What does healthcare's value-based revolution mean for ASC benchmarking?

Carrie Pallardy -

Fee-for-service is receding into healthcare history and value-based care is becoming the new industry standard. Ambulatory surgery centers are no strangers to providing low-cost, high-quality care, but how that equation is demonstrated is dramatically changing. How will ASC benchmarking need to change to meet healthcare's new payment model and gold standard?

"Benchmarking needs to go beyond just reporting numbers and making pretty graphs," says Joan Dentler, MBA, president and CEO of Avanza Healthcare Strategies. "There needs to be an analysis of the outcomes that includes the cost implications, both those from the initial encounter and any ongoing costs related to the patient's condition." Data is no longer the end game; effectively putting that data to work has become the ultimate goal.

Benchmarks will no longer be static goals to achieve, but constantly shifting marks aimed at achieving the greatest value, and thus the greatest reimbursement. "Benchmarking efforts will be refined continuously in order for ASCs to continue to receive the highest possible payments," says Ms. Dentler. "Once benchmark goals are achieved, they will be pushed even higher and/or become more specific and detailed." Clinical and financial, internal and external – ASCs will need to master each area and continue to drive improvement.
 
Value will drive benchmarking forward from a single arm of ASC operations, to an essential strategy ingrained in an ASC's most basic functions. "It has come to the place where ASCs must make benchmarking an integral part of their revenue cycle management function – whether they handle RCM internally or have it outsourced," she says. "There must be a designated individual held responsible for this function within each organization."
 
While administrators and ASC staff may fully grasp the importance of benchmarking, investors may not. "Educating investors on value-based care and how it may impact their returns seems like the biggest hurdle that may need to be addressed," says Ms. Dentler. "Many physicians took on the development and ownership of an ASC as a monetary investment that they assumed would out-perform more traditional investments." In the past, ASCs have closely followed the formula of cutting costs, while simultaneously booting volume and reimbursement – with much success. Now, the gradual, but momentous, shift away from fee-for-service has changed the game. A new level of benchmarking sophistication is required to demonstrate value and constantly push the bar higher.

More articles on ASC benchmarking:
Improving profits through cost-cutting & benchmarking: Q&A with SourceMedical's Ann Geier
Data analytics in ASCs: The future is here
10 articles on innovative surgery center benchmarking

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