In this session, panelists discussed recent technological, payment and regulatory trends in the ambulatory surgery center (ASC) space, with a focus on implementing and managing bundled payments. The group also explored complex questions raised on structuring and risk, leveraging technology to streamline ASC operations and maximize business outcomes, and structuring anesthesia arrangements for ASCs.
Session panelists included:
Jason Scalise, MD, Chief Growth Officer, HOPCo
Piper Su, Chief Growth Officer, triValence
Tony Maida, Partner, McDermott Will & Emery
Moderator: Ryan Higgins, Partner, McDermott Will & Emery
Top takeaways included:
There has been growing interest in expanding the time frame or scope of services included in a bundled payment. Such a shift in focus could help align behaviors and manage the appropriateness of care. But without appropriate real-time data, there are significant challenges in determining the scope and pricing of a bundle.
As the scope of clinical services provided safely in an ASC has continued to expand, there has been a shift from inpatient to outpatient procedures, and driving them to ASCs. The ASC community can play an integral role in determining scope and pricing of bundles.
Bundled payments have had a somewhat spotty reputation in terms of success. One challenge is that the payor may adjust the target annually, leading to cost-cutting and a race to the bottom until there is no opportunity for additional savings. Going forward, bundled payment programs should be developed with an eye toward sustainability, building in inflationary trends, demographic shifts and trends around acuteness of care.
Technology in the ASC Space
As ASC procedure volume increases, more tech companies are focusing on the ASC sector, but ASCs are still just starting to get access to some of the technologies that other sectors have had for a decade or more.
When evaluating new products, ASCs should ask for references from other users and make sure claims about the technology are backed up by data and user experience.
There are a few different models for providing anesthesia in ASCs. Given the shortage of anesthesia service providers, ASCs may need to be flexible in selecting a model and pay careful attention to Anti-Kickback Statute compliance and corporate practice of medicine considerations.