ASCs are recognized by many payers as high-quality, cost-effective sites of service, but some centers are still struggling to secure reimbursements.
Matthew Ewasko is the administrator of Physicians Alliance Surgery Center in Cape Girardeau, Mo. He spoke with Becker's about his ASC's biggest obstacles with private payers and how his center has recovered from COVID-19.
Editor's note: This interview was edited lightly for clarity and brevity.
Question: What are your biggest obstacles with private payers?
Matthew Ewasko: Our biggest obstacles continue to be ensuring that we are being reimbursed properly according to our contracts. Payers are increasingly attempting to not pay for procedures at the correct rates. This is adding workloads on our billing department, since they are chasing down payments or gathering additional documents so that we can dispute any claim denials.
In the future, I see our facility needing to include additional carveouts in our contracts so that the more complex cases can be reimbursed properly so that they can be done in our facility. These cases should be done in the ASC setting, but we must ensure that we get the necessary reimbursement.
Q: Has your center recovered from COVID-19?
ME: Many of our service lines have recovered from a case volume standpoint, but we still have a few in which volume is below historical volume. In speaking with our surgeons, I continue to hear that patients are hesitant to come to a medical facility for an elective procedure while the pandemic is still a part of our daily lives. At the same time, others have just accepted this as something that we will have to live with for a while, and gone about their regular daily routines.
Financially, we are still trying to adjust to the ever-increasing cost of supplies for our facility. At the beginning of the pandemic, [personal protective equipment] costs increased due to the limited supply caused by rapid increased demand. Now we continue to see supply costs increase, but it is seen on all items due to lower inventories and increased back-order delays. I think we need to start looking at our historical data and truly ask ourselves if we will return to what we once considered normal, or if we need to develop a new normal moving forward.