The ongoing shift toward value-based payment models has left many healthcare executives weighing the pros and cons of the practice compared to more traditional fee-for-service models.
ASC Coding, Billing & Collections
The Justice Department's new pilot program, which rewards whistleblowers who provide evidence of corporate misconduct, could lead to an uptick of whistleblower activity related to private payer fraud, The National Law Review reported Aug. 15
Most physicians expressed disapproval of relative value unit-based pay in Medscape's 2024 "Physicians and RVUs Report."
On Aug. 1, CMS released the nearly 3,000-page final rules on reimbursement and other inpatient issues, according to an Aug. 7 blog post by Coronis Health.
Differences in reimbursement between ASCs and HOPDs are an ongoing pain point for surgery centers. However, many opportunities to profit off of specialty procedures remain, regardless.
Advertisement
Physicians are eyeing Stark law as the Department of Justice doubles down on enforcement, with an uptick in complaints-in-intervention and Stark-related settlements.
As of 2023, nearly half of U.S. hospital and health systems have at least one partnership, affiliation, or ownership interest in ASCs. Reports from industry publications indicate ASCs are becoming central to the overall financial strategy of extensive healthcare service…
More than 80% of surgeries are now performed in an outpatient setting, according to the Ambulatory Surgery Center Association. ASC procedures are almost always less expensive than in hospital outpatient departments.
The vertical integration of physician groups and health systems is resulting in a push to procedures to hospital outpatient departments over ASCs, driving Medicare and patient out-of-pocket costs up, according to a study published July 25 in Science Direct.
ASCs are flourishing across the country, with payers, patients and health systems taking note of the cost-savings potentials.