easier for ASCs to collect payments. Even before the pandemic, many ASCs implemented policies to collect copays up front, before services were rendered, to avoid a lengthy collections process. Centers also work with healthcare financing companies when patients are unable to pay the full bill up front.

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