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New Jersey ASCs Look to Partner, Be Acquired as Out-of-Network Reimbursement Disappears

More ambulatory surgery centers are looking to partner or be acquired by hospitals, as payor reimbursements ratchet down and out-of-network becomes an increasingly infeasible strategy, according to an NJBiz report.

According to Larry Trenk, market president of USPI and president of the New Jersey Association of Ambulatory Surgery Centers, surgery centers have historically profited from an out-of-network strategy, meaning they don’t negotiate commercial contracts with insurers and instead bill their fees directly to the payor. But pressure from payors – including threats to the professional contracts of physicians who bring their cases to surgery centers, and incentives for patients to choose in-network facilities – has made contract negotiation more attractive.

USPI has worked with Meridian Health in Monmouth and Ocean counties in New Jersey, building or acquiring six ASCs over 13 years. 

Hospitals are also looking to acquire ambulatory surgery centers, as they seek market share in the midst of healthcare reform implementation. The advent of ACOs means that hospitals will be seeking high-quality, low-cost providers to keep expenses down, and ASCs could present an opportunity.

Joseph A. Trufino, president and CEO of the Atlantic Health System, told NJBiz that hospitals are acquiring surgery centers to coordinate care between providers and establish a dedicated base of patients.

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