Reimbursement for total joints, spine and big ENT cases to go up, ASC admin says

Cori Prisco, DNP, RN, administrator at Fort Lee, N.J.-based Hudson Crossing Surgery Center, joined "Becker's Ambulatory Surgery Centers Podcast" to discuss ASC payer trends in the near future.

Note: This is an edited excerpt. Listen to the full podcast episode here.

Question: How do you see some of the payer trends and contracting changing in the next few years?

Dr. Cori Prisco: I see us being able to use the data we have to show the payers that this just makes sense. We provide value, we provide efficiency. A lot more procedures are going to be brought to the outpatient setting than we've ever seen before, because we're able to contain costs, and payers are going to see that.

We're going to be able to negotiate better rates for some of these larger procedures, like the total joints, bigger ENT cases and spine cases. Centers that aren't doing these cases are looking to expand their programs because the payers are starting to pay for them, and they're starting to pay well for them. 

At the same time, we have to make sure we're verifying benefits and making sure this new technology is all going to be covered so we can still contain costs. And then I think we're seeing more employer direct healthcare plans emerging. So I think individually, surgery centers are going to be negotiating directly with more of these plans.

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