Vol. 2, No. 3 ASC PHYSICIAN FOCUS
AN ASCA PUBLICATION >> Contents
• 10 Lessons from Running a Cash- Based ASC .............................................2
• Make Plans to Attend 2019’s Largest ASC Conference .................2
• Achieving Effective Medical Director Leadership ..........................3
• ASCs Win Big with Medicare’s Final 2019 ASC Payment Rule ..................3
• Addressing Physician Dynamics When Adding a New Specialty .....4
• Online Tool Provides Average Medicare Prices for ASC and HOPD Procedures ...........................................4
Message from the CEO
and safety in ASCs and hospital outpatient departments (HOPDs) using a voluntary survey that will be available across the country beginning in April 2019.
During October, The Leapfrog Group announced plans to begin collecting and reporting data about quality
Most Important ASC Business Trends in 2019
Four ASC leaders discuss the business trends they expect to drive ASC prosperity in 2019.
Chris Bishop, Chief Executive Officer, Regent Surgical Health in Westchester, Illinois: The bundled payment trend is growing. Providers and payers recognize the opportunity to reduce the cost of certain high- volume, high-cost procedures like total joint replacements and spinal fusions. Structuring the bundle to ensure every partner is aligned and executes is extremely complicated. Fully understanding risk factors and how everyone interacts is crucial to developing a successful program.
For organizations still in the research or concept phase of bundles, it is likely time to accelerate efforts. According to research, bundled payments are the fastest growing payment type, with projected growth of six percent over the next five years. This would place bundled payments at 17% of all medical payment types by the year 2022.
Leapfrog, a national nonprofit organization driven by employers and other purchasers of health care, has been reporting comparable data about hospital inpatient care for 20 years.
To enhance the value of this new program, Leapfrog has been talking with ASCA and inviting individual ASCs to participate and provide feedback during the program’s pilot testing phase.
If your ASC would like to participate, I encourage you to contact Leapfrog’s Help Desk.
Bill Prentice Chief Executive Officer
Tony Kilgore, Chief Executive Officer, Surgical Care Affiliates in Deerfield, Illinois: Value-based care will be increasingly important to the viability of ASCs and in refocusing our health care system on the quadruple aim of cost, quality and patient and provider satisfaction. While value- based contracting offers many benefits, it can present a challenge for ASC operators that are unprepared to manage value-based reimbursement on their own.
The number of facilities with value- based agreements will continue growing over the course of the next year. The key to successful contracting is having the right value levers and potential paths to risk arrangements. We’re continuously evaluating how to support our facilities in pursuit of the quadruple aim and to improve health care in America.
Lori Ramirez, Chief Executive Officer, Elite Surgical Affiliates in Houston, Texas: The landscape of ASCs is changing rapidly. There are fewer players in this space each year and consolidation is rampant. National players are acquiring small ASC operators for financial stability and leverage with managed care payers. In an effort to create efficiency and “work smarter, not harder,” ASC operators are building smaller and more specialized surgical centers of excellence.
In addition, technology is surpassing all expectations as robotics, smart systems and virtual reality become more prominent. These systems will soon also affect routine tasks such as direct patient care. The use of analytics and quality outcomes data will define the success and growth of companies in this space in the next 10-20 years.
Peggy Wellman, Market President – Pacific, United Surgical Partners International in Addison, Texas: There are several trends worth watching. Physician-owned medical groups are taking on more capitated risk for facility services and working with physician networks to expand ASC use. Health systems that manage capitated risk are also focusing on reducing costs and expanding ASC use.
Payers are focusing more on appropriate site of service. Traditional payers are changing benefit designs to promote ASCs where clinically appropriate. Large employers are using bundled arrangements to reduce cost and improve quality.
Recent developments are also expanding the ability for ASCs to safely care for more patients. As the Medicare-approved ASC procedure list expands, this validates the ability of ASCs to support new cases, such as those in cardiology, spine and total joints.
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