Patient satisfaction, bundled payments and high-deductible health plans are top of mind for ASC administrators across the country.
Four ASC and practice administrators spoke to Becker's ASC Review about trends they're observing in their respective markets.
Note: Responses were lightly edited for style and clarity.
Chris Markford, administrator of the Orthopaedic Surgery Center of Clearwater (Fla.): I'm seeing greater interest in bundled programs with the facility as the responsible party. I believe one reason such a model is being pushed on us is so that we move away from a payment model that includes implant reimbursement. The payers are recognizing the fact that coverage for implants only leads to higher surgical costs. Forcing the facility to seek out less expensive options ultimately leads to overall savings for the payer. Ideally, the surgeon's share of the bundle would be impacted by implant choice since he or she would have skin in the game. Building out those bundled models and having your top 20 cases priced out would help any facility be prepared for the eventual request.
Kerri J. Gantt, administrative director of Gastroenterology Associates of S.W. Florida in Fort Myers and Cape Coral: ASCs are positioned to do well in value-based care by the sheer nature of the cost savings and efficiencies inherent to an ASC. For example, gastroenterology physicians can participate in GIQuIC [GI Quality Improvement Consortium], a registry that provides benchmarking information specific to colonoscopies and upper endoscopies. While GI physicians have a lot of good data, the insurance companies are not yet positioned to determine how the provided metrics will save the insurance company money. ASCs must be able to demonstrate quality through accreditation and quality measures.
Marcy DelVecchio, RN, administrator of New Albany-based Central Ohio Surgical Institute: The ASC space has evolved to provide a more efficient flow and is definitely directed at patient safety and satisfaction. Hospital-owned ASCs are very difficult to compete against in a saturated ASC market, as a freestanding ASC.
Pamela Bronson, practice administrator for Exeter, N.H.-based Access Sports Medicine & Orthopaedics: [We've seen] higher deductibles and coinsurance. [Among patients, there's a] lower percent of uninsured, but [a] higher percent of underinsured. This is due to the shift in patient responsibility through higher deductibles, copays and stricter guidelines for covered services for elective procedures. [There are also] more payer-sponsored incentives offered directly to patients as an incentive to use lower-cost providers.
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