The effects of low reimbursement rates for procedures performed in ASCs continue to be a source of ongoing stress for physicians.
Here are three ways reimbursement challenges are affecting physicians.
Note: Responses have been lightly edited for length and clarity.
Eric Eskioglu, MD. Former Executive Vice President and Chief Medical and Scientific Officer of Novant Health (Charlotte, N.C.): There is general wariness of decreasing Medicare and private payer reimbursements. Even though we avoided the catastrophic Medicare physician reimbursement cuts, we still ended up with around 4 percent decrease beginning in 2023. When you include the annual inflation rate of 7 percent, this means physicians are making approximately 11 percent less than just a year earlier.
Adam Bruggeman, MD. Spine Surgeon at Texas Spine Care Center (San Antonio): I don't think we have seen the end of consolidation within the healthcare ownership market. The mix of increasing costs and reduced reimbursement will continue to accelerate consolidation, leading to further acquisitions in the ASC and health system space. This trend will continue to drive costs upward, and I ultimately believe will help increase the desire to lift the ban on physician-owned hospitals over time. New growth in the sector will continue to come from ASCs as surgeons recognize the importance of ownership in facilities that are seeing upward trends in reimbursement while physician compensation continues to trend downward.
Peter Whang, MD. Associate Professor in the Department of Orthopaedics and Rehabilitation at Yale University School of Medicine (New Haven, Conn.): Inflation certainly has been an issue for everyone over the last couple of years and ASCs are no different, having been affected by a wide range of increasing costs whether it is surgical implants, staffing, or even just keeping the lights on. However, what is probably more concerning in 2023 is the ongoing inflation in conjunction with the prospect of Medicare cuts. While the reduction may not have been as painful as initially anticipated, even a single digit cut in reimbursement threatens the viability of ASCs given the ever decreasing margins we face year after year. It may sound like a broken record, but the healthcare system needs an overhaul in order to find longer-term solutions to address the inherent inefficiencies that plague us all — physicians, patients and society as a whole.