Luke Lambert (CEO of Ambulatory Surgical Centers of America): Circumstances vary quite a bit state to state. The variables that impact whether a state is good or not for orthopedics are:
- How does worker’s compensation pay?
- Do the big payors pay reasonably for orthopedics cases and their implants?
- Is going out-of-network an option?
Not every state is great for orthopedics. California and Texas used to be very strong states but changes to the worker’s compensation program reimbursement have made them less attractive.
Pennsylvania does not have good worker’s compensation reimbursement.
In New York, going out-of-network isn’t an option so success with orthopedics depends on your ability to contract well.
Some states have recently become a better option for orthopedics. For example, Massachusetts used to be terrible for orthopedics but over time we’ve been able to educate payors and improve contracts. Now reimbursement is sufficient to support an orthopedic ASC whereas 10 years ago it wasn’t.
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