Becker's ASC Review

22 Thought Leadership ASC leaders weigh in on supply chain issues By Patsy Newitt E ven as COVID-19 cases decline nation- ally, supply chain disruptions related to the pandemic are still hurting ASCs' ability to function. Here are six ASC leaders' thoughts on the state of the supply chain: Amar Setty, MD. CEO of Premier (Balti- more): e fragile supply chain for pharma- ceuticals led to frequent and unpredictable drug shortages for years. COVID-19-related supply shocks have been equally profound — from syringes, needles and fluids, disposables, oxygen, etc. Shortages are leading to price increases. We are dealing with delays, cancel- lations and a lot of stress. e administration could do more to stimulate supply through policies to increase supplies. Joe Peluso. Administrator of Aestique Surgery Center (Greensburg, Pa.): Unlike past crises, CMS is restoring the Medicare inpatient-only list while ignoring site-neutral payments between ASCs and hospital outpa- tient departments; does not address supply chain issues that drive up the cost of supplies; and attempts to utilize federal emergency authority to require mandates for healthcare and business workforces — without providing a comment period on the regulations, giv- ing short time frame to implement, no clear guidelines and imposing loss of Medicare/ Medicaid funding as conditions of participa- tion for healthcare facilities. Mark Spina. Director of operations at Endos- copy Center of Connecticut (Hamden): It's proving to be very difficult to get private payers to recognize the increase in labor and supply costs brought about by the labor shortage and supply chain disruptions in the economy. Melissa Hermanson, RN. Administrator of Ambulatory Care Center (Vineland, N.J.): I'm also worried about the supply chain. We have already begun to experience backlogs and shortages of essential supplies again. Many manufacturers are down across the country and globally. Robert Nelson. Executive director of Island Eye Surgicenter (Westbury, N.Y.): Now more than ever, ASCs must have a laser focus on their supply costs. Review every contract, and if you are not taking advantage of prices available through a group purchasing option, you must do so. More specifically, there are specialty-specific group purchasing organiza- tions that are experts at working with vendors within their specialty. With proposed cuts to reimbursement, managing costs becomes imperative. Dan Good. Materials manager of Copper Ridge Surgery Center (Traverse City, Mich.): One of my biggest concerns with the supply chain is the increase of back orders on com- monly needed goods. ere have always been back orders, but since the pandemic, there seems to be an inordinate amount of rolling back orders. ese back orders take time and energy to source from another vendor or to find a clinically acceptable substitute. n Ask payers how you can share in the savings, says Surgery Partners exec By Marcus Robertson S hannon Yarrow, senior vice president of managed care at Brentwood, Tenn.-based Surgery Partners, joined "Becker's ASC Review Podcast" to talk about reim- bursement opportunities for physicians doing outpatient procedures. Note: This is an edited excerpt. Question: Are there physician reimbursement opportuni- ties available in the outpatient setting? How can physi- cians work with surgery centers to maximize some of those opportunities, whether they're bundles or other ways? How can physicians benefit from the movement to outpatient? Shannon Yarrow: In some of the largest payers around the country, what we're starting to see is that they will change their physician fee schedule and provide an enhanced reim- bursement if the site of care happens to be an ASC instead of a hospital outpatient setting. That's one way, but there are some additional creative ways that physicians can enhance their reimbursement. Even if the payers don't have a specific site of service incentive program, it's an opportunity for you to talk with them about the savings that will be generated when you start to move those cases. Ask how you can share in the savings with that payer. For example, if I was doing hundreds of orthopedic proce- dures in the hospital last year, but now 50 of them are going to move to an ASC, I can try to estimate what the differential is for the facility costs and share that with the payer and say, "I'm going to save you this many thousands of dollars. Can you give me an incentive for that? Maybe I can get a better rate on my physician fee schedule? How can we work together, because I'm going to help you [save money]?" Lastly, what I've seen is where physicians are using ASCs currently. Let's say you're a GI group and you actually do most of your cases in the ASC. One of the unique things that I've seen from some of the payers in the Northeast is they will actually give you a percentage each year and say, "Okay, GI group, you did 80 percent of your proce- dures in an ASC. If you can at least keep your 80 percent figure, or you can do a certain percentage that continues to save us money, then we can actually reward you with shared savings." Maybe on a quarterly basis, you look at how much was saved and you share those savings and they can give you some incentive bonuses. So those are some unique things that we've seen that are real opportunities for physicians who are using ASCs to enhance the reimbursement with those payers. n

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