At the 18th Annual Ambulatory Surgery Center Conference in Chicago, CEO of Health Inventures Chuck Peck gave a presentation titled "The Role of ASCs in the New Healthcare Marketplace." He mentioned several factors having an impact on healthcare, including the debt crisis and recession. The current environment shows an increase in physician partnership with and employment by hospitals. These situations could grow into accountable care organizations in the future.
ACOs could provide advantages for physicians and ASCs. Here are six questions ASCs should ask heading into the future about ACO involvement:
• How are you going to integrate ASCs that are part of our system if you become an ACO?
• How is your ASC going to be reimbursed?
• Will it be treated as a cost or revenue center?
• Will physicians continue to invest or sell out?
• Is the ASC going to become a branch of the hospital OR or will it remain independent?
"Don't take something the physicians love in the ASC and turn it into something they don't want in the hospital inpatient OR," said Mr. Peck. "This model pays for performance according to your ability to integrate quality and cost. It holds providers accountable for providing good and appropriate care, whether you receive bundled or single payments related to the treatment or condition."
Healthcare reform emphasizes providing care efficiently at a low cost with good outcomes, which ASCs have shown is possible in their facilities. However, Medicare and payors still reimburse ASC procedures at a lower rate than they reimburse hospitals, and there is no sign these rates will increase any time soon. The key concepts for optimizing reimbursement are based on the ASC's ability to prove the quality of procedures done in the facility and provide cost-savings for patients and payors.
"Most of us in the ASC industry have been seeing flat rates, which will continue over the next couple of years," says Mr. Peck. "We are telling our clients they should prepare to operate entire organizations based on the assumption that the best rates going forward will be the current Medicare rates."
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ACOs could provide advantages for physicians and ASCs. Here are six questions ASCs should ask heading into the future about ACO involvement:
• How are you going to integrate ASCs that are part of our system if you become an ACO?
• How is your ASC going to be reimbursed?
• Will it be treated as a cost or revenue center?
• Will physicians continue to invest or sell out?
• Is the ASC going to become a branch of the hospital OR or will it remain independent?
"Don't take something the physicians love in the ASC and turn it into something they don't want in the hospital inpatient OR," said Mr. Peck. "This model pays for performance according to your ability to integrate quality and cost. It holds providers accountable for providing good and appropriate care, whether you receive bundled or single payments related to the treatment or condition."
Healthcare reform emphasizes providing care efficiently at a low cost with good outcomes, which ASCs have shown is possible in their facilities. However, Medicare and payors still reimburse ASC procedures at a lower rate than they reimburse hospitals, and there is no sign these rates will increase any time soon. The key concepts for optimizing reimbursement are based on the ASC's ability to prove the quality of procedures done in the facility and provide cost-savings for patients and payors.
"Most of us in the ASC industry have been seeing flat rates, which will continue over the next couple of years," says Mr. Peck. "We are telling our clients they should prepare to operate entire organizations based on the assumption that the best rates going forward will be the current Medicare rates."
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