With CMS' price transparency rule becoming an increasingly controversial issue for hospitals, ASC leaders have their own ideas on how centers should communicate pricing.
Five ASC leaders spoke with Becker's ASC Review on what they think price transparency should look like in ASCs.
Editor's Note: These responses were edited lightly for clarity.
Question: What do you think price transparency should look like for ASCs?
Greg Schooler. COO of Cincinnati GI: Price transparency is really an integrated part of the intake process for our endoscopy center patients, not just a written policy. Our first priority is to make sure the patient is aware they will be receiving multiple charges for the services rendered. We integrate all our services into our billing statements so it is less confusing. Online payment is also available on our website. As an independent practice and endoscopy center, we are very cost competitive and always happy to share our fee structure with patients and give them a cost estimate. If a patient has hardship, we work out a payment agreement in advance so their care is not delayed due to payment status.
R. Kemp Massengill, MD. Ophthalmologist in Palos Verdes Estates, Calif.: We definitely think all pricing for both ASCs and hospitals should be easily obtainable by anyone online. Some hospitals and some ASCs charge outrageous fees, and these should be published. This should be by law and not voluntary.
Michael Patterson. CEO and President of Mississippi Valley Surgery Center & Endoscopy Center (Davenport, Iowa): I think the price transparency phenomenon is challenging for some segments because it can be very dependent on what the surgeon discovers once they begin the procedure. Some procedures are very predictable and, as such, we should be able to accurately project the cost to the patient and be able to share that with them prior to their surgery. Some procedures that have variability to what is needed during the surgery can make that more challenging. I believe every effort should be given to help patients understand their costs upfront. The complexity of payer contracts, coding, co-insurance, co-payments, etc., make it challenging. Our job as an industry should be to educate the patient, allow them to make decisions about their care and be there to support them after their surgery with any billing questions they might have. This can be resource and cost-intensive, so we need to find the balance between the two opportunities.
Monica White. Director of Revenue Cycle of The Surgical Clinic (Nashville, Tenn.): Price transparency should be a better focus for ASCs in general. We have financial counselors on the team that reach out to our patients prior to their surgery to discuss their benefits, explain what to expect from a billing perspective and include the three to four bills they will receive from the facility, provider, anesthesia and pathologist. They then set up payment plans and obtain deposits on the frontend. This improves a patient's experience as there is less surprise when any statements are received after his or her procedure.
Vishal Mehta, MD. President and Managing Partner of Fox Valley Orthopedics Ambulatory Surgery Center (Geneva, Ill.): I think we all need to be moving towards complete price transparency — with prices posted on the website for all to see. We are in the process of doing this currently. I am confident everyone will be there in the next few years.