Issue link: https://beckershealthcare.uberflip.com/i/759093
19 ASC MANAGEMENT Key financial trends to watch out for in 2017 Chris Bishop, CEO of Regent Surgical Health, notes that the biggest trend in 2017 will be similar to the transition of the past few years — the ongoing shi from fee-for-service to value-based care. "It is no secret that there is a transition taking place in how we pay for healthcare in the U.S.," he says. "e two to three forms that I am most familiar with, such as ACOs, have had limited success but will continue to grow. Additionally, there will be a strategic shi toward population health initiatives and bundled payments." e first big year of commercial bundled payments on an outpatient basis will be 2017, he adds. e outpatient bundled payment was test- ed on a minimal basis in 2016, and will be implemented with more frequency. is will force surgeons to take a bigger interest in the cost of cases, as bundled payment programs shi risk from the payer to surgeon. Increasingly, higher acuity procedures will be brought into the ASC setting, notes Mr. Bishop. Complex spine and total joint replacement cases are already becoming popular additions to surgery centers. Also, as Medicare adds codes for high acuity outpatient cases, other payers will be encouraged to follow suit. "Medicare, through their inpatient bundle activity, is starting to recog- nize that some cases are appropriate in the outpatient setting," says Mr. Bishop. "Medicare has got to continue to bend the cost curve and as long as they experience high-quality joint replacement outcomes aer being discharged same day or overnight from the hospital, they will start to add outpatient codes more rapidly." Finally, Mr. Bishop says, the industry will see downward reimburse- ment pressure on physician-owned ASCs. e loss of out-of-network reimbursement is pushing ASCs to align with hospitals, which allows surgery centers greater leverage towards a fair market value reimburse- ment during payer negotiations. "is is a flawed solution on the part of payers," he adds. "It is bad for competition, which is bad for everyone, consumers and payers." If payers offer reasonable reimbursements for independent ASCs, it may slow the move to align with the large providers in the community. Boosting ASC profitability 1. High-acuity cases. "Looking at our numbers in 2015 versus 2016, at Regent we have seen a 300 percent increase in total joint volume, and we think this will increase by 500 percent in 2017," says Mr. Bishop. Needless to say, Regent is investing heavily to grow in the TJR market. ASCs not considering TJRs are missing a major opportunity. Surgeons are also big champions of outpatient TJR, he notes. They come back from the conferences and society meetings where they see how safely these procedures can be performed in the outpatient setting. Additionally, outpatient spine procedures are gaining popularity, says Mr. Bishop. In January 2015, CMS approved nine ASC spine codes, in- cluding laminectomies and ACDFs. While these had been performed in ASCs for up to a decade beforehand, there was some hesitancy due to safety concerns and lack of payer contracts. However, evidence now exists to prove spine surgeries can be performed safely in the outpatient continued from front page