The migration of complex cases to ASCs can save employers, patients and payers money, Naya Kehayes, principal and ASC practice leader at ECG Management Consultants, said during the California Ambulatory Surgery Association's ASC Summit.
Amid the push to drive down costs, some payers are offering benefits to patients who choose ancillary facilities, such as ASCs, Ms. Kehayes said in the April meeting. Payers are stipulating, in some cases, that hospitals won't get paid for a case that can be performed safely in an ASC.
Here are her five key consideration in how ASCs can further drive down healthcare costs:
- Access to reasonable and adequate reimbursement enables surgery migration to ASCs.
- Hospitals that own ASCs are more supportive of migration when the reimbursement gap between hospital outpatient departments and ASCs is reduced.
- Offsetting the losses for hospitals for higher-acuity cases that remain in the hospital may be necessary to ensure viability for the hospital when ASC rates allow for migration of high volume and valued surgery.
- Independent physician groups who own ASCs are more vulnerable to consolidation and hospital employment if reimbursement is inadequate.
- All ASCs are not created equal — variations in service offerings and access to providers must be considered to optimize a shift in case volume.