Ms. Bronson shared her thoughts on outpatient reimbursement trends with Becker’s ASC Review.
Note: Responses were lightly edited for style and clarity.
Question: What are the biggest payer and reimbursement changes your practice has experienced over the past two to three years?
Pamela Bronson: [We’ve seen] higher deductibles and coinsurance. [Among patients, there’s a] lower percent of uninsured, but [a] higher percent of underinsured. This is due to the shift in patient responsibility through higher deductibles, copays and stricter guidelines for covered services for elective procedures. [There are also] more payer-sponsored incentives offered directly to patients as an incentive to use lower-cost providers.
Q: Are you seeing more risk-based contracts or price transparency in your market?
PB: Yes. Payers are creating more user-friendly databases for patients to find lower-cost providers.
Q: What is your strategy for working with patients who have high-deductible health plans?
PB: [We use] credit-card-on-file systems for balances due [and] more deposit collection efforts for expensive elective procedures or cost of goods sold like durable medical equipment.
Q: How do you approach payer negotiations?
PB: We position ourselves as a high-quality, lower-cost provider for their network to create value that should be rewarded in higher reimbursement than standard rates.
Q: What’s your best advice for ensuring payer negotiations are successful?
PB: Data, data, data — on both price and quality.
To participate in future Becker’s Q&As, contact Angie Stewart at astewart@beckershealthcare.com.
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