Julie Camardella, executive administrator of the Chesapeake, Va.-based CRH Ambulatory Surgery Centers, joined Becker's to discuss payer behavior and her biggest concerns regarding reimbursements.
Editor's note: These responses were edited lightly for brevity and clarity.
Question: What are your biggest concerns regarding reimbursements right now?
Julie Camardella: Reimbursements for ASCs have not kept up with increased costs associated with staffing, equipment maintenance service agreements and surgical supplies. The ASC landscape will become untenable if this discrepancy continues.
While advancements are always being made in the implant/medical device space, the costs of these products are often cost prohibitive to use in the ambulatory surgery setting because reimbursements are so much lower. In my experience, the discrepancy between ASC costs and ASC reimbursement causes reverse migration back to the hospital setting where CMS and private payers pay a lot more for the same patient outcome.
ASCs should be a part of the solution. They are known for their high quality, low infection rates, high patient satisfaction ratings and cost-effective care. All of these carry great value and should be considered when setting ASC reimbursement rates.
Q: Do you see payers pushing procedures to the ASC setting or away from the ASC setting?
JC: As an unintended consequence of the lower Medicare reimbursement model, I see a potential for payers shifting away from the ASC setting. In this scenario, both payers and patients pay more for the same procedure and service.