Becker's ASC Review

9 ASC MANAGEMENT Utah ASC director on how cash- pay pricing can grow profit margins — 4 takeaways By Angie Stewart C ash-pay surgery is a growing trend in the U.S., according to Maria Todd, PhD, director of business development at St. George (Utah) Surgical Center. Four takeaways from Dr. Todd's Linke- dIn post: 1. Under insurance-based pric- ing, ASCs are expected to negotiate contracts with a variety of payer types according to the payers' terms and conditions. 2. Insurance-based pricing causes pro- viders to absorb various transactional expenses, such as revenue management costs, costs associated with payment de- lays and compliance-related expenses. "e requirements and duties beyond direct patient care erode margins or ad- vantages associated with the maximum negotiated fees. In some cases, the performance requirements to get the money you've earned taking care of pa- tients can turn the value of the contract upside down," Dr. Todd said. 3. Cash-pay pricing is (and should be) a different rate than the insurance-based price, Dr. Todd said. e latter includes costs of labor intensity, payment delays and other administrative variables, while cash-pay prices only need to encompass the expenditure associated with collecting the cash and depositing it in the bank. 4. Cash-pay pricing gives providers greater control over how their ser- vices are sold and excludes factors that influence price calculations, ultimately increasing the providers' profit margin, according to Dr. Todd. n World's 10 biggest healthcare companies by revenue By Rachel Popa M cKesson Corp.and UnitedHealth Group are two of the world's largest healthcare companies by revenue, according to Largest.org, which ranks companies based on revenue and other factors. 1. McKesson Corp. - $208.3 billion 2. UnitedHealth Group - $201 billion 3. CVS Health - $184.7 billion 4. AmerisourceBergen Corporation - $153.1 billion 5. Cardinal Health - $129.9 billion 6. Express Scripts Holding - $100.06 billion 7. Anthem - $89.06 billion 8. Kaiser Permanente - $72.7 billion 9. Aetna - $60.5 billion 10. Humana - $53.7 billion Laser Spine Institute under fire over insurance handling — 5 key details By Angie Stewart F lorida authorities have received six complaints about Laser Spine Institute since the Tampa, Fla.-based practice abruptly shuttered in March, according to local station WBTV News. Five key details: 1. The complaints filed with the Florida Attorney General's office include one from Norman Towell, who received treatment at Laser Spine Institute for debilitating back pain. 2. A Laser Spine Institute representative allegedly told Mr. Towell that the procedure would cost $13,400 up front and that two financing companies could provide loans to cover the expenses. 3. After Mr. Towell acquired the loans and underwent surgery, he contacted his insurance company, Aetna. A payer representative reportedly told him that Laser Spine Institute hadn't filed for coverage for the claim, and that Mr. Towell shouldn't have paid more than $275 after pre- authorization. 4. Aetna told WBTV via email that it would forward Mr. Towell's case to its "executive response team." Laser Spine Institute didn't return the outlet's request for comment. 5. A separate complaint alleges Laser Spine Institute cashed checks from a patient's insurer that were intended for the beneficiary. WBTV did not provide details on the other four complaints. Laser Spine Institute shut its doors on March 1 after it failed to secure financing to continue operations. The company closed ASCs in Tampa, Cincinnati, Scottsdale, Ariz., and St. Louis at that time. During the six months prior to the closing, the ASC company had shuttered three other centers in an attempt to reduce its operating cost structure. When the ASCs closed, Laser Spine Institute re-directed patients to other local providers and 1,000 employees lost their jobs. n

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