Issue link: https://beckershealthcare.uberflip.com/i/583494
26 Coding, Billing & Collections M any healthcare providers worried about how insurance mega-mergers will impact reimbursements. How- ever, there are opportunities for ASCs as the payer environment changes. Naya Kehayes, CEO and managing principal of Eveia Health Consulting & Management, address- es these opportunities and steps ASCs should take when looking at their insurance contracts. "If an ASC has a contract with both payers that are merging, they should review the merger and acquisition language to determine if one contract rate will prevail over the other," says Ms. Kehayes. "e ASC should contact the payers to seek more information to determine if there is an impact on either contract." 1. ASCs could see new in-network op- portunities. A merger may prove beneficial to an ASC, especially if the facility previously was out-of-network with one payer. "If the ASC has a contract with one payer and de- sires to be in contract with the other payer and they consolidate, the ASC can potentially get ac- cess to the other payer as a result of the transac- tion," explains Ms. Kehayes. "e merger presents opportunity for the ASC to access members who you may not have access to prior to the merger. For example, if the ASC is out-of-network with one of the two payers merging and the payer eventually sells all services under the products that are covered under the contract the ASC is in network with, then volume is expected to grow as a result of the volume growth coming through the surviving contract." 2. Insurance companies will take more interest in ASCs in unsaturated mar- kets. Payers may opt to work with ASCs depend- ing on the type of market an ASC is operating in. "If you're in a market that is dominated by hospi- tals, and there is a need for ASCs in the network, the payer consolidation may result in the payer having more interest in working with the ASC because it provides a more cost-effective option," says Ms. Kehayes. Potential Opportunities Insurance Mega-Mergers Hold for ASCs: 4 Key Thoughts By Mary Rechtoris Complete orthopaedic surgery solutions to help you achieve better outcomes, efficiencies, and patient satisfaction. ©DePuy Synthes 2015. All rights reserved. DSUS/MOC/0415/0244 5/15 ADDB When it comes to Outpatient Solutions, our aim is your Triple Aim. Achieve your surgery center's Triple Aim goals with Outpatient Solutions from DEPUY SYNTHES ADVANTAGE ™ . We offer a comprehensive range of orthopaedic surgical solutions for joint reconstruction, sports medicine, extremities, spine and craniomaxillofacial, along with a complete HD visualization, power tools and biologics portfolio. Our product offerings are enhanced by professional education, outcomes measurement, OR efficiency solutions, and patient education. And with flexible pricing and contracting options, accessing the complete DePuy Synthes Companies orthopaedic portfolio has never been easier. Learn more about our Outpatient Solutions and make DEPUY SYNTHES ADVANTAGE your choice in outpatient orthopaedics by visiting depuysynthesadvantage.com ART_00_DSYTRAP56984_Outpatient_Ad_Resize_HalfPgAd.indd 1 2015-05-29 3:49 PM Naya Kehayes