Higher-acuity procedures can allay declining ASC reimbursements, administrator says

Adding higher-acuity procedures can help ASCs mitigate declining reimbursement costs, according to Joe Peluso, administrator of Aestique Surgery Center in Greensburg, Pa.

Mr. Peluso spoke with Becker's about how labor and supply costs are hurting ASCs amid declining reimbursements. 

Editor's note: This interview was edited lightly for clarity and brevity. 

Joe Peluso: In an ASC, with prices established by the CMS, the reimbursement for the ASCs, who have experienced increases in expenses (supplies, implants, staff, etc.), have not kept up with the market.

Labor shortages and other supply increases drive up costs. Healthcare is not a free market where prices for goods and services are self-regulated by buyers and sellers in an open market. On the revenue side, the healthcare price is largely fixed by CMS, but on the labor and supply side, competitive free-market forces drive the price. ASCs are not simply able to pass on the cost increases of labor and supplies, whereby current slim ASC operating margins can deteriorate quickly to negative margins.

While integrated healthcare delivery systems may be able to weather the storm for some period of time, many ASCs might not be so resilient.

An important way to reduce the expenses as part of the increasingly higher costs for healthcare services is through a deliberate effort to improve value by approving more complex surgical procedures that can be safely performed in lower-cost ASCs with documented high-quality outcomes and higher-rated patient experiences.

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Featured Webinars

Featured Whitepapers

Featured Podcast