When the U.S. Centers for Medicare & Medicaid Services (CMS) announced its new Wasteful and Inappropriate Service Reduction (WISeR) Model this summer, the agency framed the program as an effort to cut down on unnecessary spending, fraud and abuse in Medicare. But for ambulatory surgery centers (ASCs), the six-year test could mean new layers of prior authorization, administrative work and uncertainty around how advanced technologies will be applied in clinical decisions. The voluntary … [Read more...]
Hospital-Affiliated Doctors Least Likely to Use Lower-Cost Settings
Patients of private equity–affiliated physicians are the most likely to receive specialty procedures in lower-cost settings, while patients of hospital-affiliated physicians are the least likely. This is according to a new paper from the Icahn School of Medicine at Mount Sinai that examined the relationship between physician affiliation, site of care and reimbursement for procedures in cardiology, gastroenterology, orthopedics and urology. Using Medicare claims and commercial insurance … [Read more...]
Beyond the Brick and Mortar: Operators and Architects Rethink ASC Design to Meet Demand, Retain Staff
A growing number of ambulatory surgery centers (ASCs) are being built to meet demand for efficiency, patient convenience and higher-acuity capabilities, but designing them requires more than adding ORs and new technology. In a recent ASC News webinar, three leaders from across the industry shared what they are seeing in the field and how forward-looking operators can avoid design and development missteps. The panel featured Michael McClain, managing partner at LeftCoast Healthcare Advisors; … [Read more...]
Debate Grows Over Impact of Site Neutrality on Outpatient Care
The site-neutrality movement, aimed at standardizing payments across outpatient health care settings, has rapidly emerged as an important discussion among ambulatory surgery center (ASC) operators. While potentially beneficial in driving procedures into lower-cost environments by eliminating hospital facility fees, industry leaders have mixed perspectives on its implementation. Michael McClain, managing partner at Left Coast Healthcare Advisors, told Ambulatory Surgery Center News his … [Read more...]
From Anesthesia Coverage to Rising Expenses: Industry Leaders Share Thoughts on 2024’s Top ASC Challenges
While every year brings new challenges and opportunities, 2024 has been especially interesting for ambulatory surgery centers (ASCs) and the patients they serve. The narratives shaping this year include the ongoing shift of higher-acuity procedures into the ASC setting and continued workforce challenges, especially around anesthesiology capacity. Storylines defining 2024 also include robust M&A and joint venture activity, including rumors swirling around one of the largest ASC operating … [Read more...]