Top 3 ASC Payors by Volume for Orthopedics By Region

Here are the top three ASC payors by volume for orthopedics by CMS region, according GENASCIS’s database of information from more than 700 ASCs across the country.

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Region 1 (Conn., Mass., Maine, N.H., R.I., Vt.)

1. BCBS Anthem — 42 percent
2. Medicare — 21 percent
3. CIGNA HMO — 20 percent

Region 2 (N.J., N.Y., V.I., P.R.)
1. BCBS PPO — 43 percent
2. Other PPO — 17 percent
3. AETNA PPO — 15 percent

Region 3 (Del., D.C., Md., Md., Pa., Va., W.Va.)
1.    BCBS PPO — 52 percent
2.    Medicare — 16 percent
3.    Other PPO — 13 percent

Region 4 (Ala., Fla., Ga., Ky., Miss., N.C., S.C., Tenn.)
1.    BCBS PPO — 55 percent
2.    Medicare — 21 percent
3.    Workers’ compensation — 12 percent

Region 5 (Ill., Ind., Mich., Minn., Ohio, Wis.)

1.    BCBS PPO — 32 percent
2.    BCBS ANTHEM — 22 percent
3.    Medicare — 18 percent

Region 6 (Ark., La., N.M., Okla., Texas)
1.    BCBS PPO — 33 percent
2.    Medicare — 21 percent
3.    United Healthcare PPO — 17 percent

Region 7 (Iowa, Kan., Mo., Neb.)

1.  BCBS PPO —37 percent
2.  Medicare — 21 percent
3.  Workers’ compensation — 18 percent

Region 8 (Colo., Mont., N.D., S.D., Utah, Wyo.)
1.    BCBS PPO — 27 percent
2.    Other PPO — 19 percent
3.    (tie) BCBS Anthem — 18 percent
(tie) Workers’ compensation — 18 percent
(tie) Medicare — 18 percent

Region 9 (A.S., Ariz., Calif., M.P., Guam, Hawaii, Nev.)

1.  BCBS PPO — 42 percent
2.  Workers’ compensation — 19 percent
3.  Medicare — 18 percent

Region 10 (Alaska, Idaho, Ore., and Wash.)
1.  BCBS PP — 37 percent
2.  Other PPO — 27 percent
3.  Workers’ compensation — 15 percent

Learn more about GENASCIS.

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