In a panel discussion at 9th Annual Orthopedic, Spine and Pain Management-Driven ASC Conference in Chicago on June 10, Brent Lambert, MD, FACS, principal and founder, ASCOA, and Bill Prentice, JD, executive director, ASC Association discussed the expected impact of the Patient Protection and Affordable Care Act on ASCs. The session was moderated by Scott Becker, JD, CPA, partner, McGuireWoods.
Dr. Lambert began by noting that the healthcare reform act's survival is uncertain at this time. Not only could the Supreme Court strike down the law if it is deems unconstitutional under the Commerce Clause, but the current federal budgetary crisis also threatens its funding.
However, if the current reform package does become fully implemented, the direct impact on ASCs is rather nominal, said Mr. Prentice. "No provision in healthcare reform directly focuses on ASCs." Although he added, increased access and the move toward pay-for-performance, both of which are included in the PPACA, could impact ASCs. The move toward pay-for-performance could lead to fewer independent physicians as hospitals expand employment models. Dr. Lambert said, however, that hospital employment of physicians can be a money-losing business model and he suggests it may not be sustainable.
Later in the session, the panel moved its discussion to current legislative priorities for the industry, such as improving reimbursement for ASCs. Mr. Becker asked the panel how those who want greater reimbursement for ASCs but also want to control federal spending manage that dichotomy. Mr. Prentice responded by saying ASCs could actually help reduce spending if CMS would migrate cases away from more expensive settings and into ASCs.
The panel also discussed ACOs — a hot topic coming out of reform. Mr. Lambert said, however, he doesn't expect ASCs to widely participate in ACOs.
Mr. Prentice closed out the session by discussing the opportunity for ASCs to protect their interests under future legislation. He said he has found in his months with the ASC Association that many legislators are not familiar with ASCs but many on the Hill have been "very receptive" to the ASC story on the savings the industry can provide.
Dr. Lambert began by noting that the healthcare reform act's survival is uncertain at this time. Not only could the Supreme Court strike down the law if it is deems unconstitutional under the Commerce Clause, but the current federal budgetary crisis also threatens its funding.
However, if the current reform package does become fully implemented, the direct impact on ASCs is rather nominal, said Mr. Prentice. "No provision in healthcare reform directly focuses on ASCs." Although he added, increased access and the move toward pay-for-performance, both of which are included in the PPACA, could impact ASCs. The move toward pay-for-performance could lead to fewer independent physicians as hospitals expand employment models. Dr. Lambert said, however, that hospital employment of physicians can be a money-losing business model and he suggests it may not be sustainable.
Later in the session, the panel moved its discussion to current legislative priorities for the industry, such as improving reimbursement for ASCs. Mr. Becker asked the panel how those who want greater reimbursement for ASCs but also want to control federal spending manage that dichotomy. Mr. Prentice responded by saying ASCs could actually help reduce spending if CMS would migrate cases away from more expensive settings and into ASCs.
The panel also discussed ACOs — a hot topic coming out of reform. Mr. Lambert said, however, he doesn't expect ASCs to widely participate in ACOs.
Mr. Prentice closed out the session by discussing the opportunity for ASCs to protect their interests under future legislation. He said he has found in his months with the ASC Association that many legislators are not familiar with ASCs but many on the Hill have been "very receptive" to the ASC story on the savings the industry can provide.