Payers should adjust reimbursements for more cardiology procedures to align with the quality and cost advantages of these services in the ASC setting, one ASC leader says.
Tiffany Zachary is the administrator of Manhattan (Kan.) Specialists Center. She recently spoke with Becker's about the changes she wants to see from payers in 2024:
Editor's note: This response was lightly edited for clarity and length.
Question: What changes do you hope to see from payers in 2024?
Tiffany Zachary: I would expect payers to recognize both the quality and the cost advantages of shifting some of the lower risk procedures to the ambulatory surgery setting. Recently, Medicare approved the placement of the CardioMEMS pulmonary pressure monitoring system in the ASC setting. This is a testament to the shift of more and more cardiovascular procedures confined to the hospital setting, until now. I would expect the commercial payers to follow this lead. Given the highly successful demonstration of performance of cardiovascular procedures in this setting, I would expect the reimbursements to improve in the ambulatory setting for most cardiovascular procedures, to encourage both payers and patients to look at this option. With the patient getting more aware of price transparency, this may become inevitable for some of the procedures. One classic example is pacemaker/implantable cardioverter defibrillator generator changes, which are now often performed in hospitals at a much higher cost. Though they are also done at ASCs, the awareness of this option seems to be lacking.