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How ASCs Prevent CPT Mismatches with Health System Partners
As of 2023, nearly half of U.S. hospital and health systems have at least one partnership, affiliation, or ownership interest in ASCs. Reports from industry publications indicate ASCs are becoming central to the overall financial strategy of extensive healthcare service networks and this trend is expected to accelerate due to three main factors: pressure to reduce costs, provide care for aging population, and adapt to changes in government regulation as more complex procedures are approved for outpatient environments. -
HOPDs vs ASCs: 3 common procedures
More than 80% of surgeries are now performed in an outpatient setting, according to the Ambulatory Surgery Center Association. ASC procedures are almost always less expensive than in hospital outpatient departments. -
Physician consolidation driving procedures to HOPDs, not ASCs: Study
The vertical integration of physician groups and health systems is resulting in a push to procedures to hospital outpatient departments over ASCs, driving Medicare and patient out-of-pocket costs up, according to a study published July 25 in Science Direct. -
The state on the brink of an ASC boom
ASCs are flourishing across the country, with payers, patients and health systems taking note of the cost-savings potentials. -
The specialists billing more than $5M each year
The average general surgeon billed commercial payers more than $11.6 million each year, according to an Aug. 1 analysis published by healthcare staffing firm AMN Healthcare. -
Stark law amendment clears House committee
A House committee in June unanimously advanced legislation that would make permanent an in-office ancillary services exception to Stark law for drugs provided under Medicare. -
'We could save everyone money': Why payers need to up ASC reimbursements
ASCs in many markets are struggling to secure higher reimbursements and gain leverage in payer conversations. -
10 multimillion-dollar Stark law cases in 2 years
Here are 10 multimillion-dollar Stark law settlements Becker's has reported on in two years: -
What payers don't consider about patients' ASC experience
Charleen Tacket, administrator of Vital Heart & Vein in Houston, joined Becker's to discuss how patient experience is often missed in conversations with insurance companies. -
New Hampshire loosens PA regulations
New Hampshire Gov. Chris Sununu has signed a law stating that certain physician assistants will no longer have to sign a "collaboration agreement" with a physician for their entire career, New Hampshire Bulletin reported July 30. -
5 states cracking down on noncompetes
Here are five states that have passed laws limiting noncompete agreements since Jan. 1: -
ASCs fight for equal reimbursements with HOPDs
ASCs leaders across the country are frustrated with the disparity in reimbursements between ASCs and hospital outpatient departments for the same procedures. -
9 ways for ASCs to improve conversations with payers
Benita Tapia, RN, administrator and director of nursing at Beverly Hills, Calif.-based 90210 Surgery Center, joined Becker's to discuss what's missing in ASC conversations with payers. -
What's missing in ASC conversations with payers
From ASCs' cost-savings potential to patient outcomes, 13 leaders joined Becker's to discuss the gaps in communication between ASCs and payers. -
ASCs fight for leverage with payers
ASCs in many markets are struggling for leverage with payers, up against massive hospital systems and sparse cost information from the insurance companies. -
Company gets $3M after former employees breached noncompetes
A federal jury has ruled that insurance brokerage Lockton Cos. and two brokers will pay $3 million to USI Insurance Services for allegedly breaching noncompete agreements, Business Insurance reported July 23. -
Payer behavior threatening ASC growth
For many ASCs, navigating payer behavior and declining reimbursements is the biggest challenge in maintaining profits. -
10 things to know about rise of Stark law violations
Physicians and other healthcare providers should keep a sharp eye on potential Stark law allegations amid increasing federal scrutiny, law firm Arnold & Porter wrote in an April blog post. -
9 in 10 physicians say prior authorizations hurt patient outcomes
As many as nine out of 10 physicians say that prior authorization has a negative effect on patient outcomes, according to the American Medical Assocation's survey of about 1,000 physicians nationwide. -
Feds crack down on Stark law violations: 5 cases to know
The Department of Justice is doubling down on Stark law enforcement, with an uptick in complaints-in-intervention and Stark-related settlements, law firm Arnold & Porter wrote in an April blog post.
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