With the tremendous changes in the health care industry, it is going evolving with new rules and regulations to match up with the people’s expectations and demands. It is one of the biggest transition phases wherein the independent practices are transforming their independent practices to value-based care ASC Billing Facilities.
Ambulatory surgery centers (ASCs) are health care facilities that offer patients the convenience of having surgeries and procedures performed safely outside the hospital setting. Since their inception more than four decades ago, ASCs have demonstrated an exceptional ability to improve quality and customer service while simultaneously reducing costs. At a time when most developments in health care services and technology typically come with a higher price tag, ASCs stand out as an exception to the rule.
A Transformative Model
As our nation struggles with how to improve a troubled and costly health care system, the experience of ASCs is a great example of a successful transformation to value-based care.
ASCs perfectly support this ambition in several ways. For one, the physician-led structure on which ASCs are built follows systematic value-based care platforms, whereby a physician’s investment and engagement in the center invites collective assurances for quality and safety.
Further, these centers are able to provide a better overall experience because there are fewer complications muddling the process, such as unscheduled emergency procedures that bump already-scheduled patients and dedicated surgical teams. These more efficient processes also improve productivity and cost management: surgeons can perform up to two more procedures every day, and more predictable schedules reduce staff overtime costs.
Implementing Value-Based Care Model
Because the fee-for-service medicine model is going away, and reimbursement based on value is the new system, hospitals must provide community access points for convenient and cost-effective care. In addition to the construction of more ambulatory centers, hospitals must also invest in the latest information technology.
In Order to Maximize the ASC Reimbursements:
Providers and outpatient surgery centers need to focus on improving in terms of operational and financial perspectives.
The idea here is to ensure that the organization achieves set scores to avoid penalties and lower reimbursement rates.
Outpatient surgery centers need to consider participation in value-based payment models, such as bundled pricing, pay-for-performance, and shared savings.
Attention needs to be paid to the commercial payers, as they make up a significant percentage of ASC’s payer mix.
Because of the shared-risk arrangements between surgery centers and payers, meaningful conversations need to take place between the two regarding contracts.
As the market continues to change bringing growth to the ASC sector, several medical billing and coding companies have shown keen interest and commitment in helping ambulatory surgery centers which are designed to identify and dive into your most pressing operational issues via an expansive suite of intuitive analytics, reports, and dashboards.
As long as outpatient surgery clinics employ effective strategies to manage revenue cycle; acquire ideal payer contracts, and meet the rising challenges in the industry ASC facilities will thrive nicely in a value-based payment model.
Our experienced billing and coding staff are on top of the latest CMS and payer changes, including handling ASC claims. Reach us at 888-357-3226 or by email to learn how we can save you time and money while improving your revenue cycle.
FAQs
1. How are ASCs in Texas adapting to value-based care models?
- ASCs in Texas are embracing value-based care by focusing on quality and cost-efficiency. They streamline operations, improve patient outcomes, and reduce costs, making them ideal for providing accessible and affordable surgical care outside traditional hospital settings.
2. Why are ASCs in Texas considered a cost-effective option for surgeries?
- Texas ASCs are cost-effective because they minimize overhead expenses, allowing surgeons to perform more procedures daily. Predictable scheduling and dedicated surgical teams help reduce complications and overtime costs, enhancing both productivity and patient satisfaction.
3. How do value-based payment models impact ASC reimbursement rates in Texas?
- In Texas, value-based payment models like bundled pricing and pay-for-performance directly affect ASC reimbursements by linking payments to quality measures. Meeting set scores helps Texas ASCs avoid penalties and maintain higher reimbursement rates.
4. What strategies are Texas ASCs using to maximize revenue in a value-based care environment?
- To maximize revenue, Texas ASCs are focusing on securing favorable payer contracts, utilizing analytics to optimize operational efficiency, and actively participating in value-based care programs like shared savings and pay-for-performance.
5. How can Texas ASCs improve partnerships with commercial payers under value-based care?
- Texas ASCs can improve partnerships with commercial payers by engaging in shared-risk contracts, fostering open communication about goals, and working together to align on cost-effective and high-quality care standards.
