Becker's ASC Review

11 THOUGHT LEADERSHIP Are ASCs cutting ties with Medicare patients? By Paige Haeffele I n wake of CMS' finalized physician fee schedule, which cut physician pay by 3.4% compared to last year despite rising inflation and practice costs, some practices and physicians made the decision to drop Medicare patients. When adjusting for inflation, Medicare already pays around 26% less than it did in 2001 to physicians, with the disparity increasing in 2024. Further, the Medicare Economic Index, which measures medical practice cost inflation, increased 4.6% — the highest jump in the last 23 years. These figures are enough to make practices reevaluate their financial policies. Becker's connected with three ASC leaders to discuss whether dropping Medicare patients is part of their 2024 game plan. Note: These responses have been edited lightly for length and clarity. Question: Amid the trend of physicians dropping Medicare patients, is your practice planning on dropping Medicare and Medicaid patients? Have you heard of other practices doing so? Pam Arnold. Administrator at Indian Lake Surgery Center (Hendersonville, Tenn.). I do not see our center dropping Medicare patients, especially since they have approved total shoulders to be done in the ASC. We are primarily a total joint center and do several Medicare patients every week. Robert Lerma. Administrator at Coronado Surgery Center (Henderson, Nev.). Our center does not have plans to move away from serving our Medicare population. I have heard that some primary care providers outside our organization are moving toward a concierge business model, whereby patients would pay a monthly fee to have open access for their provider. Steven Winkler. Executive Director of Orthopedic Surgery Center (Baton Rouge, La.). We are not planning to drop Medicare patients from the practice. But as Medicare continues to reduce the reimbursement for our anesthesiologist or completely deny any reimbursement for epidural spinal injections, we will have a serious problem. The individuals who are making these decisions are not thinking about the patient that will have a needle in their back, as we do not want the patient to move, and without anesthesia the risk is huge and the potential damage is life changing. As the old expression goes, pay the two dollars and cover anesthesia. You only have to look at the Medicaid population that has tremendous trouble finding providers because the reimbursements are so low to the point that it does not cover the cost of care. Please do not let the Medicare program get to that point. n 3. Approached our implant vendors with this question: If we move to a sole vendor for implants, what would that do to the price of the implants? 4. How can we make our OR more efficient, increase throughput and/or reduce work hours? 5. Become involved with the local industry to educate them about the lower costs of an ASC when compared to the acute care hospitals and thus to steer their staff to us. 6. Work closely with the local occupational medicine providers, to ensure that we are their providers of choice for any orthopedic needs. 7. Develop relationships with plaintiff attorneys. 8. Develop relationships with the chiropractic providers. 9. Benchmarking. 10. Talk to other ASCs and read the literature for ideas from others. n 'Hospitals are scared to death': Why ASCs have the advantage in recruiting spine surgeons By Carly Behm A llowing physicians to have ownership in the places they work can make ASCs more attractive in recruiting, spine surgeon Stephen Hochschuler, MD, said. Dr. Hochschuler, of Texas Back Institute in Plano, spoke with Becker's about his outlook for ASCs and the essential nonsurgical skills physicians should have. Note: is conversation was edited for clarity and length. Question: How can ASCs gain an edge in surgeon recruiting? Dr. Stephen Hochschuler: Hospitals are scared to death right now because they're wondering where their future is. Most hospitals are owned by hospital companies or not for profits. From a surgeon standpoint, why shouldn't they own part of the facility that does the production? Unlike chiropractors, and unlike dentists who help each other,

• Cover