With the tremendous changes in the health care industry, it is going evolving with new rules and regulations to match up 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.
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 on 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.