The ‘glaringly inappropriate’ ASC reimbursement policy 

CMS pitched a 2.8 percent average rate increase for ASCs next year, and many leaders feel the move isn’t enough to offset increasing costs. 

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Larry Sobal, CEO of Heart and Vascular Institute of Wisconsin in Appleton, joined Becker’s to discuss how this move could widen the reimbursement gap between ASCs and hospitals. 

Question: How do you feel about CMS’ pitch for a 2.8 percent average rate increase for ASCs next year? 

Editor’s note: This response was edited lightly for clarity and length. 

Larry Sobal: As more procedures migrate to ASCs, particularly in cardiology where I work, the reimbursement difference between ASCs and hospitals becomes more glaringly inappropriate.  Particularly when you consider that a new ASC is likely to have as good, or likely better, technology, versus increasingly antiquated hospital catheterization labs. In addition, past CMS fee schedule increases suggest that hospitals will receive higher and more consistent increases over time versus ASCs. Should reimbursement be the same between hospitals and ASCs, in other words, “site neutrality?” Possibly not. But annual increases for ASCs should be at the same or similar rates for hospitals, and 2.8 percent will only widen that gap instead of closing it or keeping pace.

At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.

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