Commercial insurers are beginning to dedicate significant resources to bundled payments, and they are looking to partner with outpatient surgery centers as they turn a more critical eye toward cost of care.
During a panel discussion at the Becker's ASC 25th Annual Meeting: The Business and Operations of ASCs Oct. 18 in Chicago, Chris Bishop, CEO of Westchester, Ill.-based Regent Surgical Health and Christopher Stine, corporate compliance officer and director of bundled payments at Regent, discussed how more insurers and employers are looking to develop more bundled payments for ASCs.
Though Medicare was an important thought leader for the development of bundled payments, commercial insurers have surpassed the government for the adoption and innovation of these payments. Particularly, insurers are feeling pressure from employers to lower the cost of care by any means necessary.
"Employers are driving bundled payments to ASCs, as they are reading about $60,000 joint replacements and are interested in bundled payment programs that can shift joint care to a more cost-efficient setting," said Mr. Bishop. "Surgery centers must be working on designing these solutions as early adopters will end up with better pricing. Frustration with a traditional approach will lead to a substantial shift for surgery centers."
In time, employers will begin to circumvent insurers entirely and develop bundled payments directly with ASCs. Mr. Stine emphasized that issues such as which party will own the bundle and the timeline of the payments will inevitably raise difficult questions for ASC administrators, but said they should not be afraid to try whatever they think will work as they enter this exciting new space.
"In a rapidly changing environment we have tried throwing everything against the wall to see what sticks," said Mr. Stine. "There is no one-size-fits-all solution."