Becker's ASC Review

10 ASC MANAGEMENT Stark regulations tightened on physician group pay for ancillaries: 5 details By Laura Dyrda T he Stark regulations governing pay methodology for ancillary services in group practices will change Jan. 1, prompting some organizations to rewrite their policies. Shumaker, Loop & Kendrick outlined the updates in a report from JDSupra. Five details: 1. CMS will require medical practices to set the methodology for calculating distribution from designated health services, or ancillary services, prospectively. e methodology for distributing profits from services like imaging and physical therapy should be locked in be- fore groups earn income from those services. 2. Medical groups are not able to tie ancil- lary distributions directly to physicians ordering the service. Instead, groups can split profits "on a prorata basis or based on personal professional productivity (ex- cluding any revenues from the provision of [designated health services] or DHS encounters)," according to the report. 3. CMS clarified medical groups are re- quired to allocate profits, not revenues, from the ancillary services, in a Dec. 2, 2020, announcement. 4. Medical groups will be required to use the same methodology for calculating ancil- lary service distribution for all service lines. Large groups can use different methodolo- gies for allocating profits to subgroups of at least five physicians within the larger organization. 5. e final rule also made it clear that distribution methodology can't be based on the volume of services a physician orders for non-Medicare patients.n Physician signing bonuses reach $240,000, ASCs promote long term ROI By Laura Dyrda T he high end of physician signing bonuses reached well into six figures last year, according to the Merritt Hawkins 2021 Review of Physician and Advanced Practitioner Recruiting Incentives, released Aug. 9. While the median physician signing bonus was $29,656, physicians on the high end of the spectrum were offered $240,000 or more. While signing bonuses at the high end of the spectrum were around $140,000 more than they were in 2019-20, they were down from the 2015-16 high of $350,000. Hospitals often are able to provide large signing bonuses, while physicians have to spend money initially to open their own practices or buy into a surgery center. Over time, physicians in independent practice tend to receive higher average compensation than physicians employed by hospitals. The Medscape Physician Compensation Report 2021 shows employed physicians earned $300,000, compared with independent physicians who earned $352,000 on average last year. "The younger surgeons, sometimes they come out [of medical school] with a lot of debt, so that's a problem, and I understand that," said Chris Blackburn, administrator of South Kansas City Surgicenter in Overland Park, Kan. "They may not have a chunk of change to invest in a surgery center. How can I help with that? I work with bankers to help these new surgeons and get them down the road. Because long term, this is what they're going to want to do. An ASC is a good investment." Ms. Blackburn said she also attracts surgeons to the center by promoting low surgical site infection rates, high patient satisfaction scores and quick operating room turnover times, which allow surgeons to perform more cases per day. n Carle Health's $70M campus with ASC: 3 updates By Patsy Newitt U rbana, Ill.-based Carle Health is building a near- $70 million campus with an ASC. Three things to know: 1. Carle Health has erected the steel skeleton on the four-story medical office building and two- story ASC in Danville, Ill., The News-Gazette reported Sept. 12. 2. The facility will be approximate- ly 152,000 square feet across 17 acres. 3. Completion of Carle at the Riverfront is expected in De- cember 2022 with occupancy in early 2023. Carle will relocate its Danville ASC to the campus, which will host more than 250 employees. n

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