ASCs must develop new payer strategies to remain competitive, Mnet Health Services CEO David Hamilton wrote in a LinkedIn post.
Here are three reimbursement strategies to consider:
1. Risk-sharing payment. As payers seek to share financial responsibility with providers and patients, surgery centers are moving toward bundled payment arrangements that benefit all stakeholders. Although ASCs assume greater responsibility in this arrangement, it can help increase reimbursement while keeping care costs low.
2. Narrow network arrangements. Insurance companies and employers are using narrow networks to gain control of plan spending and to reach providers with superior rates. Providers can increase case volume by joining a narrow network but will have to lower procedure prices. ASCs should weigh the trade-off before making the leap.
3. Price transparency. In the midst of uproar over surprise medical billing, ASCs should deal cautiously with out-of-network patients. Price transparency can help ASCs avoid backlash. It's also important for ASCs to explicitly state procedure rates, ensuring there are no hidden charges or unclear conditions, to avoid getting blacklisted by payers.