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How 5 ASCs are preparing for outcomes-based reimbursement

Five ASC leaders discuss value-based care and what their centers are doing to prepare for outcomes-based reimbursement in the future.

Learn more about key ASC industry trends, value-based care, price transparency and more at the Becker's ASC 25th Annual Meeting: The Business and Operations of ASCs, Oct. 18-20, 2018 in Chicago. Learn more and register here.

JoAnn Vecchio. Administrator of ASC of WNY (Amherst, N.Y.): Our ASC is working very hard with payers and surgeons to promote positive patient satisfaction and continued positive outcomes that continue to promote our centers strengths. As payers move to outcomes based reimbursement, we want to be sure we have the groundwork completed to ensure a smooth transition. Incorporating physician satisfaction is a big part of our future plans.

Knowing that our surgeons are our best recruitment tool, we want to ensure we are meeting or exceeding their needs as well as providing an environment in which they are truly satisfied. Periodic specialty meetings are key to this satisfaction. With the changing landscape in physician recruitment and increasing competition from inter health system referrals, it becomes so much more important for a freestanding ASC to be able to stand out among the rest. Being able to promote a high satisfaction rating from not only patients but from surgeons as well can reinforce a center's strength.

Jeffrey Flynn, CASC. Administrator of Gramercy Surgery Center (New York City): The landscape is changing dramatically and there are new concepts that each center needs to be willing to embrace to survive and thrive. The first is that the insurance companies are now recognizing us as the lower cost centers of care and for the first time having their facility contract negotiators and not their ancillary services negotiators deal with us.
The second area of growth is the independent physician association groups are teaming up with the payers in cost savings and risk sharing programs. We are the solution for those alliances as we give them the lower cost. For the first time in a long time the primary care physician is driving the care a specialist would give to the freestanding outpatient centers.

Earl Anderson. CEO of Tennessee Orthopaedic Clinic (Knoxville): Both payers and providers are trying to identify appropriate models that define and reward value, but I don't think we've quite landed on the ideal arrangement. However, in orthopedics and in our group, we've made advancements in terms of managing episodes of care and demonstrating value from those episodes. Additionally, consumers define value in healthcare differently by looking for availability and affordability, which is a primary focus of our group.

Andy Poole. CEO of Monticello Community Surgery Center (Charlottesville, Va.): We are one of the centers that truly believes and embraces transparent pricing. Many of any of our prices are online, available on our website. We also offer self-funded employers bundled surgical pricing through direct contracts. It's not currently a huge volume of what we do, but we anticipate growth. More and more it is the individual, or the self funded business that is paying for care. They are both looking for ways to save money while receiving the best care possible. Posting or pricing, and quality metrics, will continue to increase.

As mentioned previously, our partnership with the hospitals that have high-cost structures and less efficient operations make us attractive. But you have to have the right circumstances to develop a beneficial partnership. As health systems become more strategic about the site of services and increase their risk-based contracts, they will need to have lower-cost centers available.

Heather Hilgendorf-Cooley. Administrator of Spring Park Surgery Center (Davenport, Iowa): Our ASC is largely owned by our physicians, so the buy-in to value-based care has been evident since the inception of our ASC in the late 1980s. The expansion of contract negotiations [is our biggest growth opportunity]. With an increase in a variety of performance and quality reporting that Medicare will mandate, the greater the opportunity will be for "open" dialogue with payers. For years, payers have been aware the costs associated with a procedure are much lower in an ASC verses hospital; now with the shift of procedures to ASCs and mandated reporting, ASCs will have an opportunity to be rewarded with perhaps better reimbursement.

More articles on surgery centers:
ASC payer landscape: 4 insights from administrators and leaders
Cardiovascular surgery center opens in Kansas: 4 things to know
7 tips for choosing an ASC for your practice

 

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