Becker's ASC Review

45 CODING & BILLING Top 10 Payers ASC Providers Prefer By Mary Rechtoris P eer60 released a report detailing which pay- ers ambulatory care providers prefer based on several factors, including faster reimbursement, less paperwork, claims' denial rates and staff time, among others. The report ranked the leading payers based on the number of contracts. Based on the ASCs surveyed, the following top 10 payers hold 60 percent of all con- tracts, according to Fierce Health Payer. The top 10 payers include: 1. Aetna 2. Humana 3. Anthem 4. Medicaid 5. Blue Cross Blue Shield 6. Medicare 7. Cigna 8. Tricare 9. Coventry 10. UnitedHealthcare n ASCs Reduce Outpatient Procedure Costs by $38B Per Year Compared to HOPDs: 5 Insights By Anuja Vaidya A SCs can reduce the overall cost of outpatient surgery cost by more than $38 billion dollars annually compared to hospital outpatient departments, according to a new analysis. Healthcare Bluebook, a national provider of quality and cost data for healthcare services, and HealthSmart, an independent administrator of health plans for self-funded employers, conducted the analysis. e Ambulatory Surgery Center Association provided technical assis- tance and expertise to the study. e companies conducted the analy- sis using a sample of de-identified commercial claims data for 2014. Here are five insights: 1. e study found ASC prices are significantly lower than HOPD prices for the same procedures throughout the United States, regardless of payer. ASCs offer a lower-cost site of care as compared to HOPDs. 2. ASCs can reduce a patient's out-of-pocket costs by more than $5 billion each year through lower deductibles and coinsurance payments. 3. For example, in Charleston, W.Va., cataract patients with an ACA silver plan would save $566 in out-of-pocket costs by choos- ing an ASC. 4. Additionally, for commercially insured populations, ASCs only performed 48 percent of procedures that surgeons could safely perform in surgery centers. 5. If the other 52 percent of potential ASC cases were taken to an ASC, the country would see healthcare cost savings of $41 billion annually. "e physicians and nurses providing care in ambulatory surgery centers, as well as the millions of patients they have treated, have long known that ASCs provide a high-quality, low-cost site for outpatient procedures," said ASCA CEO William Prentice. "is study is solid evidence that consumers, policymakers, insurers and employers need to take fuller advantage of the exceptional health- care value offered by ASCs." n BECKER'S ASC 23 RD ANNUAL MEETING the business and operations of ASCs october 27-29, 2016 swissotel, chicago Call 1.800.417.2035 or email registration@beckershealthcare.com

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