From Optum acquisitions to a CMS rule, here are five major moves that shook up the ASC industry in 2023:
1. In November, CMS finalized a 3.1% payment rate for ASCs and added 11 procedures to the ASC-covered list that were not included in the proposed rule, including total shoulder arthroplasty.
CMS also finalized its plans to extend the five-year interim period of using the same pay update factor for ASCs and hospital outpatient departments through 2025, citing patients avoiding elective procedures during the COVID-19 pandemic.
2. In October, HHS' Office of the Inspector General confirmed broad protection of employee safe harbor under anti-kickback laws in a recent ruling involving physician ownership of an ASC. The OIG considered a proposed bonus compensation for physician employees of a physician practice, which operates two ASCs. Under the proposed methodology, physicians who performed procedures at the ASCs would receive 30% of the net profits from the ASC facility fee.
The OIG ruled that although the methodology would violate anti-kickback law, it would be protected under the statutory exception and regulatory safe harbor for employees, given that the physician recipients would need to be employees of the practice.
3. In October, AmSurg separated from Envision Healthcare, its former parent company, which filed for bankruptcy earlier this year. It has since emerged under new ownership as a separate and independent entity from Envision.
As a result of the emergence, AmSurg's current president, Jeff Snodgrass, will serve as president and CEO. He connected with Becker's in November to discuss the company's next chapter.
4. In September, Optum, the country's largest employer of physicians, doubled down on its acquisitions of physician groups with its $3.3 billion addition of Baton Rouge, La.-based home and hospice care provider Amedisys.
The deal is facing scrutiny from the Justice Department, which requested additional information about the proposed merger in August.
5. While hospitals are facing certificate-of-need obstacles to build in many markets, some ASCs are finding it easier to receive clearance. In South Carolina, Florence, S.C.-based McLeod Health began construction this fall on a $15.3 million ASC, though four proposed hospitals are being held up by state certificate-of-need laws.
Myrtle Beach-based Grand Strand Health, Florence-based McLeod Health, Georgetown-based Tidelands Health and Conway Medical Center have proposed a new hospital or upgrades to an existing facility in the region but are on hold due to legal challenges.
South Carolina's certificate-of-need program is set to expire in 2027, which would free up the regulatory process for many new facilities.