Becker's Spine Review

19 ASC SCA Health names new CEO By Laura Dyrda S CA Health's CEO Caitlin Zulla has been promoted to CEO of Optum Health's east region, according to a March 10 statement. Jason Strauss, who has been with SCA Health for 15 years, was promoted from president to CEO of the company. Mr. Strauss has spent time as COO and group president, leading surgery centers in multiple states. He has focused on growth, strategic partnerships and talent development throughout his career. Ms. Zulla was CFO before being promoted to CEO and during her three years leading the company delivered results aligned with the Quadruple Aim. She built teams, aligned resources and evolved the organization from a surgery center business into a specialty care company. SCA's Optum Specialty Practices provides a business model for physicians to support independent practice and growth amid the shift to value-based care. In her new role with Optum, Ms. Zulla will oversee healthcare delivery services in the northeastern U.S, with responsibility for primary, specialty, surgical, home-based care and more. She will also focus on the region's urgent, behavioral, virtual and community care services. SCA Health now has more than 320 surgical facilities and 9,200 physicians in its network. The company serves around 1.43 million patients per year. It also has a physician- led managed service organization model and connects patients to Optum Care physicians through its Specialist Management Solutions business. n AmSurg ASCs have new deal with Aetna By Laura Dyrda A mSurg's more than 250 surgery centers are now in- network with Aetna after Envision Healthcare signed a multiyear deal with the insurer. AmSurg operates surgery centers and facilities across the U.S., focused primarily on ophthalmology and gastroenterology. AmSurg has facilities in 24 states and around 2,000 physicians in its network. The surgery center company is part of Envision Healthcare, a physician services network backed by private equity firm KKR. Both commercial and Medicare members of Aetna health plans are part of the deal. Aetna is owned by CVS Health. n UnitedHealthcare to cut prior authorization usage by 20% By Claire Wallace U nitedHealthcare plans to cut back on its use of prior authorization, removing procedures and medical devices from its list of services requiring signoff and reducing the number of authorizations from 13 million to 10 million annually, according to a March 29 report from e Wall Street Journal. Several procedures and devices will be removed starting in the third quarter. e insurer also plans to automate and speed up prior authorization over the next several years, according to the report. In 2024, the insurer will also eliminate several prior authorization requirements for its "gold-card" physicians and hospitals, or those who nearly always get their requests approved. Other insurers, including the Cigna Group and CVS' Aetna, are removing prior authorization requirements and automating the process as well. While insurers claim that prior authorization tamps down costs and helps patients get the best care, physicians argue that the process is time-consuming and ineffective. According to a March study from the American Medical Association, prior authorization has delayed patient care for 94 percent of physicians. "We all know that requiring prior authorizations really only leads to more bureaucracy within the insurance company, as well as within each healthcare provider's practice, because now we need people to fill out these prior authorization forms, waste time trying to get through their 1-800 number to speak with someone who has no clinical knowledge, then be told we need to speak with someone else who actually does have some medical knowledge about why these procedures are necessary. is thereby leads to increased costs because we all need to hire more people to handle these needless requests," Linda Lee, MD, medical director of endoscopy at Boston-based Brigham and Women's Hospital and associate professor of medicine at Harvard Medical School, told Becker's. "We're not deaf to the complaints out there," Philip Kaufman, chief growth officer at UnitedHealthcare, told e Wall Street Journal. "We've taken a hard look at ourselves and this process." In 2022, the Department of Health and Human Services reported that 13 percent of prior-authorization denials by Medicare Advantage plans were for benefits that should have been covered, according to the report. United has yet to specify what services will be affected by the change but suggested they will include certain types of medical equipment and genetic testing used for diagnosis. n

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