Becker's ASC Review

33 Thought Leadership What should price transparency look like in ASCs? By Patsy Newitt W ith CMS' price transparency rule becoming an increasingly controversial issue for hospitals, ASC leaders have their own ideas on how centers should communicate pricing. Five ASC leaders spoke with Becker's ASC Review on what they think price transparency should look like in ASCs. Question: What do you think price transparency should look like for ASCs? Greg Schooler. COO of Cincinnati GI: Price transparency is really an integrated part of the intake process for our endoscopy center patients, not just a written policy. Our first priority is to make sure the patient is aware they will be receiving multiple charges for the services rendered. We integrate all our services into our billing state- ments so it is less confusing. Online payment is also available on our website. As an independent practice and endoscopy center, we are very cost competitive and always happy to share our fee structure with patients and give them a cost estimate. If a patient has hardship, we work out a payment agreement in advance so their care is not delayed due to payment status. R. Kemp Massengill, MD. Ophthalmologist in Palos Verdes Estates, Calif.: We definitely think all pricing for both ASCs and hospitals should be easily obtainable by anyone online. Some hospitals and some ASCs charge outrageous fees, and these should be published. is should be by law and not voluntary. Michael Patterson. CEO and President of Mississippi Valley Sur- gery Center & Endoscopy Center (Davenport, Iowa): I think the price transparency phenomenon is challenging for some segments because it can be very dependent on what the surgeon discovers once they begin the procedure. Some procedures are very predictable and, as such, we should be able to accurately project the cost to the patient and be able to share that with them prior to their surgery. Some pro- cedures that have variability to what is needed during the surgery can make that more challenging. I believe every effort should be given to help patients understand their costs upfront. e complexity of payer contracts, coding, co-insurance, co-payments, etc., make it challeng- ing. Our job as an industry should be to educate the patient, allow them to make decisions about their care and be there to support them aer their surgery with any billing questions they might have. is can be resource and cost-intensive, so we need to find the balance between the two opportunities. Monica White. Director of Revenue Cycle of The Surgical Clinic (Nashville, Tenn.): Price transparency should be a better focus for ASCs in general. We have financial counselors on the team that reach out to our patients prior to their surgery to discuss their ben- efits, explain what to expect from a billing perspective and include the three to four bills they will receive from the facility, provider, anesthesia and pathologist. They then set up payment plans and obtain deposits on the frontend. This improves a patient's experi- ence as there is less surprise when any statements are received after his or her procedure. Vishal Mehta, MD. President and Managing Partner of Fox Valley Orthopedics Ambulatory Surgery Center (Geneva, Ill.): I think we all need to be moving towards complete price transparency — with prices posted on the website for all to see. We are in the process of doing this currently. I am confident everyone will be there in the next few years. n 3 ASC trends one CEO is following closely this year By Patsy Newitt R aleigh, N.C., has seen extensive ASC growth in the past year — its population has increased 18.7 percent since 2010. Brain Bizub, the CEO of Raleigh (N.C) Orthopaedic Clinic, spoke to Becker's ASC Review about the growth of his center and the ASC trends he's follow- ing. Question: What three trends should ASC industry leaders follow closely today? Brian Bizub: The first one is benchmark- ing patient satisfaction, data collection and whatever else you can collect. You can then dissect it and find what your strengths and weaknesses are. Patient satisfaction is obviously a huge marker for an ASC. They're our marketing step. Primarily, they're the ones going out saying, 'Have your surgery at ASC, don't have it at the hospital' — benchmarking our ASC against other ASCs. Next is looking at reimbursement and bundled payments — whether bundles make sense for an ASC, or whether they end up being programs that work for a few years but then reimbursement is so reduced that your profit margin gets even smaller in the long run. The other thing I would pay attention to is what President Joe Biden's admin- istration is planning. The House has a bill to hopefully eliminate the Provider Relief Fund tax. We got a penalty from the money that we received to help us through the pandemic. I'm not quite sure how much more stringent they could be putting price- transparency laws in place, which I'm a big fan of. I think patients should have the right to know what a procedure costs. However, what they don't have in most of the transparency models that I've seen on the hospital level is the quality indicators that go along with that. As we all know, pricing is a huge factor in the world today, and everyone's looking at it based on high deductibles and HSA plans. n

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