Between 2023 and 2024, spine ASCs have faced challenges when it comes to denial rates, but they’re seeing progress in areas including billing speed and prior authorizations, according to data from HST Pathways.
HST Pathway’s report represents 131,973 unique cases across 300 centers. Here are 10 things to know:
1. Operating room utilization declined from 25% in 2023 to 23% in 2024.
2. Prior authorizations increased from 38% in 2023 to 47% in 2024.
3. Insurance verification rates were flat between 2023 and 2024 at 80%.
4. Outpatient spine cancellation rates saw a small improvement, dropping from 22.7% in 2023 to 22.2% in 2024.
5. Insurance-related cancellations are 9%, above the 3.6% average across all specialties.
6. Patient data collection rose from 65% in 2023 to 67% in 2024.
7. Billing has become more efficient with the average days to bill falling from 10 days in 2023 to eight days in 2024.
8. Claims denial rates were 10% for outpatient spine cases in 2024, an increase from 9% in 2023.
9. Net revenue per case in 2024 fell 8.7% compared to 2023. The average net revenue per case in 2024 is $6,255.
10. Average case volume declined from 65 per month in 2023 to 60 per month in 2024.
