Low reimbursements, especially when combined with high rates of inflation, have become one of the greatest challenges ASCs are up against in 2023.
Three notes on ASC reimbursement, according to the VMG Health "2023 Healthcare M&A Report":
1. CMS released the 2022 Hospital Outpatient Prospective Payment System and the ASC payment system policy changes and payment rates final rule on Nov. 1, 2021. The final ruling increased the ASC conversion factor by 2 percent in the 2022 calendar year. This was a decrease from the 2021 calendar year final rule, which increased ASC payment rates by 2.4 percent.
2. CMS' ASC payment final rule for the 2023 calendar year was released Nov. 1, 2022. This final rule resulted in overall expected growth in payments equal to 3.8 percent in the 2023 calendar year. The increase was determined based on a projected inflation rate of 4.1 percent less the reduction of 0.3 percent mandated by the Affordable Care Act.
3. The 3.8 percent growth in payments for 2023 is the largest increase in projected payments year over year. However, the increase still may not be enough to offset the effects of inflation.