According to the speakers, lift is an industry term that refers to the enhanced revenue an ASC achieves by partnering with a health system, hospital or another entity capable of delivering higher reimbursement on commercial contracts. “Basically, it means doing the same number of cases, but getting more for the same cases,” said Mr. Goettling.
So why should surgery centers consider such a partnerships?
According to Mr. Goettling, there are three main reasons for surgery centers to consider this option:
1. There is a lack of opportunities for surgery centers to grow case volume.
2. Individual ASCs have limited negotiating leverage with commercial payers.
3. Lift can be used as a tool to combat eroding out-of-network reimbursement levels.
The lift results in a change to the bottom line directly, said Mr. Chirillo. The big healthcare organizations, like Tenet for example, can use their leverage to get the best possible deal for the surgery center. “It is such a small piece of what the large for-profits negotiate typically,” he said. But ASCs need to identify the lift opportunity before making the decision, as it is important to make an informed decision. One thing ASCs should do before making a decision is a complete comprehensive billing report analysis down to the CPT level, said Mr. Goettling.
From a purely economic standpoint, obtaining lift makes sense for an ASC, Mr. Goettling said. The challenge of trying to get good rates from payers for an individual center is real.
“The rates that a hospital can get because of their leveraging ability means they can get widely different rates,” he said. “But, of course, you must decide what is best for your surgery center.”
