Issue link: https://beckershealthcare.uberflip.com/i/1538336
10 THOUGHT LEADERSHIP CMS' newest payment model will bring ASCs 'front and center' By Cameron Cortigiano T he Transforming Episode Accountability Model from CMS is set to go into effect Jan. 1, 2026, and ties payments to the hospital to the total cost of care as well as quality of care delivered across an entire surgical episode. ASCs will be important to hospitals being able to succeed under the new model due to the quality of care reporting, care coordination and post-op transition requirements. Eddie Qureshi, CEO of Rainfall Health, recently connected with Becker's to share the potential impact of the new model on hospitals and how ASCs will step more into the forefront. Rainfall Health is an AI-powered healthcare soware company that has been working with hospitals to help get them into compliance with the TEAM model before it goes live in a few months. Note: Responses were lightly edited for clarity and length. Question: What is different about the new TEAM model compared to how hospitals and facilities currently operate? Eddie Qureshi: Not to be too dramatic, but I think it is leagues different from everything that's come before. is one is really moving and trying to create a blueprint for the next generation of outcome- based care. CMMI is saying that we're going to tie in everybody from an ASC to a hospital to primary care to hospice, everything together into one episode. It's going to actually put ASCs more front and center wherever possible, because there's a huge financial component to this model as well. Care coordination is at the center of it. Quality is going to be part of the reimbursement model. Q: Do you anticipate that hospitals will turn to ASCs and outpatient facilities to make sure they are compliant with the ASCs sound the alarm on block time inefficiency By Patsy Newitt A mid persistent staffing challenges, shrinking reimbursements and tighter margins an overlooked, and often critical, threat to ASC profitability is inefficient block time utilization, leaders told Becker's. "One of the most overlooked cost factors threatening ASCs is the inefficient use of OR time, specifically, underutilization or poor scheduling practices," said Heather Combs, RN, ASC administrator at Austin (Texas) Regional Clinic. "Whether a room is in use or not, the center is paying for it." Operating rooms represent a massive investment in infrastructure, equipment and staffing. When ORs sit idle due to late starts, long turnover times or poor block scheduling, the financial fallout can drain ASC revenue. For some centers, block time inefficiency isn't just an internal issue. Patrick McEneaney, CEO of Crystal Lake- based Northern Illinois Foot and Ankle Specialists, told Becker's that ongoing anesthesia shortages is a significant disruptor. "There are surgery centers that are not functioning at full capacity because of this," he said. "It is a knife in the heart to an ASC when cases have to be turned down from lack of anesthesia." To address block-time inefficiencies, some ASCs are turning to analytics and proactive scheduling strategies. Pradnya Mitroo, MD, of Fresno (Calif.) Digestive Health shared a scheduling model that improves block fill rates by preemptively offering vacation-time slots to other providers. "The greatest impact on improving revenue in our [endoscopy] center has been getting the schedules completely backfilled when physicians are on vacation," she said. "I have created a process where the managers of both of our divisions review [the] three-month schedule for all providers for vacations. It is then offered to each of the physicians in both divisions to fill. Then, three weeks prior, anything that is not filled by then goes back to the physicians to fill up, sometimes their schedules may have changed. This has improved our block utilization significantly and improved revenue." Similarly, Brett Maxfield, CRNA, the director of anesthesia and surgical services at Teton Valley Health Care in Driggs, Idaho, said this improving block utilization can also reduce costs for staffing and anesthesia while boosting revenue. More centers are expanding their operating hours and restructuring block schedules to align with shifting volume patterns and specialty demands. "The ASC world is changing fast, and operating Monday through Friday from 7:00 a.m. to 3:00 p.m.is a thing of the past," Johnny Russell, director of area operations at Sacramento, Calif.-based Sutter Health, said. "Longer hours have become the new norm to meet the demands." For Taryn Bradtmueller, BSN, RN, regional director of ASCs at EyeCare Partners, collaboration with schedulers and office leaders is central to full block usage. "Monitoring OR usage closely is vital to ensure full-block schedules," she said. "Adjusting block schedules to meet demand can decrease labor costs and anesthesia stipends, as well as increase revenue." n