Issue link: https://beckershealthcare.uberflip.com/i/170040
Coding, Billing & Collections 8. State legislators are demanding price transparency. Legislators at the state level are writing legislation that requires healthcare providers to publish their prices. "More state legislators are starting to address price transparency and introduce new legislation," says Mr. Blankinship. "The time is now for the ASC industry to be the first movers in transparency for surgeries." A bill requiring hospitals to make their bills more transparent and comprehensible to patients has appeared in the North Carolina legislature, requiring hospitals to post prices for their 50 most common procedures. They would also have to delineate charges for uninsured patients, Medicare, Medicaid and private payors. "I'm afraid that hospitals will start being more transparent and they will get more credit over the ASCs for their transparency even though ASCs are less expensive for the same procedures," says Mr. Blankinship. "The problem is that ASCs have always been the follower to the hospitals, but now they must lead with price transparency." 9. Surgeons must value their time. Most surgeons haven't considered exactly what their time is worth; they have taken salaries from hos- 41 pitals or accepted insurance company rate offerings without determining their own rates. hospitals and regulatory bodies because competition is increased. "Physicians are so brainwashed into letting other people tell them what they should be paid instead of determining their own rates and letting the consumer render a verdict for whether that judgment was sound," says Dr. Smith. "Surgeons need to determine what they are worth. Medicare might pay $78 for a total knee replacement, which was the rate for the last total knee I did for Medicare. The bureaucrats didn't value my time as much as I did, and I decided I wasn't going to do that anymore." "Some of the big hospitals are going to fight this because this is going to hurt their business and embarrass them if they claim to be non-profit," says Dr. Smith. "People will wonder why hospitals charge 10 times more than ASCs down the street. There will be pushback, and I don't think it's completely out of the question to think the federal government will raise issues as well." Price signals to buyers and sellers the value of services or products rendered, based on abundance or scarcity as well as a variety of other complex issues. "When I ask surgeons how much they want to be paid, a lot of them don't know," says Dr. Smith. "They have to switch philosophical gears to determine how much their service is worth, and that's a big obstacle." 10. Be ready for government and hospital pushback. As more surgery centers begin publishing their prices and benefiting from price transparency, there will likely be pushback from The Office of Inspector General has recently released more guidance on physician-owned entities, specifically physician-owned distributorships, which could have an impact on other investments, such as the surgery center. "Transparency is the most gigantic thing to come along in healthcare because it's going to expose the cartelization of healthcare for what it really is. I think it will cause a massive deflation in the healthcare industry, which is really good news for the consumer and really horrible news for people making money off of price secrecy," says Dr. Smith. n