At the 20th Annual Surgery Centers Conference on Oct. 25, industry experts shared insight on the current ASC industry and predictions for 2014.
Pulitzer Prize winner and Editor of The Washington Post Bob Woodward moderated the panel lead by Nap Gary, COO of Regent Surgical Health; Richard Wohns, MD, JD, MBA, of NeoSpine; I. Naya Kehayes, MPH, of Eveia Health Consulting and Management and Scott Becker, JD, CPA, partner of McGuireWoods.
Mr. Woodward opened the session by asking the panel to weigh in one of the biggest issues in healthcare: the Patient Protection and Affordable Care Act. Dr. Wohns pointed out that physicians will see a volume increase in the patient pool, including a great amount of patients being directed to ASCs. There is particularly a growing opportunity for spine in the outpatient setting, including procedures such as discectomies and fusions. “I think we are on the right track, but we are missing a lot of foundation,” said Dr. Wohns.
Though ambulatory surgery centers continually prove to be safe and cost-effective alternatives to hospitals, there is uncertainty whether or not the federal government understands these advantages. Medicare reimbursement for ASCs in comparison to reimbursement for hospital outpatient departments has been declining for years. ASCs now receive 58 cents per every dollar that hospitals receive. Yet, ASCs are poised to save Medicare $57.6 billion over the next decade. “In an era when the focus is on improved quality and cost savings, ASCs stand as a real model,” said Mr. Gary.
“We need to look at how Medicare sets the bar for approved procedures and reimbursement with commercial payers,” said Ms. Kehayes. She recommends ASC leaders advocate for the industry and call for a change in the list of procedures allowed in ASCs and for change in how procedures are reimbursed. ASCs can demonstrate excellent patient satisfaction and quality outcomes, both of which can serve as leverage to change reimbursement rates from both government and commercial payers. “The floodgates won’t really open until Medicare approves these goals,” said Mr. Becker.