Operational costs are soaring for ASCs while reimbursements continue to decline. Some physicians point to a lack of communication from payers regarding ASC's true costs for creating this financial tension.
For some, leaning into the advantages of ASCs in comparison to inpatient settings –– such as cost-effectiveness, lower infection rates and patient satisfaction –– are powerful points in negotiations with payers.
"It seems obvious, but it is critical to articulate how ASCs have been proven to save money long term, in a very high-volume way," Shakeel Ahmed, MD, gastroenterologist and CEO at Atlas Medical Group (St. Louis) told Becker's. "Developing a partnership where both sides are committed to the common mission of quality care at moderate cost is likely to improve negotiations and result in more favorable reimbursement terms."
Having all of these arguments available with relevant and easily presented data is also vital in successful payer negotiations, Tracy Helmer, administrator of Tri-City Surgical Centers in Mesa, Ariz., told Becker's. Factual data, in concise graphical displays, is the quickest way to show the benefits of contracting with an ASC. Think of it as your elevator speech," he said.
"You have limited time to catch their eye with an effective cost-saving idea," Mr. Helmer added. "Help them be the cutting edge of that migration of cases into more well-suited environments that reduce hospital-based risk."
Others urge payers themselves to look at the numbers for a more complete comparison of the costs and savings between ASCs and hospitals.
"If ASCs could get the payers to do a full-scale comparison with other providers in the area, I would like to think they would be more open to adjusting reimbursement rates," Tracie Hark, administrator of Northeast Missouri Ambulatory Surgery Center (Hannibal), told Becker's.
Patient satisfaction is known to be higher in ASCs. In a recent U.S News & World Report survey patients choose ASCs over hospitals for outpatient procedures due to the shortened wait times, faster procedures and more personalized care. Some leaders say this is the most important and compelling aspect to drive home in conversations with payers.
"One thing that comes to mind is the patient satisfaction of being treated in an ASC," Charleen Tacket, administrator of Vital Heart & Vein (Houston) told Becker's. "I think the overall cost reductions and quality are in the conversation, but I often think the patient perspective may be missed in these conversations."